Modelling Information Needs and Sources in a COVID-19 Designated Hospital.

COVID-19 remains an important focus of study in the field of public health informatics. COVID-19 designated hospitals have played an important role in the management of patients affected by the disease. In this paper we describe our modelling of the needs and sources of information for infectious disease practitioners and hospital administrators used to manage a COVID-19 outbreak. Infectious disease practitioner and hospital administrator stakeholders were interviewed to learn about their information needs and where they obtained their information. Stakeholder interview data were transcribed and coded to extract use case information. The findings indicate that participants used many and varied sources of information in the management of COVID-19. The use of multiple, differing sources of data led to considerable effort. In modelling participants' activities, we identified potential subsystems that could be used as a basis for developing an information system specific to the public health needs of hospitals providing care to COVID-19 patients.

The Utilization of Health Informatics Interventions in the COVID-19 Pandemic: A Scoping Review.

On March 11, 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the highly infectious virus that causes coronavirus disease (COVID-19), was characterized by the World Health Organization (WHO) as a global pandemic [1,2]. Due to its highly contagious nature, COVID-19 has catalyzed the introduction of non-pharmaceutical interventions such as social distancing and quarantine measures [6]. Thus, the pandemic has shifted society to become reliant on healthcare technologies. The objective of this scoping review is to establish what health informatics interventions have been applied, validated and tested globally during the COVID-19 pandemic. The findings demonstrated a range of 12 types of health informatics interventions with various global applications and use. As evidenced by the intervention heterogeneity, the necessity to adopt a global cohesive strategy to improve human safety through the utilization of smart, efficient, and communicable technologies is vital.

Medical Emergency Data and Networks: A German-Canadian Comparison.

A significant number of problems in emergency care are caused by a lack of provider access to pre-existing patient information at the point of care. Medical Emergency Datasets (MEDs) are brief summarizations of an individual's medical history, providing vital patient information to emergency medical providers. The German MED was validated by German physicians and - based on an international research project - also by Canadian physicians. Physicians in both countries considered the content very useful. The MED is currently being introduced in Germany as part of the Telematic Infrastructure. At the same time, the COVID pandemic forced healthcare professionals around the work to optimize the digital information exchange among different healthcare providers. While the exchange of data is important, additional personal expert advice is sometimes vital. Real time virtual support systems (RTVS) were introduced in Germany and Canada to support team-based healthcare delivery, independent of the actual location. Such systems have been implemented for intensive care, emergency medicine, primary care and several other medical specialties. These systems serve as a safety net, a funnel (appropriate utilization; linking patients back to primary care networks - thus reducing fragmented or disrupted services) and a medical network by building interprofessional relationships.

Copy and paste in the electronic medical record: A scoping review

Copy and paste (CPF) can be defined as the act of duplicating medical documentation from one section of the electronic medical record (EMR) and placing it verbatim in another section. The objective of this scoping review is to 1) describe the prevalence of copy and paste usage in EMR documentation, 2) detail the known measurable safety hazards associated with its use, and 3) identify potential solutions and/or strategies that can be used to mitigate the negative consequences of the CPF while preserving its essential role in documentation efficiency. The Joanna Briggs Institute guidelines were used to identify, screen, and assess the text of articles for final inclusion in CPF article review. The primary search strategy for copy-paste articles was developed in PubMed® and then translated to CINAHL®, ScienceDirect®, and IEEExplore® to extract additional articles. Identified copy-paste articles were imported into Covidence®. Two reviewers determined the final articles that were included in the review. The search retrieved 63 publications of which 17 were identified for final inclusion. The scoping review revealed CPF of medical text is a common occurrence that cuts across all clinician types (e.g., physicians and nurses). The scoping review revealed that automated methods for finding duplication in electronic documentation had emerged. A limited number of studies with quantifiable harms associated with CPF were found. Clinicians stated that CPF 1) had a negative impact on critical thinking, 2) led to medical complications being more likely to be overlooked, and 3) led to safety issues being missed with copy-paste content. A few different approaches were tested by researchers as alternatives to CPF. They included dictation systems, practice guidelines, note templates, highlighting of copied information, note splitting, and text insertion. CPF is long overdue for innovative approaches to minimizing patient risk and maximizing provider efficiency. https//doi.org/10.34105/j.kmel.2021.13.028

Ambient Assisted Living: Identifying New Challenges and Needs for Digital Technologies and Service Innovation.

BACKGROUND: The ambient assisted living (AAL) market is rapidly becoming fundamental to the delivery of health and social care services for the elderly. Worldwide many different steps have been taken to increase the engagement of older adults with these technologies. Much of this work has focused on the development of novel digital services that increase wellbeing or tackle social challenges. AIM: The aim of the study was to identify and describe the demands for AAL-services from the perspective of older adults. We also examine the challenges and needs of the ambient assisted living market using a needs based approach. METHOD: An exploratory case study was conducted with an aim to capture information about older adults' demands for AAL services. A survey was used to collect the data. The survey study respondents validated the results. RESULTS: The results of the study indicate that the area of AAL needs be studied from a multiple-sided market perspective. Our research suggests there is a need to describe and understand the factors that facilitate or constrain the implementation of services with focus on health and social care. There is also a need to describe and analyze the relationship between policy and practice and its effects on the AAL market. It is necessary to capture expressed demand, to identify market challenges at the macro level and to be able to understand how services should operate and serve older adults in practice. Such research is critical to the development of guidance for policy makers, suppliers and service providers. DISCUSSION: Older adults are asking for intelligent, assistive living solutions that help them to continue to live independent lives and remain socially included in their networks, associations, and communities. The elderly need services that stimulate and maintain their physical and intellectual capital. The development of innovative AAL environments is, however, a complex social process that involves the use and delivery of innovative ICT-based services. The implementation and use of AAL to support older adults involve service providers and elderly consumers. CONCLUSIONS: The results of the study may be of interest to policy makers, entrepreneurs, technology suppliers, service providers and health and social care organizations, who are willing to innovate and influence the development of the AAL market through their choices and decisions.

Evidence-Based Health Informatics as the Foundation for the COVID-19 Response: A Joint Call for Action.

BACKGROUND: As a major public health crisis, the novel coronavirus disease 2019 (COVID-19) pandemic demonstrates the urgent need for safe, effective, and evidence-based implementations of digital health. The urgency stems from the frequent tendency to focus attention on seemingly high promising digital health interventions despite being poorly validated in times of crisis. AIM: In this paper, we describe a joint call for action to use and leverage evidence-based health informatics as the foundation for the COVID-19 response and public health interventions. Tangible examples are provided for how the working groups and special interest groups of the International Medical Informatics Association (IMIA) are helping to build an evidence-based response to this crisis. METHODS: Leaders of working and special interest groups of the IMIA, a total of 26 groups, were contacted via e-mail to provide a summary of the scientific-based efforts taken to combat COVID-19 pandemic and participate in the discussion toward the creation of this manuscript. A total of 13 groups participated in this manuscript. RESULTS: Various efforts were exerted by members of IMIA including (1) developing evidence-based guidelines for the design and deployment of digital health solutions during COVID-19; (2) surveying clinical informaticians internationally about key digital solutions deployed to combat COVID-19 and the challenges faced when implementing and using them; and (3) offering necessary resources for clinicians about the use of digital tools in clinical practice, education, and research during COVID-19. DISCUSSION: Rigor and evidence need to be taken into consideration when designing, implementing, and using digital tools to combat COVID-19 to avoid delays and unforeseen negative consequences. It is paramount to employ a multidisciplinary approach for the development and implementation of digital health tools that have been rapidly deployed in response to the pandemic bearing in mind human factors, ethics, data privacy, and the diversity of context at the local, national, and international levels. The training and capacity building of front-line workers is crucial and must be linked to a clear strategy for evaluation of ongoing experiences.

Enhancing Safety During a Pandemic Using Virtual Care Remote Monitoring Technologies and UML Modeling.

OBJECTIVES: This paper describes a methodology for gathering requirements and early design of remote monitoring technology (RMT) for enhancing patient safety during pandemics using virtual care technologies. As pandemics such as COrona VIrus Disease (COVID-19) progress there is an increasing need for effective virtual care and RMT to support patient care while they are at home. METHODS: The authors describe their work in conducting literature reviews by searching PubMed.gov and the grey literature for articles, and government websites with guidelines describing the signs and symptoms of COVID-19, as well as the progression of the disease. The reviews focused on identifying gaps where RMT could be applied in novel ways and formed the basis for the subsequent modelling of use cases for applying RMT described in this paper. RESULTS: The work was conducted in the context of a new Home of the Future laboratory which has been set up at the University of Victoria. The literature review led to the development of a number of object-oriented models for deploying RMT. This modeling is being used for a number of purposes, including for education of students in health infomatics as well as testing of new use cases for RMT with industrial collaborators and projects within the smart home of the future laboratory. CONCLUSIONS: Object-oriented modeling, based on analysis of gaps in the literature, was found to be a useful approach for describing, communicating and teaching about potential new uses of RMT.