Pediatricians' perception of factors concerning the clinical application of blockchain technology to pediatric health care: a questionnaire survey.

BACKGROUND: Interest in digital medical information has increased because it allows doctors to easily access a patient's medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians' thoughts and attitudes toward introducing blockchain technology into the medical field. METHODS: This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree). RESULTS: The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5-4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3-4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018). CONCLUSION: When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants' perceptions are essential factors to consider when introducing technology in the medical field.

Rapid Molecular Tests for Detecting Respiratory Pathogens Reduced the Use of Antibiotics in Children.

Multiplex polymerase chain reaction (mPCR) is increasingly being used to diagnose infections caused by respiratory pathogens in pediatric inpatient facilities. mPCR assays detect a broader array of viruses, with higher specificity and sensitivity and faster turnaround than previous assays. We adapted the FilmArray Respiratory Panel (FA-RP) for diagnosing respiratory infections. FA-RP is an in vitro mPCR assay that simultaneously and rapidly (in about 1 h) detects 20 pathogens directly from respiratory specimens. Here, we studied the clinical efficacy of FA-RP in children who underwent testing for respiratory pathogens at Yeungnam University Hospital from November 2015 to August 2018. From November 2015 to June 2016, routine mPCR testing was performed on nasopharyngeal swabs using the routine mPCR kit. From November 2016 to July 2018, mPCR testing was performed using FA-RP. A total of 321 tests by routine mPCR and 594 tests by FA-RP were included. The positive detection rates for routine mPCR and FA-RP were 71.3% and 83.3%, respectively. FA-RP reduced the lead time, waiting time, turnaround time, intravenous (IV) antibiotic use, and length of hospital stay for pediatric patients. The decreased use of antibiotics is expected to reduce antibiotic resistance in children.

A Quantitative and Qualitative Review on the Main Research Streams Regarding Blockchain Technology in Healthcare.

(1) Background: Blockchain technology has been gaining high popularity in the healthcare domain. This has brought about a spate of recent studies regarding blockchain technology in healthcare, creating high demand for quantitative or qualitative reviews on the main research streams thereof. In order to contribute to satisfying the high demand, this research presents a quantitative and qualitative review on studies regarding blockchain technology in healthcare. (2) Methods: A quantitative review was performed by searching the Web of Science database for articles published until 10 March in 2020, and a qualitative review was conducted by using the content analysis based on the integrative view of Leavitt's diamond model. (3) Results: The quantitative review identified five research streams. The number of articles about blockchain technology in healthcare has dramatically increased since 2016, with a compound annual growth rate of 254.4%. English is the most dominant language used in the articles, and the USA and China are the top two countries of origin of the articles, representing overwhelming portions. The IEEE Access, Journal of Medical Systems, Journal of Medical Internet Research, Applied Sciences Basel, and Sensors are the top five journals in terms of publication. The articles showed an L-shaped distribution in terms of their annual average numbers of citations. The qualitative review revealed two research streams. Most of the top 10 articles ranked by their annual average numbers of citations concentrated on developing or proposing new technological solutions using blockchain technology to effectively revolutionize the current methods of managing data in the healthcare domain. The majority of the top 10 articles pursued the convergence of blockchain technology with cloud technology or IoT. (4) Conclusions: This article illuminates the main research streams about blockchain technology in healthcare through a quantitative and qualitative review, providing implications for future research on blockchain technology.

Essential Medical Information for Stroke Patients Undergoing Interhospital Transfer: A Delphi Study.

OBJECTIVE: For improving the efficiency of transferring medical records for stroke patients undergoing interhospital transfer, we evaluated what is the essential medical information for physicians using the Delphi method. DESIGN: We set up an expert panel of 31 physiatrists, who participated in this study. The 32 preliminary items of the transferred medical information were listed by a physiatrist for the first round of the Delphi method, and degree of necessity for these 32 items was evaluated using a 3-point scale ("very necessary," "necessary," and "not necessary"). We considered "very necessary" and "necessary" as "agreed to its necessity." According to the Delphi method, a satisfactory level of consensus can be achieved with the agreement of significant majority (≥80%) in the expert panel. RESULTS: Based on the experts' feedback, some items were added as the preliminary items. After the second round of the Delphi method, the items confirmed to be necessary information during interhospital transfer were motor and sensory evoked potentials, Barthel Index, Mini-Mental State Examination/Global Deterioration Scale, Motor-Free Visual Perception Test, Manual Function Test, Purdue Pegboard Test, hand grip power, monofilament, 2-point discrimination test, Manual Muscle Test, Nottingham Scale, modified Brunnstrom Classification, functional ambulation category, Glasgow Coma Scale, language function test, imaging study, videofluoroscopic swallowing study, rehabilitation goal, previous medical history, comorbidity, and medication information. CONCLUSIONS: If the previously mentioned necessary items are presented together at once during interhospital transfer, physicians who receive new stroke patients can evaluate patients' medical information more easily and completely.

Attitudes Toward Blockchain Technology in Managing Medical Information: Survey Study.

BACKGROUND: The recently developed blockchain technology uses a peer-to-peer network to distribute data to all participants for storage. This method enhances data safety, reliability, integrity, and transparency. To successfully introduce blockchain technology to medical data management, it is essential to obtain consent from medical doctors and patients. OBJECTIVE: The aim of this study was to examine medical doctors' and patients' attitudes toward the use of blockchain technology and interpret the findings within the framework of expectancy theory. METHODS: In this questionnaire survey, we examined medical doctors' (n=90) and patients' (n=90) attitudes toward the use of blockchain technology in the management and distribution of medical information. The questionnaire comprised 8 questions that assessed attitudes toward new means of managing and distributing medical information using blockchain technology. Responses were rated on a scale that ranged from 1 (very negative) to 7 (very positive). RESULTS: Medical doctors (mean 3.7-5.0) reported significantly more negative attitudes than patients (mean 6.3-6.8). Furthermore, self-employed doctors reported more negative attitudes than employed doctors and university professors. CONCLUSIONS: To successfully introduce blockchain technology to medical data management, it is necessary to promote positive attitudes toward this technology among medical doctors, especially self-employed doctors.