Presentation for UP Health Informatics HI201 under Dr. Iris Tan and Dr. Mike Muin. The topic for discussion Interoperability & Standards, a healthcare scenario was given regarding two disparate information systems, one found in a clinic, another with a hospital information system. #MSHI #HI201
HL7
Health level 7
What is HL7?
What does it stand for
HL7 Mission
HL7 contains message standards
HL7 in HealthcareManagement System
Standards
Limitations of HL7
Healthcare Interoperability: New Tactics and TechnologyHealth Catalyst
Every provider agrees on the need for healthcare interoperability to achieve clinical data insights at the point of care. The question is how to get there from the myriad technologies and the volumes of data that comprise electronic medical records. It’s been difficult to organize among participants that have had little incentive to cooperate. And standards for sending and receiving data have been slow to develop. This is changing, but the key components that are still vital to realizing insights are closed-loop analytics and its accompanying tools, an enterprise data warehouse and analytics applications. This article defines the problems and explores the solutions to optimizing clinical decision making where it’s needed most.
HL7
Health level 7
What is HL7?
What does it stand for
HL7 Mission
HL7 contains message standards
HL7 in HealthcareManagement System
Standards
Limitations of HL7
Healthcare Interoperability: New Tactics and TechnologyHealth Catalyst
Every provider agrees on the need for healthcare interoperability to achieve clinical data insights at the point of care. The question is how to get there from the myriad technologies and the volumes of data that comprise electronic medical records. It’s been difficult to organize among participants that have had little incentive to cooperate. And standards for sending and receiving data have been slow to develop. This is changing, but the key components that are still vital to realizing insights are closed-loop analytics and its accompanying tools, an enterprise data warehouse and analytics applications. This article defines the problems and explores the solutions to optimizing clinical decision making where it’s needed most.
Interoperability in Healthcare: Making the Most of FHIRHealth Catalyst
With the CMS and ONC March 2020 endorsement of HL7 FHIR R4, FHIR is positioned to grow from a niche application programming interface (API) standard to a common API framework. With broader adoption, FHIR promises to support expanding healthcare interoperability and prepare the industry for complex use cases by addressing significant challenges:
Engaging consumers.
Sharing data with modern standards.
Building a solid foundation for healthcare interoperability.
The Biggest Barriers to Healthcare InteroperabilityHealth Catalyst
Improving healthcare interoperability is a top priority for health systems today. Fundamental problems around improving interoperability include standardization of terminology and normalization of data to those standards. And, the volume of data healthcare IT systems produce exacerbates these problems.
While interoperability regulations focus on trying to make it easy to find and exchange patient data across multiple organizations and HIEs, the legislation’s lack of fine print and aggressive implementation timelines nearly ensures the proliferation of existing interoperability problems. This article discusses the biggest barriers to interoperability, possible solutions to interoperability problems, and why it matters.
In this webinar, Dale Sanders will provide a pragmatic, step-by-step, and measurable roadmap for the adoption of analytics in healthcare-- a roadmap that organizations can use to plot their strategy and evaluate vendors; and that vendors can use to develop their products. Attendees will have a chance to learn about:
1) The details of his eight-level model, 2) A brief introduction to the HIMSS/IIA DELTA Model, 3) The importance of permanent organizational teams to sustain improvements from analytic investments, 4) The process of curating and maturing data governance, and 5) The coordination of a data acquisition strategy with payment and reimbursement strategies
Data marts,Types of Data Marts,Multidimensional Data Model,Fact table ,Dimension table ,Data Warehouse Schema,Star Schema,Snowflake Schema,Fact-Constellation Schema
Health Care Analytics
Table of Content:
What is Healthcare Analytics
Objectives of Healthcare Analytics
Types of Analytics
Source of Data
What do Healthcare companies achieve with healthcare analytics
Booming technologies in the Healthcare Industries with some of their uses
Existing Healthcare analytics tool in the market
-----------------------------------------------------------------------
Objectives of Healthcare Analytics
The fundamental objective of healthcare analytics is to help people make and execute rational decisions.
Data - Driven
Analytics in healthcare can help ensure that all decisions are made based on the best possible evidence derived from accurate and verified sources of information.
Transparent
Healthcare analytics can break down silos based on program, department or even facility by promoting the sharing of accurate, timely and accessible information
Verifiable
The selected option can be tested and verified, based on the available data and decision-making model, to be as good as or better than other alternatives.
Robust
Healthcare is a dynamic environment; decisions making models must be robust enough to perform in non-optimal conditions such as missing data, calculation error, failure to consider all available options and other issues.
-------------------------------------------------------------------------------
Types of Analytics
Descriptive Analytics
Uses business Intelligence and data mining to ask: “What has Happened”
Diagnostics Analytics
Examines data to answer, “Why did it happen ?”
Predictive Analytics
Uses optimization and simulation to ask: “What should we do”
Prescriptive Analytics
Uses optimization and simulation to ask: “What should we do”
----------------------------------------------------------------------------------
Sources of Data
Human Generated data
Web and social media data
Machine to Machine data
Transaction data
Biometric data
---------------------------------------------------------------------------------
What do Healthcare companies achieve with healthcare analytics
Hospitals
Reducing Cost
Reducing cost of analytics by building an easy-to-use analytics platform
Identifying and preventing anomalies such as fraud
Automating external and internal reporting
Improving patient outcomes
Clinical decision support
Pharmacy
Randomized clinical trials are expensive to conduct and are not effective at identifying rare events, heterogeneous treatment effects, long-term outcomes. Pharma companies rely on healthcare analytics to identify such relationships. However, inferring causal relations can be difficult as data can be easily misinterpreted to view unrelated factors as inter-dependent.
What is Health Informatics?
HI Goals
HI stakeholders
HI subfields / subspecialties
Healthcare trends & HI
HI professional environments
HI education / training opportunities & degrees
HI organizations / journals / meetings / events
HI professional certificates
HI books
Healthcare Data Integrity and Interoperability Standards Podcast SummaryM2SYS Technology
As the healthcare industry moves closer to full scale implementation of health information exchanges and integrated delivery networks, the call for data integrity and interoperability standards has grown increasingly louder to help ensure that data quality isn’t compromised so physicians and patients can have complete confidence in the information reflected by their electronic health records.
We interviewed John Donnelly, President of IntePro Solutions in Colonia NJ and an expert in healthcare technology standards, interoperability and innovation about data integrity and data standardization protocols in the context of the shift to electronic medical records and the subsequent data sharing across health information exchanges.
Interoperability in Healthcare: Making the Most of FHIRHealth Catalyst
With the CMS and ONC March 2020 endorsement of HL7 FHIR R4, FHIR is positioned to grow from a niche application programming interface (API) standard to a common API framework. With broader adoption, FHIR promises to support expanding healthcare interoperability and prepare the industry for complex use cases by addressing significant challenges:
Engaging consumers.
Sharing data with modern standards.
Building a solid foundation for healthcare interoperability.
The Biggest Barriers to Healthcare InteroperabilityHealth Catalyst
Improving healthcare interoperability is a top priority for health systems today. Fundamental problems around improving interoperability include standardization of terminology and normalization of data to those standards. And, the volume of data healthcare IT systems produce exacerbates these problems.
While interoperability regulations focus on trying to make it easy to find and exchange patient data across multiple organizations and HIEs, the legislation’s lack of fine print and aggressive implementation timelines nearly ensures the proliferation of existing interoperability problems. This article discusses the biggest barriers to interoperability, possible solutions to interoperability problems, and why it matters.
In this webinar, Dale Sanders will provide a pragmatic, step-by-step, and measurable roadmap for the adoption of analytics in healthcare-- a roadmap that organizations can use to plot their strategy and evaluate vendors; and that vendors can use to develop their products. Attendees will have a chance to learn about:
1) The details of his eight-level model, 2) A brief introduction to the HIMSS/IIA DELTA Model, 3) The importance of permanent organizational teams to sustain improvements from analytic investments, 4) The process of curating and maturing data governance, and 5) The coordination of a data acquisition strategy with payment and reimbursement strategies
Data marts,Types of Data Marts,Multidimensional Data Model,Fact table ,Dimension table ,Data Warehouse Schema,Star Schema,Snowflake Schema,Fact-Constellation Schema
Health Care Analytics
Table of Content:
What is Healthcare Analytics
Objectives of Healthcare Analytics
Types of Analytics
Source of Data
What do Healthcare companies achieve with healthcare analytics
Booming technologies in the Healthcare Industries with some of their uses
Existing Healthcare analytics tool in the market
-----------------------------------------------------------------------
Objectives of Healthcare Analytics
The fundamental objective of healthcare analytics is to help people make and execute rational decisions.
Data - Driven
Analytics in healthcare can help ensure that all decisions are made based on the best possible evidence derived from accurate and verified sources of information.
Transparent
Healthcare analytics can break down silos based on program, department or even facility by promoting the sharing of accurate, timely and accessible information
Verifiable
The selected option can be tested and verified, based on the available data and decision-making model, to be as good as or better than other alternatives.
Robust
Healthcare is a dynamic environment; decisions making models must be robust enough to perform in non-optimal conditions such as missing data, calculation error, failure to consider all available options and other issues.
-------------------------------------------------------------------------------
Types of Analytics
Descriptive Analytics
Uses business Intelligence and data mining to ask: “What has Happened”
Diagnostics Analytics
Examines data to answer, “Why did it happen ?”
Predictive Analytics
Uses optimization and simulation to ask: “What should we do”
Prescriptive Analytics
Uses optimization and simulation to ask: “What should we do”
----------------------------------------------------------------------------------
Sources of Data
Human Generated data
Web and social media data
Machine to Machine data
Transaction data
Biometric data
---------------------------------------------------------------------------------
What do Healthcare companies achieve with healthcare analytics
Hospitals
Reducing Cost
Reducing cost of analytics by building an easy-to-use analytics platform
Identifying and preventing anomalies such as fraud
Automating external and internal reporting
Improving patient outcomes
Clinical decision support
Pharmacy
Randomized clinical trials are expensive to conduct and are not effective at identifying rare events, heterogeneous treatment effects, long-term outcomes. Pharma companies rely on healthcare analytics to identify such relationships. However, inferring causal relations can be difficult as data can be easily misinterpreted to view unrelated factors as inter-dependent.
What is Health Informatics?
HI Goals
HI stakeholders
HI subfields / subspecialties
Healthcare trends & HI
HI professional environments
HI education / training opportunities & degrees
HI organizations / journals / meetings / events
HI professional certificates
HI books
Healthcare Data Integrity and Interoperability Standards Podcast SummaryM2SYS Technology
As the healthcare industry moves closer to full scale implementation of health information exchanges and integrated delivery networks, the call for data integrity and interoperability standards has grown increasingly louder to help ensure that data quality isn’t compromised so physicians and patients can have complete confidence in the information reflected by their electronic health records.
We interviewed John Donnelly, President of IntePro Solutions in Colonia NJ and an expert in healthcare technology standards, interoperability and innovation about data integrity and data standardization protocols in the context of the shift to electronic medical records and the subsequent data sharing across health information exchanges.
Explains about Health Record Standards, ICTs, Standards for Healthcare Sector, Ministry of Health and Family Welfare. For more information visit: http://www.transformhealth-it.org/
Standards and Interoperability: Creating a whole that is bigger than the sum ...AllSeen Alliance
Yongjin KIM, CTO/EVP, Modacom Co. Ltd.
Graham Martin, CEO & Chairman, EnOcean Alliance
Claudio M. Camacho, Head of IoT, Tuxera Inc
Presented at the AllSeen Alliance's Partner Programme at Mobile World Congress 2015.
Linkages to EHRs and Related Standards. What can we learn from the Parallel U...Koray Atalag
This is the prezo I used during the CellML workshop in Waiheke Island, Auckland, New Zealand on 13 April 2015. The aim was to introduce information modelling methods and tools for the purpose of inspiring computational modelling work in the area of semantics and interoperability.
Interoperability and the Internet of Things – To standardize or not to standardize?
Originally presented on March 12, 2015.
Watch On-Demand: http://ecast.opensystemsmedia.com/520
The Edge of Linguistics lecture series from Prof. Fredreck J. Newmeyer
During Oct 7 to Oct 17, Prof. Newmeyer offered a lecture series on a wide range of linguistic topics in Beijing Language and Culture University.
Lecture 1: The Chomskyan Revolution
Lecture 2: Constraining the Theory
Lecture 3: The Boundary between Syntax and Semantics
Lecture 4: The Boundary between Competence and Performance
Lecture 5: Can One Language Be ‘More Complex’ Than Another?
Background:
Fredreck J. Newmeyer is Professor Emeritus of Linguistics at the University of Washington and adjunct professor in the University Of British Columbia Department Of Linguistics and the Simon Fraser University Department of Linguistics. He has published widely in theoretical and English syntax.
Capability-based Business Model TransformationIlia Bider
Presentation at Ascendia workshop 2014
Any organization in subject of changes in the environment, or having the desire to improve, needs to change their processes, personnel and their use of resources. Changes, may they be called for by external threats or opportunities or internal strengths or weaknesses, take their departure in an organizations existing capabilities. To support change, there is thus a fundamental need to understand and analyse an organizations capabilities in order to perform changes. In this paper we present an approach to support organizational change by the use of a capability based recursive analysis, and a set of improvement patterns. The recursive analysis is based on resource types, and capability sub-types. We illustrate the approach by using several examples taken from the industry.
Bringing Things Together and Linking to Health Information using openEHRKoray Atalag
My prezo at Medinfo 2015 Conference in the workshop:
Digital Patient Modeling and Clinical Decision Support by Kerstin Denecke, Stefan Kropf, Claire Chalopin, Mario A, Cypko, Yihan Deng, Jan Gaebel, Koray Atalag
Picture Archival and Communication System [PACS] has evolved continuously over the last two decades. You can read the overview of PACS in this PPT Slides
Archetype-based data transformation with LinkEHRDavid Moner Cano
How can we convert data to standard data (EN ISO 13606, openEHR, HL7 CDA...) using archetypes? LinkEHR is a tool that helps in achieving this objective.
This presentation was made at the "Arctic Conference on Dual-Model based Clinical Decision Support and Knowledge Management", that took place the 27th and 28th of May, 2014 in Tromsø, Norway.
A Survey On Ontology Agent Based Distributed Data MiningEditor IJMTER
With the increased complexity in number of applications and due to large volume
of availability of data from heterogeneous sources, there is a need for the development of
suitable ontology, which can handle the large data set and present the mined outcomes for
evaluation intelligently. In the era of intensive data driven applications distributed data mining can
meet the challenges with the support of agents. This paper discusses the underlying principles for
effectiveness of modern agent-based systems for distributed data mining
Achieving Semantic Integration of Medical Knowledge for Clinical Decision Sup...AmrAlaaEldin12
Abstract. Enhancing the outputs of the Clinical Decision Support systems (CDS) is a permanent concern for many research communities, which have to deal with an abundance of entities, data, structures, methods, application, tools, and so on. In the few past decades, there were theorized and standardized tech- nologies that could help researchers to obtain better results. The paper presents a method to enrich the inputs of the CDS through a semantic integration of sev- eral medical knowledge sources, by using the Topic Maps standard, in order to obtain more refined medical recommendations. Future research directions and challenges are summarized and conclusions are issued.
CLOUD-BASED DEVELOPMENT OF SMART AND CONNECTED DATA IN HEALTHCARE APPLICATIONijdpsjournal
There is a need of data integration in cloud – based system, we propose an Information Integration and Informatics framework for cloud – based healthcare application. The data collected by the Electronic Health Record System need to be smart and connected, so we use informatica for the connection of data
from different database. Traditional Electronic Health Record Systems are based on different technologies, languages and Electronic Health Record Standards. Electronic Health Record System stores data based on interaction between patient and provider. There are scalable cloud infrastructures, distributed and heterogeneous healthcare systems and there is a need to develop advanced healthcare application. This advance healthcare application will improve the integration of required data and helps in fast interaction between the patient and the service providers. Thus there is the development of smart
and connected data in healthcare application of cloud. The proposed system is developed by using cloud platform Aneka.
Data Integration in Multi-sources Information Systemsijceronline
International Journal of Computational Engineering Research (IJCER) is dedicated to protecting personal information and will make every reasonable effort to handle collected information appropriately. All information collected, as well as related requests, will be handled as carefully and efficiently as possible in accordance with IJCER standards for integrity and objectivity.
Computers in pharmacy are used for the information of drug data, records and files, drug management (creating, modifying, adding and deleting data in patient files to generate reports), business details.
Applications of Computer Science in Pharmacy
Computer is mandatory in this advanced era and pharmacy and related subjects are not exception to it. This review mainly focuses on the various applications, software’s and use of computers in pharmacy. Computer science and technology is deeply utilized in pharmacy field everywhere like in pharmacy colleges, pharmaceutical industries, research centers, hospital pharmacy and many more. Computer significantly reduces the time, expenditure, and manpower required for any kind of work. Development of various softwares makes it trouble-free to handle huge data. In short, computers are playing critical role in pharmacy field, without computers pharmacy research will be long-lasting andexpensive.
Pharmacy field plays a crucial role in patient health care. It is a huge field which is present worldwide. To run pharmacy field professionally and efficiently, it requires huge management and manpower. But nowadays use of computers in pharmacy field reduced the manpower and time. Computers are almost related to every corner of pharmacy field. These are utilized in the drug design technique, retail pharmacy shop, clinical research centers, crude drug identification,drug storage and business management, hospital and clinical pharmacy, in pharmacy colleges for computer assistedlearning.
Internet is huge collection of data. It is available in just one click. Various search engines like Google, Yahoo, Rediff, Bing help in searching online data related to pharmacy field just one have to enter his or her area of interest in search engine.
In Pharmacy field, effective use of computers started from 1980. Since then there is great demand of computers in pharmacy field. Computers are having their own advantages like reduction in time, accuracy, and reduction in man power, speed, multitasking, non-fatiguness, high memory, data storage and many more.
USE OF INTERNET IN PHARMACY
Internet is collection of huge data. And this data is available for us in just a one click. Internet is useful tool in literature survey. Books are also available on the internet. Various research journals can be easily accessed via internet. There are number of web-sites which are related to pharmacy field. Some of these web sites are as follows;
www.phrma.org
Organization representing America's pharmaceutical research companies provides details of drug development, industry news, and health guides.
www.healthcareforums.com
Created to facilitate interaction among healthcare professionals on specific topics which include discussion of cases, research and other relevant issues.
www.astra.com
This is the official web-site of ASTRA pharmaceuticals which produces medications for respiratory tract, cardiovascular and gastrointestinal diseases, and for pain
IJRET : International Journal of Research in Engineering and Technology is an international peer reviewed, online journal published by eSAT Publishing House for the enhancement of research in various disciplines of Engineering and Technology. The aim and scope of the journal is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high-level learning, teaching and research in the fields of Engineering and Technology. We bring together Scientists, Academician, Field Engineers, Scholars and Students of related fields of Engineering and Technology
Ontology oriented concept based clusteringeSAT Journals
Abstract Worldwide health centre scientists, physicians and other patients are accessing, analyzing, integrating and storing massive amounts of digital medical data in different database. The potential for retrieval of information is vast and daunting. The objective of our approach is to differentiate relevant information from irrelevant through user friendly and efficient search algorithms. The traditional solution employs keyword based search without the semantic consideration. So the keyword retrieval may return inaccurate and incomplete results. In order to overcome the problem of information retrieval from this huge amount of database, there is a need for concept based clustering method in ontology. In the proposed method, WorldNet is integrated in order to match the synonyms for the identified keywords so as to obtain the accurate information and it presents the concept based clustering developed using k-means algorithm in accordance with the principles of ontology so that the importance of words of a cluster can be identified. Keywords: Ontology, Concept based clustering, K-means algorithm and information retrieval.
Useful and Effectiveness of Multi Agent Systemijtsrd
A multi agent system MAS or self cooperating system is a computerized system organized of multiple interacting intelligent agents. The problems that are difficult to solve for an individual agent or a monolithic system can be solved by multi agent system easily. MAS is a loosely coupled of software agents' network that interact to solve problems that are beyond the individual capacities or knowledge of each software agent. Distributed systems with a group of intelligent agents that communicate with other agents to achieve goals are directed by their masters. MAS group aims to develop new theory and computational models of higher order social cognition between people and computer systems by producing their abilities to reason about one another automatically. More specifically, multi agent control systems are fundamental parts of a wide range of safety critical engineering systems, and are commonly found in aerospace, traffic control, chemical process, power generation and distribution, flexible manufacturing, chemical processes, power generation and distribution, flexible manufacturing, robotic system design and self assembly structures. Moe Myint Myint ""Useful and Effectiveness of Multi-Agent System"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-3 , April 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23036.pdf
Paper URL: https://www.ijtsrd.com/computer-science/artificial-intelligence/23036/useful-and-effectiveness-of-multi-agent-system/moe-myint-myint
The Data Operating System: Changing the Digital Trajectory of HealthcareHealth Catalyst
In 1989, John Reed, the CEO of Citibank and the early pioneer for ATMs, said, “I can see a future in which the data and information that is exchanged in our transactions are worth more than the transactions themselves.” We are at an interesting digital nexus in healthcare. Few of us would argue against the notion that data and digital health will play a bigger and bigger role in the future. But, are we on the right track to deliver on that future? It required $30B in federal incentive money to subsidize the uptake of Electronic Health Records (EHRs). You could argue that the federal incentives stimulated the first major step towards the digitization of health, but few physicians would celebrate its value in comparison to its expense. As the healthcare market consolidates through mergers and acquisitions (M&A), patching disparate EHRs and other information systems together becomes even more important, and challenging. An organization is not integrated until its data is integrated, but costly forklift replacements of these transaction information systems and consolidating them with a single EHR solution is not a viable financial solution.
The Data Operating System: Changing the Digital Trajectory of HealthcareDale Sanders
This is the next evolution in health information exchanges and data warehouses, specifically designed to support analytics, transaction processing, and third party application development, in one platform, the Data Operating System.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
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1. Interoperability and
Standards
Healthcare Scenario 1
Admitting Orders from a Clinic
to a Hospital
J. Don M. Soriano, MD MBA
2. Healthcare Scenario 1
Dr. Santos (Internal Medicine) uses
an EMR called ClinicSys. He uses it
for SOAP notes, clinical abstracts,
referral letters and admitting notes.
He is a consultant at Reyes General
Hospital (RGH). RGH has a Hospital
Information System (HIS) called
HospitalSys. Dr. Santos wants to
send a patient for admission (with
admitting orders) to RGH. Dr. Santos
wants to get notice that patient has
been admitted.
• I chose Scenario 1 because
it is the one I am most
familiar with and can relate
to. My discussion though is
limited by my current
knowledge of IT applications
and terminologies.
• I tried to deconstruct the
problem, seen from the
perspective of a hospital
administrator faced with an
issue, looking for solutions.
Research notes were
included to supplement my
answers.
3. Points to Consider
• Interoperability is “the ability of different information technology
systems and software applications to communicate, to exchange data
accurately, effectively, and consistently, and to use the information that
has been exchanged.”
• There are two parts to that definition - the exchange of data and the
use of that data that has been exchanged. Interoperability issues can
arise from any part of this equation.
• “Data has to move between two or more systems – the exchange of
information. The receiving system and users must be able to process
and use the data. To “use” the data we need to ensure that it’s
delivered in a way that can be easily understood by the receiving
system and users so it can be applied. That’s where semantic
interoperability enters the picture.” - Dennis Giokas
4. • In my previous blogs, I discussed the issues with regard to
people, processes, technology and financial resources. Looking
at it from another perspective, these factors can be seen in the
Ishikawa Fishbone diagram for root cause analysis.
• Modifying this a bit to fit the context of the discussion, we can
come up with these diagrams:
People Process
Technology Content
Interoperability
Issues
5. Interoperability
Issues
People Process
No clear strategic direction for
evolutionary changes in overalll
technology environment of HIS
Limited IT knowledge of
medical staff
Limited IT knowledge of
admitting section staff
EHR may need upgrade
or replacement
HIS may need upgrade
or replacement
Poor integration
between components of
HIS
Poor quality of information -
lack of consistency, duplication,
out-of-date information
Poor Database Design -
table of data elements
may need normalization
Technology Content
We then use this diagram
to determine project goals
6. What entities are involved?
• Dr. Santos
• Doctor’s EMR (ClinicSys)
• Reyes General Hospital HIS
(HospitalSys)
• Admitting Section, Reyes General
Hospital
Information System 1
(EMR ClinicSys) creates
admitting order, sends
admitting order to
Information System 2
(HospitalSys)
Information System 2
(HospitalSys) receives
admitting order, sends
notice when patient is
admitted to Information
System 1 (ClinicSys)
Assumption: Notice of patient admission
is sent once the patient has a room
7. What applications need
to talk to each other?
• Doctor’s EMR (ClinicSys)
• Reyes General Hospital
HIS (HospitalSys)
• Integrated components of
HIS:
1. Databases - Patient
Registry and Medical Staff
with admitting privileges
2. Room Management
System
Patient
Registry
Directory
Medical Staff
Room
Management
System
8. Project goals for making applications
talk to each other
• Evaluate cause and effect factors by
reviewing Fishbone diagram
• Create an IT support group for medical
staff
• Form a technical working group which
includes medical staff, hospital
management, IT support group to discuss
ways to integrate disparate doctors’
systems and hospital system
• Determine standards needed such as
data content standard, data exchange
standard
• Identify and prevent data level conflicts
• Re-train hospital staff regarding data
collection and coding
“ Data level conflicts are differences in data which can
be caused by multiple representations and
interpretations of similar data.
Examples of data level conflicts are data-value
conflicts, data representation conflicts, data-unit
conflicts, and data precision conflicts.
Data-value conflicts are conflicts in data values. Data
values may mean different things depending on their
relationships to other factors.
Data representation conflicts happen when the same
data is represented in different ways (dates can be
represented as 9/17/2006, 17-9-2006 and/or
September 17, 2006).
Data-unit conflicts are those where the same values are
represented in different units – feet, yards, meters, etc.
Data precision conflicts happen when the same type of
data is represented in ways that differ conceptually.” -
From System Interoperability by Jennifer Macaulay
9. How can we make disparate systems and
applications talk to each other?
• Database translation
approach
“ The database translation approach is a
point-to-point solution based on direct
data mappings between pairs of
information systems. The mappings are
used to resolve data discrepancies
among the systems. The database
translation approach is most appropriate
for a small-scale information-processing
environment with a reduced number of
participants. The number of translators
grows with the square of the number of
components in the integrated system.
The corresponding translators must be
placed between the information
systems.”
Information in IS1 is represented by vertical lines, while the information in
IS2 is shown as horizontal lines representing a disparate system.
10. How can we make disparate systems and
applications talk to each other?
• Federated systems
approach
“Federated systems consist of a set of
heterogeneous databases in which federation users
can access and manipulate data transparently
without knowledge of the data location. Each
federation database includes a federated schema
that incorporates the data exported by one or more
remote information systems. There are two types of
federations: A tightly coupled federation is based
on a global federated schema that combines all
participant schemas. The federated schema is
constructed and maintained by the federation
administrator. A loosely coupled federation includes
one or more federated schema that are created by
users or the local database administrator. The
federated schema incorporates a subset of the
schema available in the federation. This approach
becomes rapidly complex when the number of
translators required becomes large.
The federated system is made only of horizontal
and vertical lines that IS1 and IS2 want to
exchange.”
11. How can we make disparate systems and
applications talk to each other?
• Ontology approach
“ The ontology-based
interoperability approach uses
ontology to provide an explicit
conceptualization of the common
domain of a collection of information
systems. An ontology defines a
common vocabulary that can be
used by users from different
systems. The construction of an
ontology for a domain is a difficult
task and often requires merging
existing overlapping ontologies. The
interoperability solutions based on
ontology describe the semantics of
information rather than their
organization or their format.”
12. How can we make disparate systems and
applications talk to each other?
• Standardization approach
“ In the standardization approach, the
information sources use the same model or
standard for data representation and
communication. The use of a standard
metamodel reduces the number of
translators (this number grows linearly with
the number of components) to resolve
semantic differences. However, the
construction of a comprehensive
metamodel is difficult; the manipulation of
high-level languages is complex; and there
are no unified database interfaces.
A centralized information system can be
built to replace the original information
systems (IS1, IS2). The global centralized
schema is a combination of the data
(horizontal and vertical lines) contained in
IS1 and IS2.”
13. How can we make disparate systems and
applications talk to each other?
• Multi base approach
“ Language-based multibase systems
consist of a loosely connected
collection of databases in which a
common query language is used to
access the contents of the local and
remote databases. In this approach, in
contrast to the distributed and
federated systems, the burden of
creating the federated schema is
placed on the users, who must
discover and understand the
semantics of the remote databases.
This solution is well adapted for
information systems that are based on
the same family of data models and
do not require complex query
translators.”
14. How can we make disparate systems and
applications talk to each other?
• Mediation approach
“ The mediation approach is based on two
main components: mediator and wrapper.
The mediator is used to create and support
an integrated view of data over multiple
sources. It provides various services to
support query processing. For instance, a
mediator can cooperate with other
mediators to decompose a query into
subqueries and generates an execution
plan based on the resources of the
cooperating sites. The wrapper is used to
map the local databases into a common
federation data model. The wrapper
component provides the basic data access
functions. In the diagram, a translator,
which acts as a wrapper, is placed
between the conceptual representation of
the mediator and the local description of
each information source.”
15. How can we make disparate systems and
applications talk to each other?
• WS approach
“ As new data models are developed for Web-based
information systems, there is a need to extend
interoperability solutions to take into account
requirements and specifications of the new models.
The existing Web technologies are not initially intended
to address some of the issues involved in database
integration. For instance, the Web-browsing paradigm
is efficient for data lookup in a large environment, but it
is inadequate for database integration support. To use
this paradigm to locate and merge data requires costly
applications that are often tailored to specific
integration needs. New challenges have arisen from the
development of Web-based information systems. One
of the challenges is the need to develop Web-oriented
tools to support information integration and allow
access to local as well as remote information sources.
Recently, Web services (WS) have been proposed as a
method to address some of the challenges of Web-based
integrated systems. A Web service can be
viewed as a set of layers contained in a stack. The
layers are dynamically defined following user needs
and are called through a set of Internet protocols.”
16. What’s next?
• “Health Level-7 or HL7 refers to a set of
international standards for transfer of clinical and
administrative data between Hospital information
systems. These standards focus on the application
layer, which is "layer 7" in the OSI model.” - HL7.org
• “SNOMED CT or SNOMED Clinical Terms is a
systematically organized computer processable
collection of medical terms providing codes, terms,
synonyms and definitions used in clinical
documentation and reporting. It is considered to be
the most comprehensive, multilingual clinical
healthcare terminology in the world. The primary
purpose of SNOMED CT is to encode the meanings
that are used in health information and to support
the effective clinical recording of data with the aim
of improving patient care. SNOMED CT provides
the core general terminology for electronic health
records. Its comprehensive coverage includes:
clinical findings, symptoms, diagnoses,
procedures, body structures, organisms and other
etiologies, substances, pharmaceuticals, devices
and specimen.” - ihtsdo.org
SNOMED
17. Proposed solutions
• Option - Check if an upgrade for
both Information Systems would
resolve the problem
• Option - Upgrade the Hospital
Information System, find out
which Clinic Systems are
interoperable then inform doctors
of these systems, have them
switch
• Option - Replace present Hospital
Information System with another
having a strategic intent of
interoperability with other systems
• Option - Use Database
translation approach if only
the ClinicSys of Dr. Santos is
to be considered
• Option - Use Standardization
approach if several other
doctors have their own
disparate information systems
• Option - Consider a Web-based
platform information
system for everyone to use
18. Data elements
• Date
• Doctor’s name
• Specialty
• Status (category of doctor’s Hospital
Admitting Privileges eg. Active Rotating,
Visiting Staff with admitting privileges
etc.)
• Patient’s name
• Patient Hospital ID number
• Patient’s birthday
• Account number (number which serves
as unique identifier for present
admission)
“Data elements are the smallest named item of data that
conveys meaningful information or condenses lengthy
description into a short code. It is called data field in the
structure of a database.”
“The data that is stored in tables is organized in a logical
manner based on a particular purpose to help minimize
duplication, reduce data anomalies, and reinforce data
integrity. The process by which data is logically
organized is called normalization; it not only simplifies the
way data is defined, but it also regulates its structure.”
“Stored data is manipulated using a programming
language called Structured Query Language, or SQL.
Many varieties of SQL exist, but most are based on set
theory relational operators such as and, or, not, and in, all
of which are used to perform operations on the data. The
operations that can be used in relational databases
include insert, select, update, and delete privileges.
Since the early 2010s, the relational database
management system (RDBMS), is the most commonly
used database format.”- wisegeek.org/what is a relational
database
19. Trigger events
• At what point (activity or
event) in the process should
the transfer of information
happen? The trigger event
could be the creation of the
admitting orders.
• At what point in the
application/software process
should the transfer of
information happen? The
trigger event could be the
transmission of the admitting
order.
“In a digital health care system,
applications create HL7 messages
because of a real-world event. The HL7
organization has written the HL7 standard
based on the assumption that an event in
the real world of health care creates the
need for data to flow among applications,
even when these applications span
heterogeneous systems. The HL7 standard
calls this real-world event a trigger event.
An automated system must systematically
recognize the trigger event.
Trigger events always result in the creation
of one or more messages that trigger an
action in the application that processes the
message.” - msdn.microsoft.com
20. Reference
• http://what-when-how.com/
information-science-and-technology/
interoperability-of-information-
systems/
“Standards are enablers.
Interoperable systems are what
support the business
and clinical requirements in a
typical e-health agenda.”
Dennis Giokas
Emerging Technology Group