This document discusses knowledge engineering in oncology and developing decision support systems from patient data. It notes that current medical decisions are limited by the large volume of data and evidence. Rapid learning from patient data can help guide individualized treatment decisions. The document outlines MAASTRO's approach to knowledge engineering, which involves collecting data from multiple centers while keeping the data within each institution. Ontologies and semantic interoperability are used to integrate the data and develop prediction models using machine learning. The models are validated on independent data to evaluate their ability to classify outcomes and estimate survival probabilities. The goal is to develop validated models that can provide clinical decision support and help personalize cancer treatment.
Clinicians, Leveraging AI expertise, Understanding the
Regulatory Framework
• Clinical interpretability guiding the adoption of AI-first
differential diagnoses
• Disparity in data literacy affecting the communication of
AI among healthcare scientists
• Regulatory challenges impeding the penetration of AI
into clinical practice - from research to policymakers
Frank J. Rybicki MD, PhD, Professor and Chair, Department
of Radiology, UNIVERSITY OF OTTAWA FACULTY OF
MEDICINE
Digital Future of the Surgery: Brining the Innovation of Digital Technology i...Yoon Sup Choi
Sungkyunkwan University's Department of Human ICT Convergence discusses how digital technology such as wearable devices, augmented reality, artificial intelligence, and 3D printing can be integrated into surgery. Wearable devices like Google Glass have been used in operating rooms to view CT scans and consult with distant colleagues. Augmented reality overlays 3D models onto live views to help identify tumors. Artificial intelligence like IBM Watson assists with treatment suggestions by analyzing medical literature and cases. The digital future aims to connect experts globally and enhance surgical training, planning and guidance.
The document discusses how IBM's Watson technology can be applied to healthcare to improve clinical decision making and reduce diagnostic errors. It describes Watson's ability to analyze large amounts of structured and unstructured data, generate differential diagnoses, consider various hypotheses, and provide evidence and a confidence level for its responses without making a definitive diagnosis. The document also outlines how electronic health records could be enhanced with Watson to better record assessments, generate checklists to aid decision making, and provide relevant knowledge resources to clinicians.
Systematic Reviews: the researcher's perspective and the research question. E...healthlibaust2012
The document discusses the perspectives of researchers conducting systematic reviews and the importance of developing a clear research question. It emphasizes that a well-constructed question using the PICO/PICo framework is fundamental to guiding the review process, including developing inclusion criteria and an effective search strategy. Researchers may have different levels of experience and understanding of systematic reviews, so librarians play an important role in helping them conceptualize the question and properly carry out the various review steps, such as developing a reproducible search strategy.
Market Study of Electronic Medical Record (EMR) Systems in EuropeCGI
This document summarizes a market study of electronic medical record (EMR) systems in Europe. It finds that the overall EMR market in Europe is estimated to be between €2.9-3.4 billion, with the largest markets in the UK, Germany, and France. Adoption rates of clinical information systems vary widely across Europe, with the Nordic countries having the highest penetration. Key trends include differences in healthcare infrastructure and funding across countries, a need for systems modernization, and a slow move toward common standards. Country-specific examples from Finland and Denmark show high EMR adoption but a need for upgraded systems in some areas.
Watson Health is a population health platform that aims to address inefficiencies in healthcare systems through advanced analytics and cognitive computing. The platform utilizes clinical data, genomics data, medical literature and other sources to generate personalized insights for providers, payers, researchers, individuals and others. It delivers these insights through a HIPAA-compliant cloud that leverages IBM's ecosystem of over 250 healthcare partners. The goal is to help transform healthcare by providing more actionable knowledge at the point of care through differentiated capabilities such as advanced analytics, machine learning and cognitive computing.
Technology enabled behavior changes for diabetic patientsJames Rose
Technology enabled behavioral changes can improve care for diabetic patients. A patient engagement system uses algorithms to analyze patient data like A1C and lipid levels, then sends alerts and reminders to both patients and providers. This increases recommended testing compliance up to 74% and supports best practices. Studies show such systems can reduce hospital admissions, ER visits, and overall costs while improving population health metrics. Engaging patients and providers in the care process through technology results in better financial, operational and health outcomes for medical groups.
This document discusses knowledge engineering in oncology and developing decision support systems from patient data. It notes that current medical decisions are limited by the large volume of data and evidence. Rapid learning from patient data can help guide individualized treatment decisions. The document outlines MAASTRO's approach to knowledge engineering, which involves collecting data from multiple centers while keeping the data within each institution. Ontologies and semantic interoperability are used to integrate the data and develop prediction models using machine learning. The models are validated on independent data to evaluate their ability to classify outcomes and estimate survival probabilities. The goal is to develop validated models that can provide clinical decision support and help personalize cancer treatment.
Clinicians, Leveraging AI expertise, Understanding the
Regulatory Framework
• Clinical interpretability guiding the adoption of AI-first
differential diagnoses
• Disparity in data literacy affecting the communication of
AI among healthcare scientists
• Regulatory challenges impeding the penetration of AI
into clinical practice - from research to policymakers
Frank J. Rybicki MD, PhD, Professor and Chair, Department
of Radiology, UNIVERSITY OF OTTAWA FACULTY OF
MEDICINE
Digital Future of the Surgery: Brining the Innovation of Digital Technology i...Yoon Sup Choi
Sungkyunkwan University's Department of Human ICT Convergence discusses how digital technology such as wearable devices, augmented reality, artificial intelligence, and 3D printing can be integrated into surgery. Wearable devices like Google Glass have been used in operating rooms to view CT scans and consult with distant colleagues. Augmented reality overlays 3D models onto live views to help identify tumors. Artificial intelligence like IBM Watson assists with treatment suggestions by analyzing medical literature and cases. The digital future aims to connect experts globally and enhance surgical training, planning and guidance.
The document discusses how IBM's Watson technology can be applied to healthcare to improve clinical decision making and reduce diagnostic errors. It describes Watson's ability to analyze large amounts of structured and unstructured data, generate differential diagnoses, consider various hypotheses, and provide evidence and a confidence level for its responses without making a definitive diagnosis. The document also outlines how electronic health records could be enhanced with Watson to better record assessments, generate checklists to aid decision making, and provide relevant knowledge resources to clinicians.
Systematic Reviews: the researcher's perspective and the research question. E...healthlibaust2012
The document discusses the perspectives of researchers conducting systematic reviews and the importance of developing a clear research question. It emphasizes that a well-constructed question using the PICO/PICo framework is fundamental to guiding the review process, including developing inclusion criteria and an effective search strategy. Researchers may have different levels of experience and understanding of systematic reviews, so librarians play an important role in helping them conceptualize the question and properly carry out the various review steps, such as developing a reproducible search strategy.
Market Study of Electronic Medical Record (EMR) Systems in EuropeCGI
This document summarizes a market study of electronic medical record (EMR) systems in Europe. It finds that the overall EMR market in Europe is estimated to be between €2.9-3.4 billion, with the largest markets in the UK, Germany, and France. Adoption rates of clinical information systems vary widely across Europe, with the Nordic countries having the highest penetration. Key trends include differences in healthcare infrastructure and funding across countries, a need for systems modernization, and a slow move toward common standards. Country-specific examples from Finland and Denmark show high EMR adoption but a need for upgraded systems in some areas.
Watson Health is a population health platform that aims to address inefficiencies in healthcare systems through advanced analytics and cognitive computing. The platform utilizes clinical data, genomics data, medical literature and other sources to generate personalized insights for providers, payers, researchers, individuals and others. It delivers these insights through a HIPAA-compliant cloud that leverages IBM's ecosystem of over 250 healthcare partners. The goal is to help transform healthcare by providing more actionable knowledge at the point of care through differentiated capabilities such as advanced analytics, machine learning and cognitive computing.
Technology enabled behavior changes for diabetic patientsJames Rose
Technology enabled behavioral changes can improve care for diabetic patients. A patient engagement system uses algorithms to analyze patient data like A1C and lipid levels, then sends alerts and reminders to both patients and providers. This increases recommended testing compliance up to 74% and supports best practices. Studies show such systems can reduce hospital admissions, ER visits, and overall costs while improving population health metrics. Engaging patients and providers in the care process through technology results in better financial, operational and health outcomes for medical groups.
Brief view of the achievements of a regional long-term e-health strategy done in Andalusia, the southernmost region of Spain. It is a comprehensive strategy for the whole population of this spanish region: more than 8 million inhabitants. EHR, electronic prescription, appointment, lab tests, image and others. An independent economic study shows a 260 euros of benefit for each 100 euros invested after 10 years of starting the initiative
Leveraging Advanced Analytics to Help Hospitals Measure Efficacy of Treatment...Booz Allen Hamilton
The document discusses leveraging advanced analytics to help hospitals measure treatment efficacy and improve detection of healthcare associated infections. It describes Booz Allen developing an "Event-Centric Ontology" framework to analyze electronic health records from a hospital system looking to reduce mortality from severe sepsis and septic shock. Their analyses found a correlation between higher compliance with treatment protocols and lower mortality, and an early detection model that outperformed chance at identifying patients at risk of developing severe sepsis.
Short revision on the current status of the electronic prescription module of the eHR in Andalusia Region and the available tools improving patient safety. CDSS may avoid interactions, unnecessary duplications, undetected allergies and many others.
Information in the new world: Can we make cancer data count?MHP Communications
The document discusses how cancer data and information can be better utilized. It argues that both a supply side information revolution to improve data collection and quality, as well as a demand side revolution to increase use of data by commissioners, providers, and patients is needed. Examples are given of how data could help commissioners prioritize issues, providers target quality improvements, and patients make informed healthcare choices. Overall, the document advocates that while progress has been made in collecting cancer data, more must be done to translate that intelligence into actions that improve outcomes.
1) The role of health care data analysts is evolving as the volume of available data grows exponentially. With zettabytes of data being generated, analysts must make sense of both structured and unstructured information.
2) Data analytics can provide insights to improve patient outcomes, lower costs, and enhance the health care experience. Examples show how visualizing data helps health systems better understand utilization and identify at-risk patients.
3) As incentives shift from fee-for-service to value-based models, health systems must transform to focus on population health. Advanced analytics and predictive modeling will be crucial to achieving the goals of better care, lower costs, and improved health.
This document discusses the importance of collaborative care and care coordination for healthcare delivery systems. It notes that solo practice is no longer a sustainable business model and that fee-for-service payments have limitations. The document provides evidence that care coordination can reduce costs through fewer hospital admissions and readmissions without worse health outcomes. It also shows that patients experience a lack of communication and information sharing between their different doctors. To improve care coordination, mobile access to patient data and collaborative workflows are seen as critical, as mobile devices are increasingly how physicians access information. The right devices and secure mobile computing are needed to enable these new care coordination models.
Knowledge Science for AI-based biomedical and clinical applicationsCatia Pesquita
The great barrier to AI adoption in healthcare and biomedical research is lack of trust.
Assessing trustworthiness requires data, domain and user context, which can be supported by ontologies, knowledge graphs and FAIR data.
Kevin Fickenscher, M.D., CPE, FACPE, FAAFP
President, Healthcare Division
Chief Medical Officer
AMC Health, Inc.
Former President and CEO
American Medical Informatics Association
HIMSS slides: IT leaders show MU, ICD-10 progress but fear staff shortagesTrimed Media Group
The survey summarizes the results of the 24th Annual HIMSS Leadership Survey of 298 senior IT executives from US hospitals on key healthcare IT issues:
1) Two-thirds have already qualified for Meaningful Use Stage 1 and three-quarters expect to qualify for Stage 2 in 2014.
2) IT staffing remains a top concern, with 21% worried about securing needed staff.
3) Achieving Meaningful Use and optimizing current systems were the top IT priorities for the next two years.
This document discusses disruptive innovation in patient-centered healthcare and outlines challenges facing healthcare systems. It notes that healthcare costs are concentrated among a small portion of patients and are growing due to aging demographics. Healthcare spending is also not efficiently allocated, with less than 10% spent on direct point-of-care services. The document advocates investing in electronic health records, telehealth, and other information technologies to improve care coordination and outcomes while reducing costs. It argues healthcare systems should innovate with the patient's needs and health outcomes as the priority.
The document summarizes a study that developed a composite index to benchmark electronic health (eHealth) deployment across acute hospitals in Europe. The index assessed eHealth across four areas: infrastructure, applications, health information exchange, and security/privacy. It was based on survey data from over 1,000 hospitals across 12 European countries and analyzed factors like computer systems, electronic health records, picture archiving, telemedicine, and cross-border health information exchange. The goal was to distill a complex reality into a manageable form to inform evidence-based eHealth policymaking at the European level.
Mentoring Roundtable Discussion “Application of Medical AI”AMI Inc.
The document discusses the application of medical AI, including examples of research and usage. It describes how medical AI can be used for classification, object detection, and segmentation of medical images like fundus images, endoscopic images, CT/MRI scans, and X-rays. It also discusses how AI can be applied to biological signals like ECG. Key metrics for medical AI like sensitivity and specificity are explained. Challenges in medical AI like data handling, domain knowledge requirements, and ensuring interpretability are also covered.
Martin Bardsley & Adam Steventon: Stemming demand: how best to track the impa...Nuffield Trust
The document discusses approaches for evaluating interventions aimed at reducing demand for emergency healthcare services using routine data. It summarizes challenges with traditional evaluation methods and proposes using existing data sets to continuously monitor outcomes over time for broad groups of users, developing accurate comparison groups, and exploiting linked data sets. Key approaches discussed are a randomized controlled trial of a telecare intervention and using case controls derived from routine data to account for issues like regression to the mean.
Comparative evaluation of non mercury thermometers in a hospital setting and ...Ali Naffaa
A research study about finding the most accurate, economically viable, and user friendly alternative to mercury thermometer for the Lebanese healthcare industry
Joseph Dal Molin: Implementing VistA internationally: Myth-busting lessons fr...Nuffield Trust
In this slideshow Joseph Dal Molin, President of the E-cology Corporation and Chairman of WorldVistA, outlines Jordan’s health system and its approach to implementing VistA.
Joseph Dal Molin presented at the Nuffield Trust seminar: Sharing international experience: Is implementing the VA's electronic health record system an option for the NHS? in July 2012.
The document discusses the benefits of mobile device connectivity for healthcare. It notes that over 30% of physicians make decisions with incomplete information, and mobile technologies could eliminate 11-30% of office visits. Remote monitoring is shown to reduce costs and hospital admissions for conditions like diabetes, congestive heart failure, and COPD. Widespread use of remote monitoring for chronic conditions could save over $200 billion in healthcare costs over 25 years. Standards-based WiFi technologies can effectively support remote patient monitoring.
This talk is being delivered on June 19th 2012 as part of CBI's 3rd Annual Social Media Regulations and Compliance Conference in Arlington, Virginia: http://www.cbinet.com/brochures/PC12028_brochure.pdf
Multidisciplinary care: a perspective from diagnosis and treatment of rare cancers. Casali P. Technical Conference: Multidisciplinary Care in Cancer as a model of health care quality (Madrid: Ministry of Health and Social Policy, 2010)
La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Sánchez de Toledo J. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
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Similar to Perspective of the Researcher. Perkins R. eHealth week 2010
Brief view of the achievements of a regional long-term e-health strategy done in Andalusia, the southernmost region of Spain. It is a comprehensive strategy for the whole population of this spanish region: more than 8 million inhabitants. EHR, electronic prescription, appointment, lab tests, image and others. An independent economic study shows a 260 euros of benefit for each 100 euros invested after 10 years of starting the initiative
Leveraging Advanced Analytics to Help Hospitals Measure Efficacy of Treatment...Booz Allen Hamilton
The document discusses leveraging advanced analytics to help hospitals measure treatment efficacy and improve detection of healthcare associated infections. It describes Booz Allen developing an "Event-Centric Ontology" framework to analyze electronic health records from a hospital system looking to reduce mortality from severe sepsis and septic shock. Their analyses found a correlation between higher compliance with treatment protocols and lower mortality, and an early detection model that outperformed chance at identifying patients at risk of developing severe sepsis.
Short revision on the current status of the electronic prescription module of the eHR in Andalusia Region and the available tools improving patient safety. CDSS may avoid interactions, unnecessary duplications, undetected allergies and many others.
Information in the new world: Can we make cancer data count?MHP Communications
The document discusses how cancer data and information can be better utilized. It argues that both a supply side information revolution to improve data collection and quality, as well as a demand side revolution to increase use of data by commissioners, providers, and patients is needed. Examples are given of how data could help commissioners prioritize issues, providers target quality improvements, and patients make informed healthcare choices. Overall, the document advocates that while progress has been made in collecting cancer data, more must be done to translate that intelligence into actions that improve outcomes.
1) The role of health care data analysts is evolving as the volume of available data grows exponentially. With zettabytes of data being generated, analysts must make sense of both structured and unstructured information.
2) Data analytics can provide insights to improve patient outcomes, lower costs, and enhance the health care experience. Examples show how visualizing data helps health systems better understand utilization and identify at-risk patients.
3) As incentives shift from fee-for-service to value-based models, health systems must transform to focus on population health. Advanced analytics and predictive modeling will be crucial to achieving the goals of better care, lower costs, and improved health.
This document discusses the importance of collaborative care and care coordination for healthcare delivery systems. It notes that solo practice is no longer a sustainable business model and that fee-for-service payments have limitations. The document provides evidence that care coordination can reduce costs through fewer hospital admissions and readmissions without worse health outcomes. It also shows that patients experience a lack of communication and information sharing between their different doctors. To improve care coordination, mobile access to patient data and collaborative workflows are seen as critical, as mobile devices are increasingly how physicians access information. The right devices and secure mobile computing are needed to enable these new care coordination models.
Knowledge Science for AI-based biomedical and clinical applicationsCatia Pesquita
The great barrier to AI adoption in healthcare and biomedical research is lack of trust.
Assessing trustworthiness requires data, domain and user context, which can be supported by ontologies, knowledge graphs and FAIR data.
Kevin Fickenscher, M.D., CPE, FACPE, FAAFP
President, Healthcare Division
Chief Medical Officer
AMC Health, Inc.
Former President and CEO
American Medical Informatics Association
HIMSS slides: IT leaders show MU, ICD-10 progress but fear staff shortagesTrimed Media Group
The survey summarizes the results of the 24th Annual HIMSS Leadership Survey of 298 senior IT executives from US hospitals on key healthcare IT issues:
1) Two-thirds have already qualified for Meaningful Use Stage 1 and three-quarters expect to qualify for Stage 2 in 2014.
2) IT staffing remains a top concern, with 21% worried about securing needed staff.
3) Achieving Meaningful Use and optimizing current systems were the top IT priorities for the next two years.
This document discusses disruptive innovation in patient-centered healthcare and outlines challenges facing healthcare systems. It notes that healthcare costs are concentrated among a small portion of patients and are growing due to aging demographics. Healthcare spending is also not efficiently allocated, with less than 10% spent on direct point-of-care services. The document advocates investing in electronic health records, telehealth, and other information technologies to improve care coordination and outcomes while reducing costs. It argues healthcare systems should innovate with the patient's needs and health outcomes as the priority.
The document summarizes a study that developed a composite index to benchmark electronic health (eHealth) deployment across acute hospitals in Europe. The index assessed eHealth across four areas: infrastructure, applications, health information exchange, and security/privacy. It was based on survey data from over 1,000 hospitals across 12 European countries and analyzed factors like computer systems, electronic health records, picture archiving, telemedicine, and cross-border health information exchange. The goal was to distill a complex reality into a manageable form to inform evidence-based eHealth policymaking at the European level.
Mentoring Roundtable Discussion “Application of Medical AI”AMI Inc.
The document discusses the application of medical AI, including examples of research and usage. It describes how medical AI can be used for classification, object detection, and segmentation of medical images like fundus images, endoscopic images, CT/MRI scans, and X-rays. It also discusses how AI can be applied to biological signals like ECG. Key metrics for medical AI like sensitivity and specificity are explained. Challenges in medical AI like data handling, domain knowledge requirements, and ensuring interpretability are also covered.
Martin Bardsley & Adam Steventon: Stemming demand: how best to track the impa...Nuffield Trust
The document discusses approaches for evaluating interventions aimed at reducing demand for emergency healthcare services using routine data. It summarizes challenges with traditional evaluation methods and proposes using existing data sets to continuously monitor outcomes over time for broad groups of users, developing accurate comparison groups, and exploiting linked data sets. Key approaches discussed are a randomized controlled trial of a telecare intervention and using case controls derived from routine data to account for issues like regression to the mean.
Comparative evaluation of non mercury thermometers in a hospital setting and ...Ali Naffaa
A research study about finding the most accurate, economically viable, and user friendly alternative to mercury thermometer for the Lebanese healthcare industry
Joseph Dal Molin: Implementing VistA internationally: Myth-busting lessons fr...Nuffield Trust
In this slideshow Joseph Dal Molin, President of the E-cology Corporation and Chairman of WorldVistA, outlines Jordan’s health system and its approach to implementing VistA.
Joseph Dal Molin presented at the Nuffield Trust seminar: Sharing international experience: Is implementing the VA's electronic health record system an option for the NHS? in July 2012.
The document discusses the benefits of mobile device connectivity for healthcare. It notes that over 30% of physicians make decisions with incomplete information, and mobile technologies could eliminate 11-30% of office visits. Remote monitoring is shown to reduce costs and hospital admissions for conditions like diabetes, congestive heart failure, and COPD. Widespread use of remote monitoring for chronic conditions could save over $200 billion in healthcare costs over 25 years. Standards-based WiFi technologies can effectively support remote patient monitoring.
This talk is being delivered on June 19th 2012 as part of CBI's 3rd Annual Social Media Regulations and Compliance Conference in Arlington, Virginia: http://www.cbinet.com/brochures/PC12028_brochure.pdf
Similar to Perspective of the Researcher. Perkins R. eHealth week 2010 (20)
Multidisciplinary care: a perspective from diagnosis and treatment of rare cancers. Casali P. Technical Conference: Multidisciplinary Care in Cancer as a model of health care quality (Madrid: Ministry of Health and Social Policy, 2010)
La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Sánchez de Toledo J. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Ortiz H. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Barnadas A. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
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Experiencias y percepción de la atención integral de los pacientes con cáncer. Moreno Marín P. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Medina JA. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
Experiencias y percepción de la atención integral de los pacientes con cáncer. Fisas Armengol A. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
Este documento describe la atención oncológica multidisciplinar y la gestión de casos como un modelo de calidad asistencial. Explica que la gestión de casos implica coordinar y facilitar el acceso a los servicios sanitarios adecuados para cada paciente. Además, describe el rol de la enfermera gestora de casos en unidades oncológicas, cuyas funciones principales son coordinar el plan de tratamiento del paciente y servir de referente para el paciente y el equipo médico. Finalmente, concluye que la gestión de casos contribuye
La mejor evidencia junto a la mejor organización: el reto de la coordinación profesional en atención oncológica. Díaz Mediavilla J. Jornada Técnica: Atención Multidisciplinar en Cáncer como modelo de calidad asistencial (Madrid: Ministerio de Sanidad y Política Social, 2010)
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The power of lifestyle interventions to prevent cardiovascular diseases. Tuomilehto J. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
Alcohol and chronic diseases: complex relations. Guillemont J. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
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Addressing cardiovascular disease at EU level: tangible plans for the future. Hübel M. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
1) Denmark aimed to create common processes and data structures across 13 municipalities and multiple medical vendors from 2002-2007, but faced issues with too many concurrent users and high data transmission.
2) From 2007-2012, Denmark established a shared medication record and common database to address prior issues.
3) The document discusses various roles that medical intermediaries can play, including consumer/professional content aggregation, patient management, records management, physician career services, and more. It also covers intermediation theory and the challenges in Europe.
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The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
As the world population is aging, Health tourism has become vitally important and will be increased day by day. Because
of the availability of quality health services and more favorable prices as well as to shorten the waiting list for medical
services regionally and internationally. There are some aspects of managing and doing marketing activities in order for
medical tourism to be feasible, in a region called as clustering in a region with main stakeholders groups includes Health
providers, Tourism cluster, etc. There are some related and affecting factors to be considered for the feasibility of medical
tourism within this study such as competitiveness, clustering, Entrepreneurship, SMEs. One of the growth phenomenon
is Health tourism in the city of Izmir and Turkey. The model of five competitive forces of Porter and The Diamond model
that is an economical model that shows the four main factors that affect the competitiveness of a nation and its industries
in this study. The short literature of medical tourism and regional clustering have been mentioned.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
“Environmental sanitation means the art and science of applying sanitary, biological and physical science principles and knowledge to improve and control the environment therein for the protection of the health and welfare of the public”.The overall importance of sanitation are to provide a healthy living environment for everyone, to protect the natural resources (such as surface water, groundwater, soil ), and to provide safety, security and dignity for people when they defecate or urinate .Sanitation refers to public health conditions such as drinking clean water, sewage treatment, etc. All the effective tools and actions that help in keeping the environment clean come under sanitation. Sanitation refers to public health conditions such as drinking clean water, sewage treatment. All the effective tools and actions that help in keeping the environment clean and promotes public health is the necessary in todays life.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Selective alpha1 blockers are Prazosin, Terazosin, Doxazosin, Tamsulosin and Silodosin majorly used to treat BPH, also hypertension, PTSD, Raynaud's phenomenon, CHF
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Perspective of the Researcher. Perkins R. eHealth week 2010
1. Enabling Clinical Research
Through Effective Use Of
Patient Data
Perspective of the Researcher
Richard Perkins
President, eClinical Forum
2. Overview…
1. Some Relevant Statistics
To understand
2. A Different Future
the rationale,
needs, 3. The Challenge
challenges,
potential 4. Why Now
solutions… 5. How EHRs Could Enhance
Clinical Research
2
3. Some Relevant Statistics…
Pharma Research Healthcare
Bringing a new treatment 250,000 patients participate in
to the market costs >800 M European clinical trials a year
Euro and increases at
Recruited by 4200 investigators
~10% a year
Completing ~1400 data points
Clinical research uses 55-
per patient
75% of R&D budget
A typical trial has 6000 data
>37,000 Clinical Trials
queries (time and cost to
58% of trials do not meet correct)
projected recruitment Generates 525-2025 M Euro for
rates! healthcare
Physician /
3 Investigator
4. Some Relevant Statistics…
Growth in Electronic Data Capture to 61% of
ongoing trials (from 13% in 2001)…
40% Average of 61%
35% of trials ongoing ‒ To provide faster,
at respondent
30%
sites use EDC
better quality and
% Responders
25% more reliable data
20% 37% only
use EDC
to support safety
15%
and efficacy
10%
5%
0%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Percentage of EDC Trials Ongoing at Site
No EDC Trials All EDC Trials
Source: eClinical Forum Site Survey 2009, European data N=131
4
5. Some Relevant Statistics…
Growth of EHRs to >50% …
– Enhance patient safety
– Improve quality of healthcare EU Hospitals (2004)
– Reduce healthcare costs
50%
EU GPs (2008)
67-92%
Source: Personal communication - ICT use
among Hospitals in Europe, 2004
5 Source: Benchmarking ICT use among General Practitioners in Europe, April 2008
6. Some Relevant Statistics…
and… The percentage of patient data perceived
as entered into EDC system and the patient
record? 70%
In your opinion what percentage of data that was
60% entered into the CRF was also entered into the
patient file or notes?
% Responders 50%
70-100%! 40%
30%
20%
A significant 10%
opportunity for 0%
0 10 20 30 40 50 60 70 80 90 100
efficiency gains! Percentage Duplicated n = 124
Source: eClinical Forum Site Survey 2009, European data
6
7. A Different Future…
We Need…
a common
understanding
and approach
We Need…
to connect
Healthcare and
Pharma/Academic
Research
7
8. A Different Future…
Connect Healthcare and Research …
For more efficient use of patient data, to avoid redundant
entry and to improve trial performance
80%
72%
• 72% of investigational 70%
Of Benefit
60%
sites consider 50%
connecting healthcare 40%
and clinical trial 30%
26%
20%
systems to be of 10%
benefit! 0%
3%
Yes No Missing
Source: eClinical Forum Site Survey 2009, European data
8
9. A Different Future…
Imagine… Patient Data Exchange Between Healthcare
and Drug Development Systems
Emerging and Future EHR-Research Connectivity and Complexity
Healthcare System
Clinical Trial
System Integrated Future
Current Divided Interoperable Ideal
Integrated Future
Current Divided • EHRs used to… Interoperable Ideal
• EHR systems holding source for data used in • EHR and research systems work
clinical trials may not meet essential regulatory • Evaluate Patient Populations seamlessly together so that groups
• Accelerate Patient Recruitment
requirements benefit from data access and mining
• Clinical care data required for clinical trials is capabilities across healthcare and
• Capture CT Data
entered into EHR and into clinical trial systems research data sets
• Research holds source data not part of normal • Research systems and healthcare
• Exchange CT Data
clinical care systems sit on the same spine
• Redundant data entry, transcription errors and • Systems conform to the same data
• The EHR becomes the patient data repository
source issues cost healthcare and industry exchange standards
time and money.
9
10. A Different Future…
Benefiting all stakeholders…
Healthcare
Identification of target population
Reduced effort for data provision leaves
more time for patient care
Simplified safety reporting and management
Potential to conduct more research
Familiarity of one interface
Authorities
New innovative therapies Higher quality, reliable data
Patient
available earlier from validated sources
Higher quality data provides under investigator control
greater safety Lower cost and faster approval of
Real-time identification of new therapies
safety issues and trends Mining of data
PharmaResearch
Evaluation of trial criteria for concept
development and trial feasibility improves trial
success
Linking of patients to trials to improve patient
recruitment
Early identification of safety issues and trial
termination improves patient safety
Data handling efficiencies
Virtual trials
10 …
11. The Challenge…
Healthcare Pharma Research
Multiple systems, semantics, ontologies, languages…
Various levels of system validation and integration,
unstructured information…
Need for controlled process for release and transfer of
data to meet ethical and data protection requirements…
Source data held in EHR may not be appropriate as
source for regulated clinical studies …
Entry of
Patient’s Clinical
Data
Various standards, levels of system Systems validated &
validation and integration, data compliant to Industry &
structure depending on country, Regulatory standards &
region, institution. Physician / policies e.g. CSUCI, ICH GCP
Investigator
11
12. Why Now…
Political, Cultural & Technical Solutions are
Starting to Bridge the Gap
1. Political FP7 ICT IMI
BRIDG EHRCR
Removing obstacles, linking
stakeholders and driving the Standards Systems
Common data Reliable,
need for change standards allow
validated
movement of
Future systems meet
2. Cultural data between
healthcare and Connected healthcare and
Healthcare &
Stakeholders see CR as a special research research
Research requirements
case for use of EHR data Munich
(InferMed:
3. Technical Siemens) Process
Controlled process for
Projects are developing solutions to APHP/ release and transfer
individual components INSERM of data meets bio-
ethical requirements
The concept has been proven in
HANYS
single site, technology instances
12
13. How EHRs Could Enhance CR…
Via a standardised, scalable platform that connects
healthcare and drug development systems…
Standardised interfaces support « Intelligent » computer-readable
Extended semantic and ontological
multiple data exchange protocols automate querying to
directories cover research
standards for healthcare and evaluate patient populations,
archetypes in multiple languages
research data collection, rules etc
Platform
Patient Population
Healthcare Environment
Query
Pharma Environment
HL7 Messages
Anonymised
Integrated Aggregated Data Extracts
Edifact Messages Technology Data Collection
Quality Rules
and
EN13606 Extracts Interoperability CT Patient Data
from/to EHR
Layer SAE
Proprietary Formats
Data Exchange
2-way exchange of pseudo- Patients can be connected to
Use of standard infrastructure allows
anonymised data eliminates clinical trials to improve
for multiple CT service providers
redundant entry recruitment
13
14. How EHRs Could Enhance CR…
… operating within a sustainable business model
Business Model
Platform
Patient Population
Healthcare Environment
Query
Pharma Environment
HL7 Messages
Integrated Anonymised
Technology Aggregated Data Extracts
Edifact Messages and Data Collection
Quality Rules
Interoperability
EN13606 Extracts Layer CT Patient Data
from/to EHR
SAE
Proprietary Formats Qualification of systems, Revenue Data Exchange
and cost models
Data protection and ethics
processes, organisations define value-added and ROI
requirements met
balance cost and oversight to drive sustainability
Organisation Process
• Role of Ethics Committees, TTPs etc • Qualification/certification
• Governance and oversight • Revenue , investment and cost models
• Support infrastructure • Workflow of activities, interfaces, rules
14
15. Key Messages…
1. The more efficient re-use of EHR data presents
opportunities for
• Healthcare to reduce redundant data entry
• Research to improve clinical trial performance
2. The concept has already been proven in single
site and technology pilots
3. There is a political expectation for integration of
healthcare and pharma/academic data (FP7 ICT, IMI)
4. The environment is right to actively support and
make change happen
15
16. Key Messages…
5. There are challenges but they can be met by
adapting and integrating existing technologies
and standards to achieve interoperability
6. A sustainable European
business model to
facilitate re-use of patient
data is needed that meets
business, operational, ethical and
data protection requirements
richard.perkins@con7.com
16
17. Enabling Clinical Research
Through Effective Use Of
Patient Data
Perspective of the Researcher
Richard Perkins
President, eClinical Forum