Indiana University-Purdue University Indianapolis (IUPUI) / Physicians receive multiple CCDs for a single patient encompassing various encounters and medical history recorded in different information systems. It is cumbersome for providers to explore different pages of CCDs to find specific data which can be duplicated or even conflicted. This study describes the steps towards a system that integrates multiple CCDs into one consolidated document for viewing or processing patient-level data. Also, the impact of the system on healthcare providers’ perceived workload is evaluated. A modular system is developed to consolidate and de-duplicate CDA-based documents. The system is engineered to be scalable, extensible and open source. The system’s performance and output has evaluated first based on synthesized data and later based on real-world CCDs obtained from INPC database. The accuracy of the consolidation system along with the gaps in identification of the duplications were assessed. Finally, the impact of the system on healthcare providers’ workload is evaluated using NASA TLX tool. All of the synthesized CCDs were successfully consolidated, and no data were lost. The de-duplication accuracy was 100% based on synthesized data and the processing time for each document was 1.12 seconds. For real-world CCDs, our system de-duplicated 99.1% of the problems, 87.0% of allergies, and 91.7% of medications. Although the accuracy of the system is still very promising, however, there is a minor inaccuracy. Due to system improvements, the processing time for each document is reduced to average 0.38 seconds for each CCD. The result of NASA TLX evaluation shows that the system significantly decreases healthcare providers’ perceived workload. Also, it is observed that information reconciliation reduces the medical errors. The time for review of medical documents review time is significantly reduced after CCD consolidation. Given increasing adoption and use of Health Information Exchange (HIE) to share data and information across the care continuum, duplication of information is inevitable. A novel system designed to support automated consolidation and de-duplication of information across clinical documents as they are exchanged shows promise. Future work is needed to expand the capabilities of the system and further test it using heterogeneous vocabularies across multiple HIE scenarios.

京都大学 / 0048 / 新制・課程博士 / 博士(工学) / 甲第21356号 / 工博第4515号 / 新制||工||1703(附属図書館) / 京都大学大学院工学研究科都市社会工学専攻 / (主査)教授 藤井 聡, 准教授 QURESHI,Ali Gul, 准教授 SCHMOECKER,Jan-Dirk / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DGAM

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Theses / The Competition Act no.89 of 1998 coupled with its amendments ushered in a new era in the competition analysis and merger approval process in South Africa. This research paper's purpose is to intimately explore the emergent doctrine of "public interest" institutionalized in this new dispensation of competition legislation. In particular this report places under the spotlight the treatment of public issues in case law jurisprudence as developed in the consideration and determination of large and notifiable mergers under the auspices of the competition tribunal of the Republic of South Africa since the inception of the said new legislative order. The efficacy of the determination of socio-political issues and pure competitive efficiency issues separately but under and by the same entity are also examined. The contrast between the South African approach to the application of the doctrine of the public interest and that of some other competition jurisdictions abroad is also explored.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

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