A major problem to be solved in health informatics is high quality, structured and timely data collection. Standard terminologies and uniform domain conceptual models are important steps to alleviate this problem which are also proposed to enable interoperability among systems. With the aim of contributing to the solution of this problem, this study proposes novel features for the Archetypes and multi-level modeling technique in health information and knowledge modeling. The study consists of the development of a research prototype for endoscopic data management, and based on that experience, the extension of Minimal Standard Terminology in Digestive Endoscopy (MST). A major contribution of the study consists of significant extensions to the modeling formalism. The proposed modeling approach may be used in the design and development of health information systems based on archetypes for structured data collection, validation and dynamic user interface creation. The thesis work is aimed to make considerable contribution to the emerging Electronic Health Records (EHR) standards and specifications.

Today, the application of information and communication technologies to healthcare is on the agenda of many countries. The main aim is to make Electronic Healthcare Records (EHR) of a patient accessible anywhere at any time to all authorized users. This is even valid in the cross-border case / the European Commission has published eHealth interoperability recommendations to the EU Member States, in which the RIDE Project contributed, for the purpose of an interoperable European Health Network. Interoperable cross-border clinical data exchange is an ambitious goal with some challenges, the most obvious one being the variety of standards. This issue gets more complicated with the locally developed standards and coding systems. Each country has its own set of standards and it is not reasonable to make all possible combinations of mappings among them during multi-party EHR exchange. Instead, what needs to be done is keeping the legacy infrastructures of the participants and agreeing on a set of common EHR standards and coding systems. Then, each country shall develop &quot / Adapters&quot / transforming local EHR instances to the commonly agreed formats which will most probably be based on widely accepted standards such as HL7 CDA. This approach enables the structure level interoperability. As the second step, in order to achieve semantic interoperability, coded terms from locally defined coding systems shall be translated to international counterparts. In this thesis, our methodology is confirmed on Turkey&#039 / s National Health Information System. &quot / Transmission Schemas&quot / are automatically transformed to HL7 v3 CDA R2 and CEN EN 13606 standard formats. The local coded terms are translated by developing a mapping platform based on Unified Medical Language System (UMLS).

This paper considers the adoption of Health Information Technology (HIT) by physician clinics with ten or fewer physicians. The paper considers the theoretical economics literature on technology adoption for a new technology and has a place in the empirical tests of these models. The two major hypotheses tested in the paper are that the probability of adopting HIT increases with the number of physicians working at the clinic and if the clinic is part of a chain of clinics, and that it also increases with increased competition at the market level measured by the number of clinics per 10,000 residents in a county. To test these hypotheses, the paper first estimates a baseline logit model followed by three hazard rate models. In each case, clinic size is found to have positive though not significant effect on the probability of adoption (in the logit model) or to decrease the predicted time to adoption for the clinic (in the hazard rate models), being in a chain of clinics is found to have a strong positive and significant on the probability of adoption, and increased competition is found to have a positive though not significant effect on the probability of adoption.

Source: Masters Abstracts International, Volume: 47-06, page: 3557. Advisers: Linda Lloyd; Linda Piller. Includes bibliographical references.

The implementation of planned organizational change is ultimately a communication-related phenomenon, and as such, it is imperative that organizational communication scholars examine the interactions surrounding EHR implementation and understand how users (e.g. healthcare practitioners) utilize, evaluate, and deliberate this new technological innovation. Previous research on planned organizational change has called for researchers to adopt a more dynamic perspective that emphasizes the active agency of organizational members throughout implementation processes and focuses on informal implementers and change reinvention (work-arounds) as individuals actively reinterpret and personalize their work roles during implementation socialization. This dissertation seeks to fill this gap in research by demonstrating how communication between doctors, nurses, and other health professionals affects the adoption, maintenance, alternation, modification, or rejection of EHR systems within health care organizations. To delve into these inquiries and examine the intersecting domains of medical informatics and organizational communication research, this dissertation proceeds in the following manner: First, a literature review, capitalizing on Laurie Lewis’s work in planned organizational change and social constructionist views of technology use in organizations, outlines the assumptions that undergird this research. Next, this dissertation builds a model that predicts the communicative and structural antecedents of the study outcome variables, which include 1) organizational resistance to EHR implementation, 2) employees’ perception of EHR implementation success, 3) levels of change reinvention—or work-arounds—due to change initiatives and activities, and 4) employees’ perceptions of the quality of the organizational communication surrounding the change. Hypotheses guiding the model specification are provided and are followed by a description of the empirical methods and procedures that were utilized to explore the variable relationships. Results of the SEM model suggest that work-arounds could play a mediating role governing the relationship between informal social influence and the outcome variables in the study. In addition, one-way ANOVAs and multiple regression analyses reveal that physicians are the most resistant to EHR implementation and perceived change communication quality positively predicts perceived EHR implementation success and perceived relative advantage of EHR and negatively predicts employee resistance. A discussion of the expected and unexpected results is offered in addition to study limitation and future directions. / text

Introduction: H1N1 flu (swine flu) first emerged in mid-April 2009, and the Centers for Disease Control and Prevention (CDC) was a lead U.S. federal agency responding to the disease, the first pandemic in more than 40 years. Aim: The purpose of this program evaluation is to assess CDC’s Web-based outreach for the first part of the H1N1 flu pandemic (April to July 2009). Evaluation focuses on the seven CDC Web sites used for H1N1 flu outreach: H1N1 Flu (English and Spanish), CDC.gov, CDC en Español, CDC Partners, CDC Seasonal Flu, and MMWR. Methods: The evaluation assessed Web use and users through data collected by the American Consumer Satisfaction Index (ACSI) and specific Web statistics gathered through Omniture SiteCatalyst. Discussion: People have been using the internet to collect health information since the early days of popular usage. During the early H1N1 flu emergency, CDC used seven different Web sites to reach out to its users, who are primarily public health professionals, healthcare providers and consumers. Most users cite one of four reasons for visiting CDC’s Web sites: health information for my work, health information for myself, health information for patient or client, and health information for someone else. Between April and July, a clear majority of users visited the Web site for H1N1 flu information (from a high of 58% in May to a low of 35% in July). CDC.gov has received ACSI satisfaction scores of 80 (considered a top performer) or higher since the first quarter of 2007; the overall site satisfaction score of 82 during the first quarter of 2009 was bested by the H1N1-specific satisfaction score of 84 from mid-April to the end of June. Traffic to the site increased enormously during the early H1N1 flu emergency, from approximately 45 million page views per month in February and March 2009 to more than 98.2 million page views in April 2009. Recommendations: Those working on CDC.gov H1N1 flu-related content should continue trying to anticipate and meet user needs by expanding Web content, partnering with external organizations to share key information through syndication and information placement, and enhancing translation capabilities.

BACKGROUND Integrated healthcare systems are believed to be enabled by the electronic exchange of clinical information. Canada and other national health systems are making substantial investments in information technology, in order to liberate and share clinical information between providers, improve the quality and safety of care, and reduce costs, yet we currently have no way of measuring these information flows, nor of understanding whether they contribute to the integration of care delivery. METHODS A literature review and consensus development process (nominal group) were used to provide guidance on system integration measures which are enabled by electronic information exchange. In order to conceptualize the components of electronic information exchange, establish a reference vocabulary for terminology, and guide the development of a questionnaire to gather field data, a formal ontology was developed. Validation of a sub-group of the survey data quality was achieved using the ontology and an unrelated database, demonstrating how ontologies may be used to adapt performance measurement methodologies to systems where constraints such as time-compression, lack of resources or access to needed information are prevalent. RESULTS The survey tool gathered cross-sectoral data from a regional health system which populated a summary measure of inter-provider electronic health information exchange (the eHIE), and measured perceptions of system integration from a single health region. The eHIE indicated that 7 -12% of clinical information that could be shared, was being shared electronically in the health region. ANOVA confirmed a significant correlation between the amount of information being exchanged electronically in this system and respondent perceptions of system integration suggesting that the eHIE may be used as a leading indicator for healthcare system integration. CONCLUSIONS It is possible to conceptualize and quantify inter-provider electronic health information exchange. As complex adaptive systems, healthcare systems are dynamic and open to correction; the use of a leading or proximal indicator such as the eHIE may inform effective policy-making and resource allocation in our pursuit of the goal of seamlessly integrated care.

This paper describes Inuit cultural considerations when defining and communicating electronic health concepts and personal health information services to urban Inuit audiences. Applying a two-eyed seeing model to build on and describe contextual meanings for Western and Inuit versions of health information and information communication technologies is critical to sustained relevance of electronic health information. Overarching concerns include reclaiming Inuit ownership and vision; sustainability; and; authority and capacity. It is within an electronic health space that Inuit can attain self-determination for the management of their own personal health data and develop a set of culturally safe and empowering practices for communicating ownership and cultural relevancy of health and health information in an evolving health care system.

Online support groups have shown a strong potential to foster resourceful environments for people living with depression without restrictions of time, space, and stigma. Research has found that users of those groups exchange various types of support. However, due to the scarcity of research, many other aspects of depression online support groups remain inconclusive. In particular, how the support exchange contributes to the everyday lives of users living with depression remains unclear. To contribute to filing some of the knowledge gaps, the present study explored what kinds of support were requested and provided in a depression online support group. By doing so, this study aimed to examine the roles of the depression online support group in the management of depression. Mixed methods were employed with a concurrent triangulation strategy. A sample of 980 posts were selected systematically from the support group. Demographic and clinical information of the users who made those posts were recorded. Quantitative and qualitative content analyses were conducted to examine the types of support being exchanged through those posts. Inter-coder reliability was calculated to ensure the consistency of the coding process. The results indicate that users sought informational support, various types of emotional support and coaching support, and social companionship. Users not only sought listening ears, but also practical advice to cope with the situations they were going through. The group appeared to serve its users as a place to meet others with similar experience; to manage loneliness; to discuss what they could not discuss elsewhere; to "just vent"; to gain advice from multiple perspectives on an issue that had been magnifying the impact of depression; to share the experience with formal care provision systems; to express immediate support needs; to share useful discoveries, accomplishments, and creative ways to manage depression; and to experience the value of helping others. This study supports the idea that depression online support groups have the strong potential to contribute to the everyday lives of people living with depression in a way that is not available elsewhere and in a way that complement to the overall framework of existing care provision systems.

A method has been developed to track infectious diseases by using data mining of active Twitter accounts and its efficacy was demonstrated during the West African Ebola outbreak of 2014. Using a meme based n-gram semantic usage model to search the Twitter database for indications of illness, flight and death from the spread of Ebola in Africa, principally from Guinea, Sierra Leone and Liberia. Memes of interest relate disease to location and severity and are coupled to the density of Tweets and re-Tweets. The meme spreads through the community of social users in a fashion similar to nonlinear wave propagation- like a shock wave, visualized as a spike in Tweet activity. The spreading was modeled as a system isomorphic to a modified SIR (Susceptible, Infected, Removed disease model) system of three coupled nonlinear differential equations using Twitter variables. The nonlinear terms in this model lead to feedback mechanisms that result in unusual behavior that does not always reduce the spread of the disease. The resulting geographic Tweet densities are coupled to geographic maps of the region. These maps have specific threat levels that are ported to a mobile application (app) and can be used by travelers to assess the relative safety of the region they will be in.