The provision of accessible and usable health information is vital for making informed health decisions and embracing active and preventative health behaviours (such as reporting of symptoms, early screening and seeking medical help). Previous research in this area has focused on health-related information seeking behaviour and use of information by citizens of developed countries and within urban geographical locations. The common thread from existing research within the context of developing countries, particularly in Africa, is the need for health information to be provided in a way that considers the diverse cultural perspectives and characteristics of rural communities; regarding both the content and the design of health information services. Considering the cultural aspects is important. However, there is little or no work that has considered the provision of health information that is culturally and locally appropriate. This research aims to investigate the health information behaviour of men in rural Nigeria and explore the local sociocultural aspects that relate to the provision of prostate cancer information. The research extends the theoretical framework of Johnson’s Comprehensive Information Seeking model to include health-related information design heuristics that address aspects of cultural appropriateness within rural contexts and particularly within the setting of developing countries. A qualitative approach was adopted as it was considered appropriate for this research. The research utilised 35 semi-structured interviews and 5 focus group discussions with men (aged 35 or over) residing in rural areas of Nigeria. Participants shared their experiences with health-related information seeking and use, the barriers they encounter and the role that culture and rurality play in that process. Findings show that within rural Nigeria, culture and religion play a vital role in shaping the health information behaviour of men. There is a lack of knowledge about important health issues that affect men, such as prostate cancer. The study documents that internal, interpersonal sources and oral-based communication methods are preferred in rural communities. Based on the findings, a revised model of health information behaviour that extends the existing scholarly perspectives to include cultural context and information use component in rural communities in Nigeria was presented.

Estudo sobre o fenômeno dos grupos de apoio aos pacientes sob a ótica da Ciência da informação, tendo em vista as questões relacionadas ao acesso à informação e ao conhecimento no campo da saúde pública. O contexto preparatório da transição paradigmática da modernidade para a pós-modernidade tem como fenômeno inovador a ação dos grupos de apoio aos pacientes na promoção da saúde e da melhoria global da qualidade de vida, por meio de ações de informação. As ações desses grupos são observadas por meio de pesquisa empírica qualitativa. São investigadas de forma específica as fontes às quais recorrem os pacientes de doenças crônicas não transmissíveis para lidar com a incerteza. Os resultados de entrevistas com profissionais de saúde e pacientes reforçam a importância dos grupos e a confiança e solidariedade subjacentes a eles. Conclui-se que os pacientes recorrem em primeiro lugar ao médico quando necessitam de informação de alta confiabilidade, mas também aos enfermeiros, amigos e à mídia. Os resultados sugerem a necessidade de ampliação da operação pública dos grupos de apoio com vistas à promoção da saúde, ao acesso livre e aberto à informação científica transliterada em saúde pública. Sugerem também a necessidade de criação de sistemas de informação voltados especificamente para os mediadores dos grupos de apoio aos pacientes, segmento ainda não contemplado com dispositivos informacionais adequados de apoio ao desenvolvimento de suas ações. / Study on the phenomenon of the support groups for the patients under the optics of Information Science, with a view to the issues related to the information access and knowledge in public health; in the context of the paradigmatic transition of the modernism to post modernism, the support groups are considered as innovative input for patients under the standpoint of the support for the health promotion and the quality of life improvement. The research, a qualitative empirical survey, analyzes entities that promote support groups for patients of non communicable chronicle diseases, aims to identify which information sources the patients seek in order to deal with the uncertainty, and distress in face of the diagnosis of a chronicle disease. The results of the interviews with health professionals and patients show the importance of the groups and their character of confidence and underlying solidarity. It concludes that the patients consider physicians as their most important sources of information, but also ask the nurses, friends and the media for more information. The study suggests some parameters for the expansion of the public operation of the support groups with a view to the health promotion, to the free and open access to \"translated\" scientific information in public health. It suggests also that there is a lack of specific information systems to support the professionals that work as information intermediaries in such groups.

Esta pesquisa caracteriza-se como qualitativa e descritiva, tendo por objetivo mapear os processos de geração e uso de informações clínicas no contexto da Radiologia Médica, utilizando como referência o Ciclo Informacional estudado na Ciência da Informação, visando a identificar metadados que possam ser empregados em arquivos didáticos para uso em práticas de ensino em Radiologia. A metodologia é dividida em quatro etapas: 1) estudo do ciclo informacional, com o intuito de conhecer propostas de autores que sistematizam os processos de geração e uso da informação; 2) descrição do fluxo de trabalho de um departamento de Radiologia Médica - IHE -, para identificar os diferentes atores nesse ambiente; 3) análise dos processos do ciclo informacional no fluxo de trabalho de um departamento de Radiologia Médica, para entender o processo de geração e uso de informações na área; e 4) análise comparativa entre os metadados indicados para o fluxo de trabalho de um departamento de Radiologia Médica - DICOM - e os metadados utilizados nas bases de imagens médicas MyPACs e Auntminnie, a fim de levantar um conjunto de informações da prática clínica para uso em arquivos didáticos. Ao estudar o fluxo de trabalho de um departamento de Radiologia foram mapeadas as informações geradas e utilizadas em cada etapa, resultando na identificação de um conjunto de metadados advindos da prática clínica, que podem ser utilizados na criação de arquivos didáticos. Neste trabalho, conclui-se que estudar os processos de geração e uso de informações clínicas, em conjunto com outros temas, pode ajudar a pensar em metodologias para organização da informação, com a finalidade de viabilizar a recuperação de informação entre aplicações que possam ser utilizadas em contextos diversos no ambiente da Radiologia Médica. / This qualitative and descriptive research aimed to map the processes related to generation and use of clinical information in Medical Radiology. In order to identify metadata for creating Radiology teaching files, the Information Cycle - adopted by Information Science - has been used such as a theoretical reference. The methodological approach was divided into four steps: 1) aiming to know approaches proposed by authors who systematize the processes related to information\'s generation and use, the information cycle was investigated; 2) by systematizing the workflow found in a Radiology Department (by using IHE\'s documents), regular users present in this environment were identified; 3) based on Medical Radiology\'s workflow and aiming to understand the information\'s generation and use processes, the steps part of the information cycle were studied; and 4) comparative analysis using metadata part of Radiology Department\'s workflow (based on DICOM standard documentation) and metadata used in the MyPACs and Auntminnie medical image databases, such analysis was done in order to select a set of information from clinical practice which may be used in teaching files\' creation. When the Radiology\'s workflow was studied, the information generated and used in each step was identified. As a result, groups of metadata from the clinical practice were identified and such metadata may be used aiming to create teaching file. In this work, we have concluded that by investigating processes related to clinical information generation and use, combined with other themes, may help to think about information organization\'s methodologies. This offers means to retrieve information from various clinical systems and the retrieved information can be used in different Radiology contexts.

A interoperabilidade entre sistemas de informação em saúde está se tornando fundamental para o compartilhamento da informação num ambiente de saúde, onde normalmente as diversas especialidades que atuam no atendimento ao paciente armazenam seus dados, em sistemas computacionais distintos e em regiões geograficamente distribuídas. Devido à diversidade existente entre estes sistemas, a integração as vezes torna-se difícil. Os problemas de interoperabilidade podem ser técnicos, onde os componentes de computação dos sistemas não permitem a cooperação devido às diferenças nos protocolos de comunicação ou semânticos, ocasionados devido à diversidade de representação da informação transmitida. Este trabalho propõe uma arquitetura para facilitar ambos os aspectos de interoperabilidade, sendo que a interoperabilidade técnica é proporcionada pela utilização de um middleware e a semântica, pela utilização de sistemas de terminologia adotados internacionalmente. Para a implementação de referência foi utilizada como middleware a arquitetura CORBA e suas especificações para o domínio da saúde, sendo que uma das especificações CORBA para o domínio da saúde foi adotada para padronizar a comunicação com os sistemas de terminologia. Para validar a implementação, foi construído um aplicativo cliente baseado na análise de requisitos de uma UTI neonatal. O cliente foi utilizado também para acessar os componentes implementados e verificar dificuldades e ajustes que podem ser feitos na implementação. / The interoperability among health information systems are becoming fundamental to share the information in a health environment, here commonly the diverse medical specialties that act in the patient care store the data, in distinct computational systems and in geographically distributed regions.Because of the existing diversity among these information systems, the integration can be a difficult task. Interoperability problems can either be technical, when the communication components do not cooperate due to the diversity of the information representation. This work proposes an architecture to improve both interoperability aspects. The technical and partial semantic interoperability is achieved by the use if a middleware whereas the semantic interoperability by the use of internationally approved terminological systems. For the reference implementation was used the CORBA middleware architecture. One of the CORBA specifications in health care was adopted to standardize the communication with the terminological systems. To validate the implementation it was developed a client application based on the requirement analysis of neonatal ICU. The client application was also used to access the software components and to verify possible problems.

This research examined if there is a relationship between engagement in quality improvement (QI) and health information technology (HIT) for local health departments (LHDs) controlling for workforce, finance, population, and governance structure. This was a cross-sectional study that analyzed data obtained from the Core questions and Module 1 in the NACCHO 2010 Profile of LHDs. Descriptive statistics, bivariate analyses, and logistic regression analyses were conducted. Findings suggest that LHD engagement in QI has a relationship with utilization of HIT including electronic health records, practice management systems, and electronic syndromic surveillance systems. This study provides baseline information about the HIT use of LHDs. LHDs and their system partners (hospitals, federally qualified health centers, and primary care providers) that utilize HIT as part of their QI decision making may have an easier time of using data to support evidence-based decision making and implementing the provisions of the Patient Protection and Affordable Care Act of 2010 in order to achieve population health for all.

Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 clinical business managers in 2 successful small health care clinics located in the mid-Atlantic region of the United States. Data were collected from semistructured interviews with health care leaders and documents from the health care organization as a resource. Inductive analysis was guided by the Donabedian theory and sociotechnical system theory, and trustworthiness of interpretations was confirmed through member checking. Three themes emerged: standardizing data formats reduced medication errors and increased profits, adopting user-friendly HIE reduced medication errors and increase profits, and efficient communication reduced medication errors and increased profits. The findings of this study contribute to positive change through improved health care delivery to patients resulting in healthier communities.

In a context where technology is increasingly being incorporated into health care practice, many U.S. health care providers and organizations are finding it challenging to connect disparate electronic documentation systems to retrieve patient information when coordinating care across providers and heath care entities. Local and regional health information exchange (HIE) systems were created to facilitate collecting information into one integrated patient record to address information transfer between heath care providers. Yet, adoption and use of HIEs have been low. The purpose of this study was to review the predictive factors accounting for physicians' use of a HIE in the U.S. state of Hawaii. Key factors from the technology acceptance model were evaluated to determine the behavioral intention resulting in actual use of the Hawaii health information exchange (HHIE). Physician characteristics (medical specialty, age, and gender) and location characteristics were also assessed. The total population of the study contained 1034 Hawaii physicians who have signed up to use the HHIE. Linear and logistic regression models were structured to evaluate the predictive nature of (a) use to determine if a physician has ever logged into the HIE and (b) usage to evaluate the extent to which a physician is logging into the HIE. Findings from the study reveal a predictive relationship between the characteristic of medical specialty and HHIE use when comparing primary care and emergency department physicians to physician specialists. Using study results, health care leaders can improve physician outreach and review barriers when using the HIE systems to coordinate care. Policy implications include the possible formulation of future requirements surrounding HIE physician participation.

The intention of implementing technology into healthcare practices is to reduce opportunity for errors in the delivery of providing health care. However, errors still occur, and many times are preventable. Configurations of health information technology systems should match clinical workflows to promote usage as intended. The purpose of this quality improvement project was to evaluate the impact of revised system configurations and use of a blood product transfusion system for the administration of blood products after one year of implementation. The method of heuristic evaluation is a usability engineering method for finding problems in a user interface design with the input of a small workgroup of subject matter experts. The project site had experienced reported incidents of blood product administration error as well as problems with systems communication since the implementation of the blood transfusion system. There were 31 nurse clinical educator staff users of the system who completed a survey evaluation of their perceptions of the blood transfusion system before and after configuration changes. The findings revealed that the mean quality and productivity score after the system configuration occurred was significantly higher than the mean score prior to the system configuration change, t (30) = -7.93, p < .001. The correlation between the one survey was also statistically significant, r = .46, p = .009. This project supports positive social change by reducing the potential for error for system users in the process of the blood administration process through heuristic evaluation through the implementation of changes to the technological system.

<p>HIV/AIDS is the largest and most serious global epidemic in the recent times. To date, the epidemic has affected approximately 40 million people (range 33 &ndash / 46 million) of whom 67%, that is, an estimated 27 million people are in the Sub Saharan Africa. The Sub Saharan Africa is also reported to have the highest regional prevalence of 7.2% compared to an average of 2% in other regions. A medical cure for HIV/AIDS remains elusive but use of antiretroviral therapy (ART) has resulted in improvement of quality and quantity of life as evidenced by the reduction of mortality and morbidity associated with the infection, hence longer and good quality life for HIV/AIDS patients on ART.</p>

In the light of an ageing society with shrinking economic resources, deinstitutionalization of elderly care is a general trend. As a result, homecare is increasing, and increasingly shared between different health and social care organizations. To provide a holistic overview about the patient care process, i.e. to be patient-centred, shared homecare needs to be integrated. This requires improved support for information sharing and cooperation between different actors, such as care professionals, patients and their relatives. The research objectives of this thesis are therefore to study information and communication needs for patient-centered shared homecare, to explore how integrated information and communication technology (ICT) can support information sharing, and to analyze how current standards for continuity of care and semantic interoperability meet requirements of patient-centered shared homecare. An action research approach, characterized by an iterative cycle, an emphasis on change and close collaboration with practitioners, patients and their relatives, was used. Studying one specific homecare setting closely, intersection points between involved actors and specific needs for information sharing were identified and described as shared information objects. An integration architecture making shared information objects available through integration of existing systems was designed and implemented. Mobile virtual health record (VHR) applications thereby enable a seamless flow of information between involved actors. These applications were tested and validated in the OLD@HOME-project. Moreover, the underlying information model for a shared care plan was mapped against current standards. Some important discrepancies were identified between these results and current standards for continuity of care, stressing the importance of evaluating standardized models against requirements of evolving healthcare contexts. In conclusion, this thesis gives important insights into the needs and requirements of shared homecare, enabling a shift towards patient-centered homecare through mobile access to aggregated information from current feeder systems and documentation at the point of need.