SEARCH · Search PubMed

Results for “Public Health Informatics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources

PubMed2004

Informed consent to the secondary use of EHRs: informatic rights and their limitations.

It is frequently asserted that the secondary use of data contained in electronic health records (EHRs) requires the informed consent of the subjects of these records. This paper argues that while correct in principle, this has four important ethically based limitations: when it seriously threatens the equal and competing right of others, when it undermines the ability of health care providers to carry out their mandates, when it imperils the possibility of establishing and maintaining a health care system in the first place, and when it makes bona fide research impossible. Nevertheless, as a general rule, when consent can be had, it should be had. This paper provides a theoretical basis for these claims by looking at the nature and role of EHRs and provides some possible approaches for incorporating them into the health care delivery process.

Confidentiality↗

PubMed2002

[Proliferation of medical schools in latin America. Causes and consequences].

Significant changes in university education have occurred in Latin America, caused by the strategic importance that it has on economical and social development. The educational system expanded and science, technology and informatics, experienced an important development. The eighties were characterized by a reduction in government expenditures, a more efficient use of resources, an increase in the number and variety of universities and university students. The creation of new universities, mostly private, was favored by a highly unregulated market. In Latinamerica, more new universities were created during the eighties than in the previous one hundred years. Since 1981, the number of universities in Chile increased from 8 to 60, the type of institutions was diversified, the government financing of public universities decreased substantially and the regulatory role of the market was emphasized. These changes have been quantitatively understandable but qualitatively unsatisfactory. Since 1981, the number of university students between 19 and 24 years old has triplicated. The number of medical schools and the annual admission of students has duplicated. In most Latin American countries, there is an insufficient number of physicians (Chile has one physician per 783 inhabitants). Since the decade of the nineties, an effort has been made to regulate the market, to introduce new barriers for the acceptance of new educational institutions, to improve the transparency of the system and to preserve the quality of teaching. The quality control of medicine and health is one of the most serious problems in Latin American countries. This includes accreditation of medical schools, health centers and specialists. In Chile there have been some progress in these topics but quality control is still unsatisfactory.

Chile↗

PubMed2005

E-health progresses in Romania.

The paper is presenting the recent evolution of e-health aspects in Romania. Data presented are based on governmental reports. Surveys organized by the "Lucian Blaga" University of Sibiu and studies carried on by the national Institute for Research and Development in Informatics (I.C.I.) have shown that Romania has important health problems, from cardio vascular diseases (CVD) to cancer and infectious diseases, a high score on mortality and morbidity and a low one on natality. Poor management of the health sector did not help to solve all these problems. In the last 14 years there were several attempts to reform healthcare but none succeeded until now. The health insurance system is operational but needs still to be improved. Acknowledging the deep crisis of the health system the Prime Minister nominated a new minister of health and important changes in the health management approach are to be envisaged. One of this is the introduction of the e-procurement system for all health related goods. In spite of the crisis of the health system, e-health applications are flourishing. We can distinguish applications at national and local level and also punctual applications. The main applications refer to hospital information systems (HIS), electronic health records (EHR), e-procurement, image processing, diagnosis and treatment aids, telediagnosis, teleconsultation, education, research and domain oriented web support services. Most academic clinical hospital is now members of a web community "mednet". Unfortunately a lot of medical web sites have disappeared for lack of funds. As the health sector is in general funded from the public budget and the health crisis is deepened in the last years, the driving force in implementing e-health concepts and technologies is not the Ministry of Health but the Information Technology (IT) community, with a strong support from the Ministry of Information Technology and Communications and also from the Ministry of Education and Research, the Romanian Academy and professional non-governmental organizations. Our government has established the strategy for achieving the e-society for almost all domains but healthcare is still the Cinderella. It is expected that IT will play the role of the Fair Godmother by improving the general health status of the population through a better management of health services and better access to information and knowledge, for both major actors: the health professionals and the citizens.

Database Management Systems↗

PubMed2002

Information society in Czech healthcare 'starting point' to prognosis for the year 2013.

A prognosis of how the information society in health care will look like in 2013 must start from the current state of affairs at the given locality regarding healthcare management by public authorities including legislative, ICT technological levels and accessibility of professional knowledge in individual fields of medicine. It is presumed that after 10 years the influence of this 'starting point' will still persist and knowledge of the current state of affairs will be needed to positively but also negatively differentiates the prognosis [Health Care in the Information Society: A Prognosis for the Year 2013, in this issue] for individual localities, e.g. Germany versus neighbouring the Czech Republic. The present article focuses on aims of Czech health care and the measures that are taken in Czech health care that are carried out and which have been already initiated. Their significance towards the future prognosis according to [Health Care in the Information Society: A Prognosis for the Year 2013, in this issue] is clear. The first measure is legalisation of conditions, which allow health care administration only be carried out with electronic forms and the protection of these sensitive personal data when they are placed in a centralised data depository where they are prepared for physicians who use them while providing health care in health institutions. In the Czech Republic an information system is developed called Internet Access to Health Patient Information (IHPI). The second measure is creating a unified central system of health information together with methodologies for data collection, data standards and protocols. In the Czech Republic there is the National Health Information System (NHIS) governed by the Institute for Health Information and Statistics (IHIS CR). The NHIS enables care providers to get information about the health state of citizens, about health institutions, about their activities and economics, it enables to regulate the provision of health care, to define conceptions of state health politics and to administrate public health. The third measure is legalisation of possibilities to establish centralised health care registers that are designated for recording and following of patients with chosen socially serious diseases. These registers help with diagnosis and therapy and reveal consequences of diseases for the patients. It helps to evaluate accessibility and quality of provided health care in the country. An important goal of the use of health care registers and information systems is for educational purposes and as causal expert systems for physicians. The National Health Registers have been introduced to the whole of the Czech Republic; some of them are accessible on-line in a countrywide data network. The last part of the paper focuses on research and education for developing the information society in Czech health care and on co-operation with EU countries in selected projects and initiatives.

Computer Systems↗

PubMedDate not supplied

Emergency medical services information systems and a future EMS national database.

Since the early 1970s, various publications and legislation have contributed to the development of emergency medical services (EMS) information systems and databases. Yet, even today, EMS systems vary in their ability to collect patient and systems data and to put these data to use. In addition, no means currently exists to easily link disparate EMS databases to allow analysis at local, state, and national levels. For this reason, the National Association of State EMS Directors is working with its federal partners at the National Highway Traffic Safety Administration (NHTSA) and the Trauma and EMS program of the Health Resources and Services Administration's (HRSA's) Maternal and Child Health Bureau to develop a national EMS database. Such a database would be useful in developing nationwide EMS training curricula, evaluating patient and EMS system outcomes, facilitating research efforts, determining national fee schedules and reimbursement rates, and providing valuable information on other issues related to EMS care.

Database Management Systems↗

PubMedDate not supplied

Nursing research in smoking cessation: a listing of the literature, 1996-2005.

A listing of publications related to nurses and tobacco is posted on the Tobacco Free Nurses Web site (www.tobaccofreenurses.org). For this conference, a chronological listing of the numbers and type of data-based articles that focused on nursing involvement in tobacco cessation published since 1996, the year of the first publication of the Agency for Health Care Policy and Research, Clinical Practice Guideline #18, through 2005 was developed. One hundred and seventy-five data-based papers that met the criteria, that is, the paper focused on smoking cessation and involved nurses, were identified. Most (88%) articles were exclusively focused on cessation. Research designs included experimental (38%), quasi-experimental (24%), descriptive-quantitative (25%), descriptive-qualitative (8%), meta-analyses (2%), and secondary analyses and systematic reviews (each 1%). The number of articles that focused on nursing involvement in tobacco cessation has increased eight fold in the past 10 years, from less than 5 articles published in 1996 to more than 40 published in 2005. The minority (35%) of data-based articles that focused on nurses and tobacco cessation were published in nursing journals.

Bibliometrics↗

PubMed1999

Challenges and future directions for tailored communication research.

As informatics technology advances, a growing number of research trials on tailored communications provide an accumulation of promising evidence to support their efficacy. These trials also reveal gaps and opportunities for future research. The scope and boundaries of tailoring must be redefined in terms of both new technology and the trade-offs between complexity, demand burden on participants, and the minimal information required for effective and efficient tailoring. Basic and methods research is needed to broaden theory, develop a common language, standardize measures, and isolate the key mediating mechanisms that facilitate tailored communications. Applied research must consider more rigorous research designs for efficacy trials and conduct more effectiveness trials to investigate the mechanisms of technology transfer to enhance large-scale diffusion of tailored communications. The role of contextual variables needs to be examined, as well as their interaction with different population groups, and also the channels, modes, and methods of tailored message delivery. Research is also needed on the feasibility of tailoring across clusters of multiple risk factors to identify the commonalities, differences, and interrelations among diverse behaviors. The potential cost-effectiveness of tailored communications must also be examined. No matter how efficacious, tailored communications delivered to large populations (i.e. mass-customization) will not make a public health impact unless proven to be practical and cost-efficient.

Cost-Benefit Analysis↗

PubMed2005

Wireless technology infrastructures for authentication of patients: PKI that rings.

As the public interest in consumer-driven electronic health care applications rises, so do concerns about the privacy and security of these applications. Achieving a balance between providing the necessary security while promoting user acceptance is a major obstacle in large-scale deployment of applications such as personal health records (PHRs). Robust and reliable forms of authentication are needed for PHRs, as the record will often contain sensitive and protected health information, including the patient's own annotations. Since the health care industry per se is unlikely to succeed at single-handedly developing and deploying a large scale, national authentication infrastructure, it makes sense to leverage existing hardware, software, and networks. This report proposes a new model for authentication of users to health care information applications, leveraging wireless mobile devices. Cell phones are widely distributed, have high user acceptance, and offer advanced security protocols. The authors propose harnessing this technology for the strong authentication of individuals by creating a registration authority and an authentication service, and examine the problems and promise of such a system.

Cell Phone↗

PubMed2006

Dealing with an information overload of health science data: structured utilisation of libraries, distributed knowledge in databases and Web content.

The organizational structures of web contents and electronic information resources must adapt to the demands of a growing volume of information and user requirements. Otherwise the information society will be threatened by disinformation. The biomedical sciences are especially vulnerable in this regard, since they are strongly oriented toward text-based knowledge sources. Here sustainable improvement can only be achieved by using a comprehensive, integrated approach that not only includes data management but also specifically incorporates the editorial processes, including structuring information sources and publication. The technical resources needed to effectively master these tasks are already available in the form of the data standards and tools of the Semantic Web. They include Rich Site Summaries (RSS), which have become an established means of distributing and syndicating conventional news messages and blogs. They can also provide access to the contents of the previously mentioned information sources, which are conventionally classified as 'deep web' content.

Computer Communication Networks↗

PubMed2002

Survey of public information about ongoing clinical trials funded by industry: evaluation of completeness and accessibility.

OBJECTIVE: To evaluate the completeness and accessibility of public information about US clinical trials of drugs in development. DESIGN: Review of online registers of clinical trials. DATA SOURCES: Drugs in phase III trials were identified using three drug industry sources: PhRMA Survey, What's in the Pipeline, and the NDA Pipeline. Drug trials were then searched for on the following publicly accessible registers of clinical trials:, and registers associated with the 37 "Comprehensive Cancer Centers" designated by the National Cancer Institute. MAIN OUTCOME MEASURE: Extent of availability of public information on phase III trials of drugs in development for treating either prostate or colon cancer. RESULTS: Search of industry sources identified 12 drugs for prostate cancer and 20 for colon cancer undergoing phase III trials. The most comprehensive publicly available register, contained trial listings for only seven of the prostate cancer drugs and 10 of the colon cancer drugs. Trials of three prostate cancer and three colon cancer drugs were listed on only one register each. A substantial proportion of trials of prostate cancer drugs (3/12) and colon cancer drugs (8/20) were not associated with trial listings in any registers. CONCLUSIONS: Existing trials registers are unlikely to be meeting user needs since many ongoing drug trials are not listed. There is a clear need for a comprehensive clinical trials register encompassing all ongoing trials, including industry sponsored trials.

Antineoplastic Agents↗

PubMed2002

[The Internet and self treatment: how to put them together?].

Information and communication technology through the Internet has brought about elements/processes/objects produced in order to be used by humane bio-sciences related to bio-medicine activities, such as public health. ICT has been covering larger domains of medical information, producing fields of specialization known as telemedicine, cyber-medicine and consumers' health information. It tries to meet consumers' need of information, by apparently creating something similar to self-treatment with some expertise. This way, consumers would be able to make more 'educated' decisions in terms of their acquisitions in the area of health. In order to reach this objective, computer programs have come up with health decision aids software. It is clear the mingling of three powers that participate in the mechanisms that organize present day life - instrumental reasoning and its technical production, the power created by the union of institutions and ideologies, and the belief in the myths, symbols and rites of scientific technology. As a possible result, we may have the colonization of societies by authorities that produce specialized knowledge, by professionals that apply such knowledge to produce technological items or pack them in technological cases, by industrial systems and by information, distribution and commercial nets.

History, 20th Century↗

PubMed1995

Assessment of the level of the actual and desirable levels of computer literacy, usage and expected knowledge of undergraduate students of nursing.

The aim of the study was to determine the perceptions of students entering nursing at the bachelors level, of their actual and desirable knowledge about computers and their applications relevant to nursing and health care. Within the health care system the use of computerized systems is increasing rapidly. In Australia, the NSW Health Department's Information Management Resource Consortium pilot project--to introduce the First Data Hospital Information System into NSW public hospitals--is a significant example of this trend. While the importance of computerized systems is fairly well recognized for the areas of management and research, they are becoming increasingly significant in the delivery of clinical care and quality assurance. It is important that nurses during their undergraduate education develop the computer literacy and awareness that will allow them access to the both the information and its management. To achieve this effectively it is essential to determine both the entry knowledge of students and what skills and knowledge are essential and desirable for their future roles as nurses. The research undertaken replicated an American study [2] and used their validated questionnaire. Both pre-registration(n=20) and post-registration (n=24) undergraduate students responded to a 21 item questionnaire. The issues addressed related to computer literacy, usage, and knowledge of clinical applications. Both groups desired more "hands on" experience and knowledge in the nurse's role in developing applications and using computers to help care for patients. These results were consistent with the Parks et. al. study. The significance of comparing actual and desirable levels of computer knowledge and awareness is in assisting educators to shape curriculum and course content to more effectively meet the educational needs of these groups in terms of Health Informatics.

Attitude to Computers↗

PubMedDate not supplied

Internet-based patient self-care: the next generation of health care delivery.

The United States health care system is an outdated model in need of fundamental change. As part of this change, the system must explore and take advantage of the potential benefits of the "e-revolution," a phenomenon that includes everyday use of the Internet by the general public. During 2002, an estimated 100 million Americans will have obtained information--including health information--from the Web as a basis for making decisions. The Internet is thus an influential force; and, as such, this medium could have a revolutionary role in retooling the trillion-dollar United States health care industry to improve patient self-management, patient satisfaction, and health outcomes. As a group, physicians use the Internet more than do many other sectors of the general adult population. However, physicians have not received sufficient information to convince them that they can provide higher-quality care by using the Internet; indeed, few studies have assessed the Internet's value for improving patients' medical self-management and health behavior, as well as their clinical outcomes and relationships with health care practitioners. New e-technology formats introduced to the growing consumer movement will drive the next generation of self-care by allowing patients to manage their own health conveniently and proficiently.

Attitude to Computers↗

PubMedDate not supplied

[Descriptive study of morbidity and mortality due to asthma at a Health Sector institution].

The objective of this study was to determine the morbidity and mortality rate due to asthma from a Health Institution, which represents the majority of working population. Asthma data were obtained from the National Institute of Informatical, Geography and Statistics (INEGI), Mexican Health Secretary (SS) and Mexican Social Security Institute (IMSS). The underlying cause of death hospitalization or visit were obtained. Asthma was coded according to the International Classification of Disease (ninth revision). Asthma death rate was adjusted by age using direct method. In the IMSS, asthma death rate increased from 3.24/200,000 in 1980 to 12.76/100,000 in 1990. The asthma letality increased from 0.34 in 1980 to 1.23 in 1990. The average length of hospital stay was 3.96 days in 1990; there was noy significant differences by sex the most affected groups were children under 4 years of age and persons older than 65 years of age. In conclusion, from 1980 to 1990, the morbidity and mortality rate due to asthma in IMSS increased. It suggests that future health policy efforts should be focused to reduce the morbidity, mainly in high risk groups.

Adolescent↗

PubMed1997

[Expert systems for medicine--functions and developments].

Medical knowledge doubles every five years. Electronic media are necessary to manage these volumes. "Multimedia" and "information highway" are buzz-words and also concern medicine. Medical informatics tries to build a bridge between medical research which generates knowledge and daily practice in hospitals, ambulatory care and public services. Knowledge is used in different representations for multiple purposes and functions. Expert systems are mostly designed to fulfil certain functions and to support routine clinical practice. This paper tries to point out some important functions and to explain the capabilities by means of two example systems which can be used in several medical units. The main problem in using expert systems is, besides the quality of knowledge, the availability of patient data. For this reason the existence of an electronic patient record is another area which will be described in this paper. Expert systems are specialised medical information systems and have to fulfil the same success criteria as all the other systems, e.g. the integration into the daily routine as a trusted tool.

Adult↗

PubMed2004

Methods for enhancing the efficiency of dental/oral health clinical trials: current status, future possibilities.

In recent years, there has been an increasing demand for clinical trials to study oral, dental, and craniofacial diseases and conditions. This has resulted from such factors as the increasing pace of discoveries requiring translational research to develop them for clinical use, FDA requirements for product approval, a need for additional data to support evidence-based dental practice, and the expansion of the NIDCR's clinical research programs. The complexity, size, and duration of clinical trials often make them quite costly to conduct, and may impede the development of novel diagnostic, preventive, and therapeutic methods that could have a significant impact on clinical practice and inform public health policy. Recent advances in such areas as genomics and proteomics, coupled with the development of new technologies, have expanded our knowledge of the etiology and pathogenesis of disease and, from this, have provided new insights into the design and conduct of clinical trials. The workshop, "Methods for Enhancing the Efficiency of Dental/Oral Health Clinical Trials: Current Status, Future Possibilities", held on May 6-7, 2004, considered a variety of ways in which these insights are being, or have the potential to be, applied to clinical trials so as to enhance their efficiency and, hence, their cost-effectiveness, without diminishing the quality of information produced. The focus of this workshop was to assess the state of the science and identify research needs for the use of biomarkers, surrogate endpoints, and new technologies in oral disease clinical trials. Examples of ways in which clinical trials of other diseases have benefited from the use of new methods and technologies and FDA considerations were also discussed.

Biomarkers↗

PubMed2002

[Well-informed on health matters--how well? The German 'Clearinghouse for Patient Information'--objective, background and methods].

OBJECTIVE: Health information for lay people in print or electronic form are internationally recognised as useful tools and as necessary in the decision-making process of individuals. The effectiveness of offered patient information depends on quality and accessibility. Because much of the available health information is significantly deficient, the Agency for Quality in Medicine developed a programme for assessing the quality of specialised health and medical information for all non-medically trained persons. The German 'Clearinghouse for Patient Information' project is an adjunct to the already established German 'Clearinghouse for Clinical Guidelines'. METHOD: The basis for quality improvement for specialised medical information consists 1. in the determination of demands on quality for patient information published in the German language, 2. development of a standardised instrument for assessing the quality of specialised medical information by non-medically trained persons, 3. establishment of an Internet portal for evaluated and rated material, and 4. the establishment and organisation of relevant partnerships with information providers and users of health and medical information. The principle building block to rate medical information for lay people are the DISCERN criteria for good patient information. The results of the quality rating of specialised medical information are made available to the public with emphasis on promoting transparency of the assessment and rating processes used. RESULTS: The Internet-based patient information service of the Agency for Quality in Medicine (www.patienten-information.de 19.06.02) has currently a selection of approximately 800 information items covering fifty disease topics with fully or partially evaluated and rated information. Partnerships to appropriate information providers and users are already established and have been tested in special single projects. CONCLUSION: To advance the process of quality improvement for medical information for non-medical and lay persons, it is essential to develop and to intensify the cooperation with stake holders and partners at different levels. Only through close cooperation with others it is possible to create a basis to continuously develop and improve the information quality assessment instrument further. In addition, effective strategies need to be developed to disseminate these endeavours to patients and consumers of health information in a user-friendly and transparent way.

Evidence-Based Medicine↗

PubMed1992

What can information systems do for primary health care? An international perspective.

The reform of health information systems has been made a priority by health managers, public health specialists and technocrats. While each of these groups has promised major benefits from improvements in information systems, insufficient attention has been paid to the limitations placed upon the theoretical possibilities of information technology by the characteristics of the health system of which the information system is but a part. Managers anticipate improved efficiency and rational allocation of resources, but rational decision making does not automatically follow from improvements in information. Epidemiologists and public health specialists seek more effective and equitable health systems but methodological problems and the expense of many conventional epidemiological approaches continue to limit the usefulness of disease surveillance, programme monitoring and evaluation. Both managers and epidemiologists are confronted with the conflicts which arise in seeking to create locally sensitive information systems within centralised health systems. Technocrats see microcomputers as essential for information systems to be truly effective and as a means of liberating health workers from the drudgery of form filling. However, the rate of organisational evolution in the health system has not kept pace with the rapid development of information technology. There are good prospects for considerable health gain to be wrought from reforms in health information systems but to realise these it is necessary that this process be 'action-led' rather than, as is conventional, 'data-led'. The latter approach sees data as the end in itself; the 'action-led' approach, in contrast, regards information as needs to interventions with a focus on how information will influence decisions. For improvements in information to result in improved health, strategies must be adopted which will ensure that information routinely informs decisions and is seen as a means to the end of improving health.

Decision Making↗