Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health data integration”

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.

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

At least 1,063 records · Page 59Linked to original sources
PubMed2001

Effect of changes in antibiotic prescribing on patient outcomes in a community setting: a natural experiment in Australia.

This study examined whether a significant change in antibiotic use caused by an Australian government directive targeted at amoxicillin with clavulanic acid (AC) was associated with changes in prescription share, health care costs, and patient outcomes. We used an integrated database of computerized general practice medical records, which included data regarding 34,242 patients and 318,234 recorded patient visits. There were 15,303 antibiotic prescriptions provided to 9921 patients during a 4-year period, with AC prescribed for 1453 (14.6%) of these patients. A total of 5125 patient outcomes were identified. There was a shift away from best-practice antibiotic prescribing, and a significant association was identified between the rate and cost of process-of-care and patient outcomes and the decrease in AC-prescription share. This policy initiative created unintended changes in prescribing behavior, increased costs to the government, and a trend toward poorer patient outcomes. Detailed analyses are required before instigating initiatives aimed at changing clinicians' prescribing behavior.

Adolescent↗
PubMed2006

A notary archive model for secure preservation and distribution of electrically signed patient documents.

The healthcare industry is moving from paper-based documentation into the digital era. Electronic health records (EHR) are playing a major role in this development. Electronic health records will not only to be shared among a growing number of healthcare providers but they have also to be archived over long periods of time. The required life cycle depends of national regulations, but typically the preservation time of patient data varies between 20 and 100 years. Availability, integrity, confidentiality and non-repudiation of stored data over these lengthy preservation periods needs to be fully proven, both to preclude loss and also ensure the ability to read and understand content is maintained. This document describes a co-operative trusted notary archive (TNA) which receives granular health data from different EHR-systems, stores data together with associated meta-information for long periods and distributes granular EHR-data objects. TNA communicates with EHR-systems and external users via archive request and distribution messages. TNA can store objects in XML-format and prove the non-repudiation and integrity of stored data with the help of event records, Time-stamps and archive e-signatures.

Access to Information↗
PubMed2005

Ecotoxicological evaluation of diesel-contaminated soil before and after a bioremediation process.

Evaluation of contaminated sites is usually performed by chemical analysis of pollutants in soil. This is not enough either to evaluate the environmental risk of contaminated soil nor to evaluate the efficiency of soil cleanup techniques. Information on the bioavailability of complex mixtures of xenobiotics and degradation products cannot be totally provided by chemical analytical data, but results from bioassays can integrate the effects of pollutants in complex mixtures. In the preservation of human health and environment quality, it is important to assess the ecotoxicological effects of contaminated soils to obtain a better evaluation of the healthiness of this system. The monitoring of a diesel-contaminated soil and the evaluation of a bioremediation technique conducted on a microcosm scale were performed by a battery of ecotoxicological tests including phytotoxicity, Daphnia magna, and nematode assays. In this study we biostimulated the native microflora of soil contaminated with diesel by adding nutrients and crop residue (corn straw) as a bulking agent and as a source of microorganisms and nutrients; in addition, moisture was adjusted to enhance diesel removal. The bioremediation process efficiency was evaluated directly by an innovative, simple phytotoxicity test system and the diesel extracts by Daphnia magna and nematode assays. Contaminated soil samples were revealed to have toxic effects on seed germination, seedling growth, and Daphnia survival. After biostimulation, the diesel concentration was reduced by 50.6%, and the soil samples showed a significant reduction in phytotoxicity (9%-15%) and Daphnia assays (3-fold), confirming the effectiveness of the bioremediation process. Results from our microcosm study suggest that in addition to the evaluation of the bioremediation processes efficiency, toxicity testing is different with organisms representative of diverse phylogenic levels. The integration of analytical, toxicological and bioremediation data is necessary to properly assess the ecological risk of bioremediation processes.

Animals↗
PubMed1989

Strategies for developing innovative programs in international medical education. A viewpoint from Latin America.

Problems affecting the quality of medical education and health services in Latin America include variable standards of medical education, geographic maldistribution of physicians, a shortage of nurses and allied health workers, overtraining of physicians in high technology, government control of health and education systems, and economic problems. The Panamerican Federation of Associations of Medical Schools (PAFAMS) was founded for the purpose of addressing such problems in Latin American medical education. PAFAMS has promoted the exchange of ideas and experience among its member associations and schools by establishing a data base of information on medical education and developing mechanisms to disseminate such information. Other PAFAMS initiatives include a program to integrate professional health education and health care services within individual communities, and the linkage of medical education programs with health care institutions as a means of improving the quality of health care. A crucial next step in Latin America is the development of a leadership program to identify and nurture leaders in individual countries who will be instrumental in developing community-based health services by means of medical education oriented to such purpose. Thus, the key issue is to develop healthcare-oriented medical education.

Education, Medical↗
PubMed2004

Designing a data and safety monitoring plan.

Evidence-based nursing practice is now the expected standard of care intensifying the need to conduct clinical research studies to investigate the efficacy of nursing interventions. To ensure that the urgency to document such efficacy does not compromise human participant safety, government research funding agencies are advocating special procedures to protect individuals who voluntarily participate in research studies. The National Institutes of Health application for clinical trial funding requires a data and safety monitoring plan (DSMP) to enhance human participant safety and clinical research integrity. This article describes an approach to developing a DSMP that includes a study risk assessment and a monitoring design based on that assessment.

Clinical Trials Data Monitoring Committees↗
PubMed2003

Integrating GIS components with knowledge discovery technology for environmental health decision support.

This paper presents a new category of decision-support tools that builds on today's Geographic Information Systems (GIS) and On-Line Analytical Processing (OLAP) technologies to facilitate Geographic Knowledge Discovery (GKD). This new category, named Spatial OLAP (SOLAP), has been an R&D topic for about 5 years in a few university labs and is now being implemented by early adopters in different fields, including public health where it provides numerous advantages. In this paper, we present an example of a SOLAP application in the field of environmental health: the ICEM-SE project. After having presented this example, we describe the design of this system and explain how it provides fast and easy access to the detailed and aggregated data that are needed for GKD and decision-making in public health. The SOLAP concept is also described and a comparison is made with traditional GIS applications.

Artificial Intelligence↗
PubMed2005

Surveillance and control of infectious diseases at local, national and international levels.

New emerging and re-emerging threats, the weight of public opinion and new technology for surveillance and treatment are likely to impact on how, and if, effective surveillance can be performed in the future. If surveillance fails to address the needs of practitioners and policy-makers, it is likely that there will be loss of confidence. Current surveillance systems are reasonably effective at detecting significant events that are localised in time and space. It is more difficult to detect diffuse and progressive events with a slow increase over time or sporadic and widespread events without obvious links to time, place or person. Detection of these events relies on good data collection, comparative background data and sophisticated analytical tools. To improve surveillance systems, we need methods with the appropriate sensitivity and specificity for the outputs desired. Targeted surveillance should enable better ascertainment of those cases which must be considered and those which can be dismissed. New methods, such as mathematical modelling and geographical information systems, support conventional surveillance in moving events into the known and predictable category. It is important to integrate surveillance across local, regional and international levels and to base surveillance on local public health structures. The purpose and value of data aggregation at each level and the amount of detail needed at each level must be carefully evaluated. The key to all these improvements is developing the workforce. Surveillance needs individuals with a broad range of skills: clinical, epidemiological, anthropological, and mathematical; in particular, people who can think laterally. These individuals must be encouraged through effective training courses, good mentorship, networking and clear career structures.

Communicable Disease Control↗
PubMed2001

Systemic conditions for performance of pharmacoepidemiologic studies in Slovenia.

In Slovenia, the national health insurance system covers almost the whole population. The average patient receives six to seven prescriptions per year with an average value of 15 USD per prescription. This paper presents the systemic conditions necessary for the performance of pharmacoepidemiologic studies. A recent study addressing the use of antiepileptic drugs is an example. The current law on Personal Data Protection, which is compliant with EU Directive 95/46/EC, prevents infringement of personal integrity resulting from inappropriate use of personal data or inappropriate management and use of databases containing personal data. Since July 2000, the Law on Health Care Related Databases has defined the databases and the ways data can be acquired, processed, transferred, and exchanged among persons authorized to perform health care services. When gathering additional data not currently contained in the health care-related databases defined by the law, written consent from participants is required, and study documentation must be submitted for approval to the national Medical Ethics Committee. The main legislation covering clinical and pharmacoepidemiologic research is the Medicinal Products and Medical Devices Act of 1999, together with its by-laws, which is also in accordance with EU Directives.

Bioethics↗
PubMedDate not supplied

Attitudes toward CAM among medical, nursing, and pharmacy faculty and students: a comparative analysis.

CONTEXT: As interest in CAM continues to increase, schools of medicine, nursing, and other health professional training programs are being encouraged to integrate content on CAM into curricula. OBJECTIVE: To assess the attitudes of faculty and staff toward CAM in medicine, nursing, and pharmacy within an academic health center. DESIGN: A survey was used to obtain data on general attitudes toward CAM, personal use, training needs, and perceived barriers to use. SETTING AND PARTICIPANTS: The survey was taken of 627 faculty and students employed or enrolled at the University of Minnesota. The overall response rate exceeded 50% for both students and faculty. RESULTS: More than 90% of faculty and students believe that clinical care should integrate the best of conventional and CAM practices and that health professionals should be prepared to advise patients about commonly used CAM methods; 88% of faculty and 84% of students indicated that CAM should be included in their school's curriculum. While there were similarities between the 3 faculty groups, the nursing faculty expressed the greatest interest in practicing CAM. CONCLUSIONS: Faculty and students within medicine, nursing, and pharmacy have favorable attitudes toward the integration of CAM within education and clinical care. Personal use of CAM and training is limited. Lack of evidence is perceived to be the most significant barrier to integration of CAM into Western medicine. The high degree of receptivity suggests the need for both faculty training and curriculum development.

Adult↗
PubMed2026

Advancing One Health genomics in Africa: opportunities and challenges for outbreak and antimicrobial resistance control.

SUMMARYAfrica's ongoing struggles with emerging epidemics and antimicrobial resistance (AMR) underscore the urgency of integrating pathogen genomics and surveillance systems into the continent's One Health strategy, particularly given the existing limitations in preparedness and technological resources. This review brings together current evidence on the growth of sequencing infrastructure, the development of regional genomic hubs, and the establishment of governance frameworks, while identifying critical challenges in data integration, bioinformatics capacity, and sustainable financing. Special focus is placed on the lack of African-based genomic data, with our analysis showing that only 1.82% of the global total is available. Case studies illustrate the immense potential and importance of pathogen genomics, giving policymakers a tangible sense of its impact. These examples demonstrate how genomic technologies integrated with artificial intelligence (AI) are transforming outbreak response, AMR surveillance, and stewardship programs by enabling early detection of zoonotic threats, mapping transmission pathways, and guiding vaccine development. However, to fully realize this scientific intel, it is essential to embed One Health pathogen surveillance within strong policy and system frameworks to ensure the translation of technical progress into lasting institutional capacity and sustainable impact. Long-term implementation depends on coordinated investment and advocacy across four interdependent pillars: data architecture, governance and sovereignty, human capital, and technical capacity.

Humans↗
PubMed2003

Towards a decision support system for health promotion in nursing.

AIMS: This study was designed to investigate what type of models, techniques and data are necessary to support the development of a decision support system for health promotion practice in nursing. Specifically, the research explored how interview data can be interpreted in terms of Concept Networks and Bayesian Networks, both of which provide formal methods for describing the dependencies between factors or variables in the context of decision-making in health promotion. BACKGROUND: In nursing, the lack of generally accepted examples or guidelines by which to implement or evaluate health promotion practice is a challenge. Major gaps have been identified between health promotion rhetoric and practice and there is a need for health promotion to be presented in ways that make its attitudes and practices more easily understood. New tools, paradigms and techniques to encourage the practice of health promotion would appear to be beneficial. Concept Networks and Bayesian Networks are techniques that may assist the research team to understand and explicate health promotion more specifically and formally than has been the case, so that it may more readily be integrated into nursing practice. METHODS: As the ultimate goal of the study was to investigate ways to use the techniques described above, it was necessary to first generate data as text. Textual descriptions of health promotion in nursing were derived from in-depth qualitative interviews with nurses nominated by their peers as expert health promoting practitioners. FINDINGS: The nurses in this study gave only general and somewhat vague outlines of the concepts and ideas that guided their practice. These data were compared with descriptions from various sources that describe health promotion practices in nursing, then examples of a Conceptual Network and a representative Bayesian Network were derived from the data. CONCLUSIONS: The study highlighted the difficulty in describing health promotion practice, even among nurses recognized for their expertise in health promotion. Nevertheless, it indicated the data collection and analysis methods necessary to explicate the cognitive processes of health promotion and highlighted the benefits of using formal conceptualization techniques to improve health promotion practice.

Bayes Theorem↗
PubMed2004

Use of GIS and exposure modeling as tools in a study of cancer incidence in a population exposed to airborne dioxin.

In environmental health research there is a recognized need to develop improved epidemiologic and statistical methods for rapid assessment of relationships between environment and health. Exposure assessment is identified as a major challenge needing attention. In this study an exposure simulation model was used to delimit almost exactly in space and time an urban population exposed to airborne dioxin. A geographic information system (GIS) was used as the electronic environment in which to link the exposure model with the demographic, migration, and cancer data of the exposed population. This information is available in Denmark on an individual basis. Standardized incidence ratios (SIRs) for both men and women in 10-year age bands were calculated for three different exposure areas. Migration patterns were outlined. SIRs showed no excess of cancer incidences during the time span chosen (13 years; 1986-1998) in the whole exposed area or in the medium or higher polluted areas. The exposure model appeared very useful in selection of the appropriate exposure areas. The integration of the model in a GIS together with individual data on addresses, sex, age, migration, and information from routine health statistics (Danish Cancer Registry) proved its usefulness in demarking the exposed population and identifying the cancers related to that population. Less than one-third of the study population lived at the same address after 13 years of observation, and only half were still residing in the area, indicating migration of people as a major misclassification.

Adolescent↗
PubMed1993

A community survey on maternal and child health services utilization in rural Ethiopia.

A household health interview survey on MCH services utilization was carried out in 22 villages of a rural district of Arsi region, Ethiopia, before the launching of an integrated MCH programme. Coverage of antenatal services was 26%, and 61% of the women who received antenatal care reported having had 3 or more visits. Antenatal care was positively associated with living within 10 km of the Health Centre. Twenty-eight percent of the mothers attended the under-5 clinic and most returned for 3 or more visits. In addition, 99% reported having breast-fed their last child but more than 25% started weaning only after the seventh month of age. Differences in practice of treating diarrhoea according to knowledge of ORS were found. Of the 33% of those with knowledge of ORS, almost 90% reported use of ORS for treating child's diarrhoea, showing a positive attitude towards modern health care. The proportion of women using family planning was 5%, with no difference found between Christians and Muslims. Results on EPI coverage validated data from routine reporting. Integration of MCH services including out-reach activities may increase access and coverage of MCH services.

Adolescent↗
PubMed2004

Overlap among clinical, counseling, and school psychology: implications for the profession and Combined-Integrated training.

Health care providers within psychology currently fall into three dominant practice areas: clinical, counseling, and school psychology. This article reviews data from four different sources-archival descriptions, training curricula, internship and employment outcomes, and professional activities-to examine the overlap among the three practice areas. Archival descriptions revealed substantial similarities, with smaller but interesting differences. A comparison of actual curricula from 10 programs accredited in each of the three practice areas yielded similar findings: Programs across the three practice areas were much more similar than different. Within-practice area variations among programs were nearly as large as across-practice area differences. We briefly review the professional activities of clinical, counseling, and school psychologists, again demonstrating considerable similarity. We conclude by explaining implications for doctoral training programs, internships settings, and professional credentialing.

Counseling↗
PubMedDate not supplied

Gaining links: health information networks arise--with integration challenges.

As chins gain favor and efficiency in several regions of the country, they are increasingly used to speed both financial and clinical data interchanges. Technologic advances in information management are shifting the laboratory from a passive entity generating data to an active medical support service.

Clinical Laboratory Information Systems↗
PubMed2001

Successful Medicaid managed care organizations: it is not an oxymoron.

Success as a Medicaid health plan is achieved by those plans with a clear understanding of Medicaid program requirements. Executives of Medicaid health plans identify four common elements that result in winning plans: (1) Leadership must have significant experience with, or otherwise develop knowledge of, the Medicaid program's regulations and populations covered; (2) the plan must have an internal managed care culture and system that integrates finance, operations, and medical management; (3) management must have access to highly specialized information and data analysis capability; (4) leadership must have well-developed relationships with key stakeholders. While these elements seem intuitive, health plans often enter the marketplace without needed groundwork firmly in place.

Database Management Systems↗