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Despite the prevalence of health communication on social media, the mechanisms by which social media affect health information exchange have received less than adequate investigation. By integrating the lenses of affordance and social support, this study examines the effect of social media affordances on health information exchange, with a particular focus on the mediation effect of social support and the boundary condition of health consciousness. Results of an online survey indicated that the affordances of information accessibility and metavoicing are positively related to both general and experiential informational support. Moreover, the affordance of association is positively related to experiential informational support and emotional support. Additionally, three types of social support have positive effects on health information exchange, and health consciousness positively moderates the effect of experiential informational support on health information exchange. This study enriches existing literature by revealing the underlying mechanisms and boundary conditions of the relationship between social media affordances and health information exchange. Furthermore, it provides new insights for practitioners to promote health information exchange on social media. [ABSTRACT FROM AUTHOR]

The exchange of medical images and patient data over the internet has attracted considerable attention in the past decade, driven by advancements in communication and health services. However, transferring confidential data through insecure channels, such as the internet, exposes it to potential manipulations and attacks. To ensure the authenticity of medical images while concealing patient data within them, this paper introduces a high-capacity and reversible fragile watermarking model in which an authentication watermark is initially generated from the cover image and merged with the patient's information, photo, and medical report to form the global watermark. This watermark is subsequently encrypted using the chaotic Chen system technique, enhancing the model's security and ensuring patient data confidentiality. The cover image then undergoes a Discrete Fourier Transform (DFT) and the encrypted watermark is inserted into the frequency coefficients using a new embedding technique. The experimental results demonstrate that the proposed method achieves great watermarked image quality, with a PSNR exceeding 113 dB and an SSIM close to 1, while maintaining a high embedding capacity of 3 BPP (Bits Per Pixel) and offering perfect reversibility. Furthermore, the proposed model demonstrates high sensitivity to attacks, successfully detecting tampering in all 18 tested attacks, and achieves nearly perfect watermark extraction accuracy, with a Bit Error Rate (BER) of 0.0004%. This high watermark extraction accuracy is crucial in our situation where patient data need to be retrieved from the watermarked images with almost no alteration. [ABSTRACT FROM AUTHOR]

Robust data privacy regulations hinder the exchange of healthcare data among institutions, crucial for global insights and developing generalised clinical models. Federated learning (FL) is ideal for training global models using datasets from different institutions without compromising privacy. However, disparities in electronic healthcare records (EHRs) lead to inconsistencies in ML-ready data views, making FL challenging without extensive preprocessing and information loss. These differences arise from variations in services, care standards, and record-keeping practices. This paper addresses data view heterogeneity by introducing a knowledge abstraction and filtering-based FL framework that allows FL over heterogeneous data views without manual alignment or information loss. The knowledge abstraction and filtering mechanism maps raw input representations to a unified, semantically rich shared space for effective global model training. Experiments on three healthcare datasets demonstrate the framework's effectiveness in overcoming data view heterogeneity and facilitating information sharing in a federated setup. [ABSTRACT FROM AUTHOR]

Background: In the last three decades, Electronic Health Records Systems (EHRSs) have become one of the top priorities of policymakers globally. Nowadays, EHRS reform is fast becoming a priority in developed countries. The introduction of EHRSs in Saudi healthcare organizations is considered one of the highest priorities of policymakers. Saudi Arabian e-health strategy pays reasonable attention to the EHRS implementation project. According to Saudi Vision 2030, the e-health transformation will be on top of IT projects in the country. However, an estimated 50% of EHRS implementations have failed. Project leadership and type of project management have been found to be crucial components of effective EHRS implementation. Aim of the study: To evaluate the role of centralized project management (CPM) in the implementation of large-scale EHRSs in Primary Healthcare Centers (PHCs) in Saudi Arabia (SA). Methods: A sequential explanatory mixed-methods approach involving a survey and semi-structured qualitative interview methods were utilized. Results: A total of 39 (75%) out of 53 policymakers at the Saudi Ministry of Health completed the survey, and 14 project team members were interviewed. Findings from both illustrated that adopting centralized project management approaches to implementation was beneficial in facilitating large-scale EHRS implementation and helped to overcome barriers that may have otherwise led to the failure of the project. EHRS interoperability and software selection were the factors that CPM influenced most positively. [ABSTRACT FROM AUTHOR]

Environmental factors amplified by climate change contribute significantly to the global burden of disease, disproportionately impacting vulnerable populations, such as individuals with rare diseases. Researchers require innovative, dynamic data linkage methods to enable the development of risk prediction models, particularly for diseases like vasculitis with unknown aetiology but potential environmental triggers. In response, we present the Semantic Environmental and Rare Disease Data Integration Framework (SERDIF). SERDIF was evaluated with researchers studying climate-related health hazards of vasculitis disease activity across European countries (NP1 = 10, NP2 = 17, NP3 = 23). Usability metrics consistently improved, indicating SERDIF's effectiveness in linking complex environmental and health datasets. Furthermore, SERDIF-enabled epidemiologists to study environmental factors in a pregnancy cohort in Lombardy, showcasing its versatility beyond rare diseases. This framework offers for the first time a user-friendly, FAIR-compliant design for environment-health data linkage with export capabilities enabling data analysis to mitigate health risks posed by climate change. [ABSTRACT FROM AUTHOR]

Purpose: Collaboration in the field of speech-language pathology occurs across a variety of digital devices and can entail the usage of multiple software tools, systems, file formats, and even programming languages. Unfortunately, gaps between the laboratory, clinic, and classroom can emerge in part because of siloing of data and workflows, as well as the digital divide between users. The purpose of this tutorial is to present the Collaboverse, a web-based collaborative system that unifies these domains, and describe the application of this tool to common tasks in speech-language pathology. In addition, we demonstrate its utility in machine learning (ML) applications. Method: This tutorial outlines key concepts in the digital divide, data management, distributed computing, and ML. It introduces the Collaboverse workspace for researchers, clinicians, and educators in speech-language pathology who wish to improve their collaborative network and leverage advanced computation abilities. It also details an ML approach to prosodic analysis. Conclusions: The Collaboverse shows promise in narrowing the digital divide and is capable of generating clinically relevant data, specifically in the area of prosody, whose computational complexity has limited widespread analysis in research and clinic alike. In addition, it includes an augmentative and alternative communication app allowing visual, nontextual communication. [ABSTRACT FROM AUTHOR]

Changes in our informational environment have brought new challenges and opportunities to address systemic issues of information inequity. Thus, when addressing systemic issues of information inequity, it is important to address it not only from the perspective of information access, as it is often considered in information science, but also from the perspective of how information objects are constructed and produced. This essay brings concerns within information science into discussion with journalism studies and critical technology studies to consider: (1) how the production of information, through the case of mainstream journalism, can create information inequity within information representations, and (2) how the dissemination and retrieval of this journalistic information through algorithmically‐mediated online information systems, specifically social media and search platforms, can replicate and reinforce information inequity within a larger information ecosystem. Thus, this essay uses an interdisciplinary lens to suggest new approaches to holistically address information inequity, putting forth a conceptual framework with actionable steps to create a more equitable information ecosystem. [ABSTRACT FROM AUTHOR]

The management and exchange of electronic health records (EHRs) remain critical challenges in healthcare, with fragmented systems, varied standards, and security concerns hindering seamless interoperability. These challenges compromise patient care and operational efficiency. This paper proposes a novel solution to address these issues by leveraging distributed ledger technology (DLT), including blockchain, to enhance data security, integrity, and transparency in healthcare systems. The decentralized and immutable nature of DLT enables more efficient and secure information exchange across platforms, improving decision-making and coordination of care. This paper outlines a strategic implementation approach, detailing timelines, resource requirements, and stakeholder involvement while addressing crucial privacy and security concerns like encryption and access control. In addition, it explores standards and protocols necessary for achieving interoperability, offering case studies that demonstrate the framework's effectiveness. This work contributes by introducing a DLT-based solution to the persistent issue of EHR interoperability, providing a novel pathway to secure and efficient health data exchanges. It also identifies the standards and protocols essential for integrating DLT with existing health information systems, thereby facilitating a smoother transition toward enhanced interoperability. [ABSTRACT FROM AUTHOR]

Dental identification systems (DISs) encompass various techniques used for forensic identification, serving as alternatives or complements to genetic methods. Technologies such as microchip implants, prosthetic inscriptions, microSD cards, and identification plaques have been proposed to address limitations in comparative methods, offering streamlined processes for forensic experts. This study reviews current and potential DIS implementations, emphasizing cost-effectiveness and community benefits. Literature analysis from PubMed (2008–2024) yielded 17 relevant articles on implantable DISs, enabling direct subject identification via teeth or prostheses. The integration of DIS aims to enhance accuracy and speed in personal profiling and legal identification, promoting technology transfer in dentistry. It will be necessary to develop strict privacy regulations to protect patient data and establish ethical guidelines for their use. The study's aim is to highlight that the universal adoption of DISs could mitigate healthcare disputes and facilitate data exchange in clinical settings, which is particularly beneficial for vulnerable populations. [ABSTRACT FROM AUTHOR]

Postural control can be challenged by breathing. What is the effect of an acute increase in respiratory demand on postural control compared to quiet breathing? A systematic review was conducted. Electronic databases were systematically searched until October 18, 2022 on studies reporting changes in center of pressure (CoP) motion related to an acute manipulation of respiratory demand compared to quiet breathing during upright standing in healthy participants and/or participants with a clinical condition. Twenty-one studies in healthy participants showed that voluntary (not metabolic-induced) hyperventilation or inspiratory resistive loading significantly increased CoP motion, while breath-holding decreased CoP motion, compared to quiet breathing (p< 0.05). Manipulating respiratory rate or breathing patterns did not reveal consistent results. Four studies showed that people with low back pain showed similar CoP responses to increasing respiratory demand (p> 0.05), except for breathing at different rates, whereas they showed greater CoP motion during quiet breathing. The extent of postural disturbance depended on the breathing mode and how it was quantified (i.e., CoP coupled with breathing movement or overall CoP measures). Voluntary hyperventilation and inspiratory resistive loading increased postural sway. For voluntary hyperventilation, this could be explained by CoP motion being directly coupled to chest wall movements whereas metabolic-induced hyperventilation did not increase CoP motion or CoP coupling with breathing. Breath-holding decreased postural sway. Patients with low back pain show greater postural sways than pain-free individuals during quiet breathing, although they exhibit similar postural adaptations to respiratory-related challenges as controls. • Studies assessing the effect of breathing demand on postural control were reviewed • Voluntary (not metabolic-induced) hyperventilation increased postural sway • Inspiratory resistive loading increased postural sway • Breath-holding decreased postural sway • Patients with low back pain show similar responses to increasing breathing demand [ABSTRACT FROM AUTHOR]

Interoperability plays a crucial role in facilitating seamless data sharing across system boundaries, necessitating collaborative efforts among multiple systems. To achieve this, the presence of a common reference model for data exchange and dedicated interfaces is essential. However, the current state of Health Information Systems (HIS) often falls short in providing effective design elements that enable smooth and continuous data exchange across diverse domains. To address this challenge, a comprehensive investigation of the technical, syntactic, semantic, and other important aspects of interoperability interfaces is necessary, both in theory and practice. This article aims to address the design challenges associated with interoperability interfaces in Electronic Medical Record (EMR) systems. We commence by establishing theoretical guidelines that serve as foundation for designing effective interfaces. These guidelines encompass key considerations for the usability of interoperability interfaces, such as importing and exporting data of EMRs. Building upon this theoretical framework, we evaluate the interoperability interfaces within OpenMRS, a widely used EMR system. By aligning the evaluations with the established theoretical guidelines, we propose a set of generic interoperability interfaces designed to enhance the seamless exchange of data across different domains. To assess their usability, we employ a predictive usability inspection, providing valuable insights into the practical aspects of these interfaces. Through this research, we aim to contribute to the improvement of interoperability interfaces in EMR systems, bridging the gap between theoretical guidelines and practical implementation. By addressing the design challenges, conducting evaluations, and proposing interoperability interfaces, we strive to enhance data exchange design and promote a more integrated and collaborative healthcare system. [ABSTRACT FROM AUTHOR]

Background: Maternal and child health (MCH) remains a significant public health concern globally despite previous efforts made to improve MCH services. Initiatives such as antenatal care, postnatal care services exclusive breastfeeding, child vaccination and supplements have been rolled out to improve MCH outcomes. However, inadequate maternal healthcare, socioeconomic factors, obstetric haemorrhaging, complications of hypertension during pregnancy, lack of maternal information, poor universal health coverage and uptake of MCH services exacerbate maternal mortality and child mortality rates, especially in resource-constrained areas in many sub-Saharan African countries including South Africa. Objective: This study aimed to review mobile health (mHealth) interventions deployed to improve maternal and child health outcomes. Methods: The study adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses model to search and retrieve relevant literature from reputable, prominent electronic databases (Google Scholar, Scopus, PubMed, Embase, CINAHL, Web of Science, etc.). A total of 26 papers were selected and analyzed. Results: The findings revealed several mHealth interventions such as MomConnect, Mobile Alliance for Maternal Action, NurseConnect, ChildConnect, CommCare, Road to Health Application and Philani Mobile Video Intervention for Exclusive Breastfeeding have been utilized by healthcare workers and women to improve access to MCH services. However, inadequate digital infrastructure, digital divide, resistance to change, inadequate funding, language barriers, short message service and data costs, lack of digital skills and support, compatibility, scalability and interoperability issues, legislative and policy compliance, lack of mHealth awareness, data security and privacy concerns hinder uptake and utilisation of mHealth interventions. There is a need to scale up and sustain mHealth interventions and update existing regulatory framework, policies and strategies. Conclusion: mHealth interventions offer unprecedented opportunities to improve access to maternal information and substantially improve maternal and child health services. Stakeholder engagement and the development of sustainable funding strategies are important for successfully implementing and scaling mHealth projects while addressing existing and emerging key issues. [ABSTRACT FROM AUTHOR]

Massive medical data are indispensable for training diagnostic models to provide high-quality health monitoring services. The methods for sharing data in existing works involve securely and essentially copying data but often overlook the integration and efficiency of data storage, exchange and application. In this paper, we propose a Secure Decentralized Trading Alliance (SDTA) to encompass the entire process holistically. With monetary incentives, we formulate a chain-net structure for recording data digests and authentic transactions, thereby transforming data sharing into data trading without duplicating data storage. Data privacy is promised by encryption. To manage and employ encrypted medical data, users can update and search their encrypted data using an index and keywords, subsequently retrieving data within the SDTA framework. It is realized by a novel dynamic searchable symmetric encryption (SSE) with an |$l$| -level access strategy, which confines users to data pertinent solely to them, thus circumventing unnecessary data leakage. We scrutinize the storage efficiency and prove the fairness and security of SDTA. Finally, we generate datasets of varying sizes, where the time required to search for a single keyword is approximately 0.04 s with 1 000 000 (keyword, identifier) pairs, showing it quite acceptable. [ABSTRACT FROM AUTHOR]

Background Before the COVID-19 pandemic, a need for a uniform approach to health information (HI) knowledge in population health analysis across Europe was evident. The Population Health Information Research Infrastructure (PHIRI) emerged as a proactive initiative to strengthen European HI capacities. This article describes the achievements of PHIRI, highlighting its capacity-building activities and their contribution towards a sustainable strategy for the implementation of the European Health Data Space (EHDS). Methods PHIRI collaboration established a work package for skill-building activities in population health in partnership with other organizations. Activities included webinars, workshops, sessions, training schools and courses for researchers and public administration workers from Europe and beyond. The primary goal of the activities was to examine the impact of COVID-19 on European health systems at both local and national levels, including healthcare facilities and policymaking entities. Results Twelve activities were organized between October 2020 and the summer of 2023. In March 2023, the Spring School on Health Information was organized to share the knowledge achieved from PHIRI and other European Union-related projects. This event also validated the European Health Information Training Programme. Conclusions PHIRI's findings emphasized the importance of equipping the workforce with core HI skills to improve health systems' preparedness and resilience. Through this research, it is possible to propose a strategy for building capacity that emphasizes the importance of providing training in human-machine dynamics. This approach will contribute to the sustainable implementation of the EHDS. [ABSTRACT FROM AUTHOR]

Health inequalities amplified by the COVID-19 pandemic have disproportionately affected racialized and equity-deserving communities across Canada. In the Municipality of Peel, existing data, while limited, illustrates that individuals from racialized and equity-deserving communities continue to suffer, receive delayed care, and die prematurely. In response to these troubling statistics, grassroots community advocacy has called on health systems leaders in Peel to work with community and non-profit organizations to address the critical data and infrastructure gaps that hinder addressing the social determinants of health in the region. To support these advocacy efforts, we used a community-based participatory research approach to understand how we might build a data collection ecosystem across sectors, alongside community residents and service providers, to accurately capture the data about the social determinants of health. This approach involved developing a community engagement council, defining the problem with the community, mapping what data is actively collected and what is excluded, and understanding experiences of sociodemographic data collection from community members and service providers. Guided by community voices, our study focused on sociodemographic data collection in the primary care context and identified which service providers use and collect these data, how data are used in their work, the facilitators and barriers to data use and collection. Additionally, we gained insight into how sociodemographic data collection could be respectful, safe, and properly governed from the perspectives of community members. From this study, we identify a set of eight recommendations for sociodemographic data collection and highlight limitations. This foundational community-based work will inform future research in establishing data governance in partnership with diverse and equity-deserving communities. [ABSTRACT FROM AUTHOR]

Population Health Management – often abbreviated to PHM – is a relatively new approach for healthcare planning, requiring the application of analytical techniques to linked patient level data. Despite expectations for greater uptake of PHM, there is a deficit of available solutions to help health services embed it into routine use. This paper concerns the development, application and use of an interactive tool which can be linked to a healthcare system's data warehouse and employed to readily perform key PHM tasks such as population segmentation, risk stratification, and deriving various performance metrics and descriptive summaries. Developed through open-source code in a large healthcare system in South West England, and used by others around the country, this paper demonstrates the importance of a scalable, purpose-built solution for improving the uptake of PHM in health services. [ABSTRACT FROM AUTHOR]

Background: The National Spinal Cord Injury Registry of Iran (NSCIR-IR) and the National Trauma Registry of Iran (NTRI) were established to meet the data needs for research and assessing trauma status in Iran. These registries have a group of patients shared by both registries, and it is expected that some identical data will be collected about them. A general question arises whether the spinal cord injury registry can receive part of the common data from the trauma registry and not collect them independently. Methods: We examined variables captured in both registries based on structure and concept, identified the overlapping period during which both systems recorded data in the same centers and extracted relevant data from both registries. Further, we evaluated the data for any discrepancies in amount or nature and pinpointed the underlying reasons for any inconsistencies. Results: Out of all the variables in the NSCIR-IR database, 18.6% of variables were similar to the NTRI in terms of concept and structure. Although four hospitals participated in both registries, only two (Sina and Beheshti Hospitals) had common cases. Patient names, prehospital intubation, ambulance arrival time, ICU length of stay, and admission time were consistent across both registries with no differences. Other common data variables had significant discrepancies. Conclusion: This study highlights the potential for health information exchange (HIE) between NSCIR-IR and NTRI and serves as a starting point for stakeholders and policymakers to understand the differences between the two registries and work toward the successful adoption of HIE. [ABSTRACT FROM AUTHOR]

Background: Interfacility patient transfers are fraught with issues such as missed or ineffective communication in Montana given wide geographic distance between facilities and variance in resources. Inaccurate, absent, or delayed patient details may negatively affect patient outcomes and further result in duplicative testing and medication errors. Objective: The objective of this study was to describe the process of patient information communication during interfacility transfers as perceived by nurses practicing in Montana. Methods: The study design was a pilot cross-sectional descriptive approach. An online Qualtrics survey included demographic questions, two exploratory communication competence instruments, and four open-ended questions regarding communicating interfacility transfer patient information. Results: A total of 33 nurses completed the study, with the majority practicing at a critical access hospital (n = 15, 47%). Communication competence mean scores increased with dyad conversations, and a lack of standardized handoff tools was noted as a challenge. Nurses identified the following as barriers in the interfacility transfer handoff: incivility, amount of paperwork, interoperability issues, incomplete or outdated information, time, and resources. Implications for Practice: There is wide variability in current communication practices, ranging from verbal to electronic document transfers. The rural healthcare space is prime to continue examinations surrounding workflow optimization, accuracy, and consistency in shared information exchange at the time of interfacility transfer. There is an opportunity for potential training and education surrounding effective communication, interpersonal behaviors that support cross-organizational interactions, and the development of a standardized handoff tool contextual for interfacility transfer patients. [ABSTRACT FROM AUTHOR]

Digital approaches to support advance care planning (ACP) documentation and sharing are increasingly being used, with a lack of research to characterise their design, content, and use. This study aimed to characterise how digital approaches are being used to support ACP documentation and sharing internationally. A scoping review was performed in accordance with the JBI (formerly Joanna Briggs Institute) guidelines and the PRISMA 2020 checklist, prospectively registered on Open Science Framework (). MEDLINE, EMBASE, PsycINFO, ACM Digital, IEEE Xplore and CINAHL were searched in February 2023. Only publications in English, published from 2008 onwards were considered. Eligibility criteria included a focus on ACP and electronic systems. Out of 2,393 records, 34 reports were included, predominantly from the USA (76.5%). ACP documentation is typically stored in electronic health records (EHRs) (67.6%), with a third (32.4%) enabling limited patient access. Non-standard approaches (n = 15;44.1%) were the commonest study design of included reports, with outcome measures focusing on the influence of systems on the documentation (i.e. creation, quantity, quality, frequency or timing) of ACP information (n = 23;67.6%). Digital approaches to support ACP are being implemented and researched internationally with an evidence base dominated by non-standard study designs. Future research is needed to extend outcome measurement to consider aspects of care quality and explore whether the content of existing systems aligns with aspects of care that are valued by patients. [ABSTRACT FROM AUTHOR]

Background: Nursing interventions in the post‐operative time period including psychological and emotional support, adverse event education, and instructions for follow‐up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post‐anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post‐operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. Aims: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated‐measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. Methods & Materials: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)‐approved study was a repeated‐measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. Results: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post‐operative Day 1. Fifty‐nine participants (78%) completed the surveys on post‐operative Day 14. Discussion: As the frequency of outpatient treatment increases, nurses conducting post‐operative research will need to collect the data outside of the hospital setting. Conclusion: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non‐traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process. [ABSTRACT FROM AUTHOR]

Curating and integrating data from sources are bottlenecks to procuring robust training datasets for artificial intelligence (AI) models in healthcare. While numerous applications can process discrete types of clinical data, it is still time-consuming to integrate heterogenous data types. Therefore, there exists a need for more efficient retrieval and storage of curated patient data from dissimilar sources, such as biobanks, health records, and sensors. We describe a customizable, modular data retrieval application (RIL-workflow), which integrates clinical notes, images, and prescription data, and show its feasibility applied to research at our institution. It uses the workflow automation platform Camunda (Camunda Services GmbH, Berlin, Germany) to collect internal data from Fast Healthcare Interoperability Resources (FHIR) and Digital Imaging and Communications in Medicine (DICOM) sources. Using the web-based graphical user interface (GUI), the workflow runs tasks to completion according to visual representation, retrieving and storing results for patients meeting study inclusion criteria while segregating errors for human review. We showcase RIL-workflow with its library of ready-to-use modules, enabling researchers to specify human input or automation at fixed steps. We validated our workflow by demonstrating its capability to aggregate, curate, and handle errors related to data from multiple sources to generate a multimodal database for clinical AI research. Further, we solicited user feedback to highlight the pros and cons associated with RIL-workflow. The source code is available at github.com/magnooj/RIL-workflow. [ABSTRACT FROM AUTHOR]

Healthcare is a critical area where blockchain technology (BT) is being heralded as a potential game-changer for facilitating secure and efficient data sharing. The purpose of this review is to examine BT applications, performance challenges, and solutions in healthcare. To begin, This review paper explores popular blockchain networks for data exchange, encompassing both public and permissioned platforms, such as Ethereum and Hyperledger Fabric. This paper analyzes the potential applications of BT's decentralized, immutable, and smart contract capabilities in healthcare settings, including secure and interoperable health data exchange, patient consent management, drug supply chain oversight, and clinical trial management. The healthcare industry might greatly benefit from the increased privacy, transparency, and accessibility that these technologies provide. Despite BT's promising medical uses, the technology is not without its drawbacks. High energy consumption, throughput, and scalability are all concerns. We wrapped up by discussing the solutions that have been implemented, including consensus processes, scalability measures like sharding, and off-chain transactions that are designed to mitigate the drawbacks. [ABSTRACT FROM AUTHOR]

Background: In the context of pediatric palliative care, where the quality of life of children with life-limiting or life-threatening conditions is of utmost importance, the integration of health technology must support the provision of care. Research has highlighted the role of healthcare personnel when utilizing health technology in home-based pediatric palliative care, but specific knowledge of healthcare personnel's views on the technological relevance remains limited. Therefore, our study has explored potentials and limitations of health technology in home-based pediatric palliative care from the perspectives of healthcare personnel. Methods: Our study utilized a qualitative, descriptive, and exploratory design, including five focus groups with a total of 22 healthcare personnel. The participants were selected from various health regions in Norway and were experienced in providing home-based pediatric palliative care. Using reflexive thematic analysis, we interpreted data obtained from focus groups, identified patterns, and developed themes. Results: The analysis resulted in the development of three intersecting themes: balancing in-person interaction and time in home-based pediatric palliative care; exchange of information can improve timely and appropriate care; and the power of visual documentation in pediatric palliative care. The healthcare personnel acknowledged difficulties in fully replacing in-person interaction with health technology. However, they also emphasized potentials of health technology to facilitate information sharing and the ability to access a child's health record within interdisciplinary teams. Conclusion: The results underscored that technology can support pediatric palliative care but must be thoughtfully integrated to ensure an individualized patient-centered approach. To maximize the benefits of health technology in enhancing home-based pediatric palliative care, future research should address the limitations of current health technology and consider the opinions for information sharing between relevant healthcare team members, the child, and their family. [ABSTRACT FROM AUTHOR]

Background: Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala. Methods: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model. Results: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology. Conclusion: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts. [ABSTRACT FROM AUTHOR]

Confidentiality is a foundational element of high-quality, accessible, and equitable health care. Despite strong grounding in federal and state laws, professional guidelines, and ethical standards, health care professionals and adolescent patients face a range of complexities and barriers to seeking and providing confidential care to adolescents across different settings and circumstances. The dynamic needs of adolescents, the oftentimes competing interests of key stakeholders, the rapidly evolving technological context of care, and variable health care billing and claims requirements are all important considerations in understanding how to optimize care to focus on and meet the needs of the adolescent patient. The following assessment of the evolving evidence base offers a view of the current state and best practices while pointing to numerous unmet needs and opportunities for improvement in the care experiences of youth as well as their health outcomes. [ABSTRACT FROM AUTHOR]

Visual impairment-related disabilities have become increasingly pervasive. Current reports estimate a total of 36 million persons with blindness and 217 million persons with moderate to severe visual impairment worldwide. Assistive technologies (AT), including text-to-speech software, navigational/spatial guides, and object recognition tools have the capacity to improve the lives of people with blindness and low vision. However, access to such AT is constrained by high costs and implementation barriers. More recently, expansive growth in mobile computing has enabled many technologies to be translated into mobile applications. As a result, a marketplace of accessibility apps has become available, yet no framework exists to facilitate navigation of this voluminous space. We developed the BLV (Blind and Low Vision) App Arcade: a fun, engaging, and searchable curated repository of app AT broken down into 11 categories spanning a wide variety of themes from entertainment to navigation. Additionally, a standardized evaluation metric was formalized to assess each app in five key dimensions: reputability, privacy, data sharing, effectiveness, and ease of use/accessibility. In this paper, we describe the methodological approaches, considerations, and metrics used to find, store and score mobile applications. The development of a comprehensive and standardized database of apps with a scoring rubric has the potential to increase access to reputable tools for the visually impaired community, especially for those in low- and middle-income demographics, who may have access to mobile devices but otherwise have limited access to more expensive technologies or services. A wide array of assistive mobile applications now serve as low cost, convenient, and effective alternatives to standard tools in the rehabilitation domain. Given an extensive (and growing) marketplace of assistive apps, we highlight the importance of developing standardized evaluation frameworks that serve to assess the merit, functionality, and accessibility of tools in respective rehabilitation fields. To provide an introduction to a novel resource accessible to the public to exhibit verified and reliable assistive apps for the visually impaired community, especially for those in low- and middle-income demographics who may not have access to common technologies and services. [ABSTRACT FROM AUTHOR]

In the past, healthcare industry used paper-based systems to manage and store medical records. However, these systems are vulnerable to data breaches, loss, and errors. To overcome these issues, a research study has been conducted to create a safe and efficient Electronic Data Interchange (EDI) system for healthcare using blockchain technology. The study utilized various tools and methods including Python as the programming language to implement the blockchain environment, the pyQT5 library for graphical user interface (GUI), and the MySQL database management system as a repository for Electronic Health Records (EHR) with DBeaver, a cross-platform tool for data management. The research work involves the development of a blockchain-based smart contract for the storage, exchange, and retrieval of EHR. Additionally, a Python application based on pyQT5 is created to provide users with a friendly GUI. The proposed blockchain-based healthcare system provides a secure and efficient platform for storing and managing EHR as well as enabling secure EDI among healthcare stakeholders like practices, doctors, labs, and pharmacies. Furthermore, the system is scalable and user-friendly, and includes various features like patient visits, history, practices, doctors, and appointment scheduling. Blockchain technology ensures EHR integrity, secure EDI, and confidentiality, while the user-friendly interface enhances the user experience compared to the existing EDI standards like health level 7 (HL7). [ABSTRACT FROM AUTHOR]

Migraine is a complex neurological disorder that affects a significant portion of the global population. As traditional pharmacological approaches often fall short in alleviating symptoms, the development of innovative therapies has garnered significant interest. This text aims to summarize the current pharmacological options for managing migraine and to explore the potential impact of novel therapies. We focused on conventional treatments, emerging therapies, and novel compounds in clinical development, including therapies targeting the trigeminovascular system, cannabis-based therapies, hormonal and metabolic therapies, and other options. English peer-reviewed articles were searched in PubMed, Scopus, and ClinicalTrials.gov electronic databases. Several novel treatment options for migraine have become available in recent years. Emerging pharmacological therapies targeting the trigeminovascular system, cannabis-based therapies, hormonal and metabolic interventions, and other emerging treatment modalities, may prove to be valuable for the treatment of migraine. Further research, clinical trials, and substantiated evidence are necessary to validate the efficacy, safety, and long-term outcomes of these therapeutic options. [ABSTRACT FROM AUTHOR]

Introduction: Documentation as well as IT-based management of medical data is of ever-increasing relevance in modern medicine. As radiation oncology is a rather technical, data-driven discipline, standardization, and data exchange are in principle possible. We examined electronic healthcare documents to extract structured information. Planning CT order entry documents were chosen for the analysis, as this covers a common and structured step in radiation oncology, for which standardized documentation may be achieved. The aim was to examine the extent to which relevant information may be exchanged among different institutions. Materials and Methods: We contacted representatives of nine radiation oncology departments. Departments using standardized electronic documentation for planning CT were asked to provide templates of their records, which were analyzed in terms of form and content. Structured information was extracted by identifying definite common data elements, containing explicit information. Relevant common data elements were identified and classified. A quantitative analysis was performed to evaluate the possibility of data exchange. Results: We received data of seven documents that were heterogeneous regarding form and content. 181 definite common data elements considered relevant for the planning CT were identified and assorted into five semantic groups. 139 data elements (76.8%) were present in only one document. The other 42 data elements were present in two to six documents, while none was shared among all seven documents. Conclusion: Structured and interoperable documentation of medical information can be achieved using common data elements. Our analysis showed that a lot of information recorded with healthcare documents can be presented with this approach. Yet, in the analyzed cohort of planning CT order entries, only a few common data elements were shared among the majority of documents. A common vocabulary and consensus upon relevant information is required to promote interoperability and standardization. [ABSTRACT FROM AUTHOR]

Succeeding at university can be a complex matter, and the barriers are manifold for students with disabilities (SwDs). Accommodations are available for those with needs, but these alone do not meet the political goals of inclusive educations. Student ambassadors act as experienced representatives on campuses, supporting others and gaining individual benefits themselves. Approaches building on SwDs' experiences and capacities can be a means to overcome the complex barriers often faced throughout education. This scoping review aimed to map research on student ambassador interventions for SwDs in higher education and identify the interventions' key concepts. The result will inform an ambassador intervention in higher education. Six electronic databases were searched for peer-reviewed articles of any design published between 2010 and December 2020. Six studies met the inclusion criteria. A thematic synthesis resulted in three key concepts: peer guidance and supportive relationships; building strategies and transferable skills; and advocating for change. However, no program utilises exclusively students with disabilities in ambassador roles. The results indicate a lack of research as well as awareness on the unexplored potential of actively involving SwDs in ambassador roles. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate the effectiveness of the clinical decision support tools (CDSTs), POC Advisor (POCA), and Modified Early Warning System (MEWS) in identifying sepsis risk and influencing time to treatment for inpatients, comparing their respective alert mechanisms. Methods: This study was conducted at two academic university medical center hospitals. Data from adult inpatients in medical-surgical and telemetry units were analyzed from January 1, 2020, to December 31, 2020. Criteria included sepsis-related ICD-10 codes, antibiotic administration, and ordered sepsis labs. Subsequent statistical analyses utilized Fisher's exact test and Wilcoxon Rank Sum test, focusing on mortality differences by age, sex, and race/ethnicity. Results: Among 744 patients, 143 sepsis events were identified, with 83% already receiving treatment upon CDST alert. Group 1 (POCA alert) showed reduced response time compared with MEWS, while Group 3 (MEWS) experienced longer time to treatment. Group 4 included sepsis events missed by both systems. Mortality differences were not significant among the groups. Conclusion: While CDSTs play a role, nursing assessment and clinical judgment are crucial. This study recognized the potential for alarm fatigue due to a high number of CDST-driven alerts, while emphasizing the importance of a collaborative approach for prompt sepsis treatment and potential reduction in sepsis-related mortality. [ABSTRACT FROM AUTHOR]

Paperwork has always been a central part of bureaucratic work. Over the last few years, bureaucratic procedures have become increasingly standardised and digitalised. Based on interviews and ethnographic fieldwork within welfare offices in Switzerland and Belgium, we reflect on the way evidence is constructed within social policy and cases built for or against noncitizen welfare recipients in order to show how paper truths are established and challenged. The focus on digital practices within public policy implementation highlights how it contributes to enhanced control mechanisms on the implementation level and how migration law continues to guide welfare governance for noncitizens. This allows targeting of the most marginalised groups, whose rights to access state support are institutionally impeded. Through database information flows, official forms, paper reports and face-to-face meetings, we further show how a hybrid form of bureaucratic work emerges, where direct contact with the client is still key, yet highly influenced by standardisation processes. [ABSTRACT FROM AUTHOR]

The study examined the relationship between information systems and operational efficiency of maritime firms' in Port Harcourt, Rivers State. Three research questions and three research hypotheses were formulated to address the specific objectives of this study. The RBV theory was adopted in this study and also quantitative research design using a correlational method of investigation. The population consists of 16 maritime firms in Port Harcourt. Census sampling was applied with focus on managers. Four managers per firm were sampled; a total of 64 managers were sampled. The reliability of the instrument was determined using Cronbach alpha test and it stood at 0.88 higher than the benchmark of 0.7. The data collected for this study were analyzed through descriptive and inferential statistics. The Spearman Rank-Order Correlation Technique was employed to test the various hypotheses formulated. The result of the analysis revealed that the information system is significantly and positively related to the operational efficiency of maritime firms' in Port Harcourt, Rivers State. The empirical results of this study confirmed this as a positive and significant relationship was found between processing transaction systems and operational efficiency of maritime firms, and between electronic data interchange and operational efficiency of maritime firms. Based on these findings, it was concluded that the information system with its dimension of processing transaction system and electronic data interchange will improve operational efficiency of maritime firms in Port Harcourt. This study recommends that maritime firms should leverage on information systems as this would ensure reduction in cost and improve operational efficiency; they should use processing transaction system in order to facilitate the recording, tracking, and management of business transactions within the organization and the port, and they should adopt electronic data interchange for processing of documents and timely delivery of same. [ABSTRACT FROM AUTHOR]

Background: The evolution of eHealth development has shifted from standalone tools to comprehensive digital health environments, fostering data exchange among diverse stakeholders and systems. Nevertheless, existing research and implementation frameworks have primarily emphasized technological and organizational aspects of eHealth implementation, overlooking the intricate legal, ethical, and financial considerations. It is essential to discover what legal, ethical, financial, and technological challenges should be considered to ensure successful and sustainable implementation of eHealth. Objective: This review aims to provide insights into barriers and facilitators of legal, ethical, financial, and technological aspects for successful implementation of complex eHealth technologies, which impacts multiple levels and multiple stakeholders. Methods: A scoping review was conducted by querying PubMed, Scopus, Web of Science, and ACM Digital Library (2018-2023) for studies describing the implementation process of eHealth technologies that facilitate data exchange. Studies solely reporting clinical outcomes or conducted outside Europe were excluded. Two independent reviewers selected the studies. A conceptual framework was constructed through axial and inductive coding, extracting data from literature on legal, ethical, financial, and technological aspects of eHealth implementation. This framework guided systematic extraction and interpretation. Results: The search resulted in 7.308 studies that were screened for eligibility, of which 35 (0.48%) were included. Legal barriers revolve around data confidentiality and security, necessitating clear regulatory guidelines. Ethical barriers span consent, responsibility, liability, and validation complexities, necessitating robust frameworks. Financial barriers stem from inadequate funding, requiring (commercial) partnerships and business models. Technological issues include interoperability, integration, and malfunctioning, necessitating strategies for enhancing data reliability, improving accessibility, and aligning eHealth technology with existing systems for smoother integration. Conclusions: This research highlights the multifaceted nature of eHealth implementation, encompassing legal, ethical, financial, and technological considerations. Collaborative stakeholder engagement is paramount for effective decision-making and aligns with the transition from standalone eHealth tools to integrated digital health environments. Identifying suitable stakeholders and recognizing their stakes and values enriches implementation strategies with expertise and guidance across all aspects. Future research should explore the timing of these considerations and practical solutions for regulatory compliance, funding, navigation of responsibility and liability, and business models for reimbursement strategies. [ABSTRACT FROM AUTHOR]

Introduction: Today, modern technology is used to diagnose and treat cardiovascular disease. These medical devices provide exact measures and raw data such as imaging data or biosignals. So far, the Broad Integration of These Health Data into Hospital Information Technology Structures--Especially in Germany--is Lacking, and if data integration takes place, only non-Evaluable Findings are Usually Integrated into the Hospital Information Technology Structures. A Comprehensive Integration of raw Data and Structured Medical Information has not yet Been Established. The aim of this project was to design and implement an interoperable database (cardio-vascular-information-system, CVIS) for the automated integration of al medical device data (parameters and raw data) in cardio-vascular medicine. Methods: The CVIS serves as a data integration and preparation system at the interface between the various devices and the hospital IT infrastructure. In our project, we were able to establish a database with integration of proprietary device interfaces, which could be integrated into the electronic health record (EHR) with various HL7 and web interfaces. Results: In the period between 1.7.2020 and 30.6.2022, the data integrated into this database were evaluated. During this time, 114,858 patients were automatically included in the database and medical data of 50,295 of them were entered. For technical examinations, more than 4.5 million readings (an average of 28.5 per examination) and 684,696 image data and raw signals (28,935 ECG files, 655,761 structured reports, 91,113 x-ray objects, 559,648 ultrasound objects in 54 different examination types, 5,000 endoscopy objects) were integrated into the database. Over 10.2 million bidirectional HL7 messages (approximately 14,000/day) were successfully processed. 98,458 documents were transferred to the central document management system, 55,154 materials (average 7.77 per order) were recorded and stored in the database, 21,196 diagnoses and 50,353 services/OPS were recorded and transferred. On average, 3.3 examinations per patient were recorded; in addition, there are an average of 13 laboratory examinations. Discussion: Fully automated data integration from medical devices including the raw data is feasible and already creates a comprehensive database for multimodal modern analysis approaches in a short time. This is the basis for national and international projects by extracting research data using FHIR. [ABSTRACT FROM AUTHOR]

Direct access testing (DAT) is an emerging care model that provides on-demand laboratory services for certain preventative, diagnostic, and monitoring indications. Unlike conventional testing models where health care providers order tests and where sample collection is performed onsite at the clinic or laboratory, most interactions between DAT consumers and the laboratory are virtual. Tests are ordered and results delivered online, and specimens are frequently self-collected at home with virtual support. Thus, DAT depends on high-quality information technology (IT) tools and optimized data utilization to a greater degree than conventional laboratory testing. This review critically discusses the United States DAT landscape in relation to IT to highlight digital challenges and opportunities for consumers, health care systems, providers, and laboratories. DAT offers consumers increased autonomy over the testing experience, cost, and data sharing, but the current capacity to integrate DAT as a care option into the conventional patient-provider model is lacking and will require innovative approaches to accommodate. Likewise, both consumers and health care providers need transparent information about the quality of DAT laboratories and clinical decision support to optimize appropriate use of DAT as a part of comprehensive care. Interoperability barriers will require intentional approaches to integrating DAT-derived data into the electronic health records of health systems nationally. This includes ensuring the laboratory results are appropriately captured for downstream data analytic pipelines that are used to satisfy population health and research needs. Despite the data- and IT-related challenges for widespread incorporation of DAT into routine health care, DAT has the potential to improve health equity by providing versatile, discreet, and affordable testing options for patients who have been marginalized by the current limitations of health care delivery in the United States. [ABSTRACT FROM AUTHOR]

Secondary use of clinical data in research or learning activities (SeConts) has the potential to improve patient care and biomedical knowledge. Given this potential, the ethical question arises whether physicians have a professional duty to support SeConts. To investigate this question, we analyze prominent international declarations on physicians' professional ethics to determine whether they include duties that can be considered as good reasons for a physicians' professional duty to support SeConts. Next, we examine these documents to identify professional duties that might conflict with a potential duty of physicians to support SeConts. [ABSTRACT FROM AUTHOR]

Data culture/s as a research topic has begun to attract attention from a wide range of disciplines, albeit with inconsistent application of definitions, dimensions, and applications. This work builds on a call to investigate data culture/s within the information studies domain as a topic related to, but distinct from, information culture. The purpose of this study is to explore what is known about data culture/s in greater depth. We apply a retroductive approach to select and consider likely dimensions, inputs, and aspects of data culture/s in order to further map this construct to the literature, and thereby highlight gaps and opportunities to add to this body of knowledge. The initial candidate dimensions explored below include data‐related skills and attitudes, data sharing, data use/reuse, data ethics and governance, and a specific focus on Indigenous perspectives to provide insights on why and how a group may contest the emergent dominant discourse of data culture/s. Our conclusion highlights areas needing further research to fully define and examine the dimensions, inputs, and aspects of data culture/s, and calls for greater understanding and engagement with data culture/s from the information studies community. [ABSTRACT FROM AUTHOR]

As interprofessional collaboration (IPC) in primary care receives increasing attention, the role of electronic medical and health record (EMR/EHR) systems in supporting IPC is important to consider. A scoping review was conducted to synthesize the current literature on the barriers and facilitators of EMR/EHRs to interprofessional primary care. Four online databases (OVID Medline, EBSCO CINAHL, OVID EMBASE, and OVID PsycINFO) were searched without date restrictions. Twelve studies were included in the review. Of six facilitator and barrier themes identified, the key facilitator was teamwork support and a significant barrier was data management. Other important barriers included usability related mainly to interoperability, and practice support primarily in terms of patient care. Additional themes were organization attributes and user features. Although EMR/EHR systems facilitated teamwork support, there is potential for team features to be strengthened further. Persistent barriers may be partly addressed by advances in software design, particularly if interprofessional perspectives are included. Organizations and teams might also consider strategies for working with existing EMR/EHR systems, for instance by developing guidelines for interprofessional use. Further research concerning the use of electronic records in interprofessional contexts is needed to support IPC in primary care. [ABSTRACT FROM AUTHOR]

Aim: To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. Design: A descriptive cross-sectional survey design was used. Methods: A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. Results: Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. Conclusion: Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. Implications for the Profession and Patient Care: Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. Impact: • This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. • It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. • These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. Reporting Method: The STROBE reporting method was used in the preparation of the manuscript. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

The article discuses development in real-time payment services in the U.S. Topics include payment systems that have been facilitating payments in the U.S. including wire transfers, automated clearing house (ACH), and Original Credit Transaction (OCD) or Push-to-Card technology, real-time payment use cases, and similarities and differences between real-time payments and FedNow Service (FedNow)

The article offers a perspective on the role of artificial intelligence (AI) in making clinical data exchange useful to ensure continuity of health care. Topics discussed include complexity of patient data in electronic medical records (EMR), data interoperability improvement, multiple formats of shared data that make it difficult to integrate in provider's core systems, and capacity of AI to address data volume and usability as well as to support EMR data accessibility and exchange safely.

AbstractThe two main forms of healthcare data exchange among entities are business-to-business (B2B) and business-to-customer (B2C). The former uses the electronic data interchange (EDI) technology between healthcare institutions, while the latter is usually conducted by providing web-based interfaces for patients. This research argues that both forms have inherent security and privacy weaknesses. Furthermore, patients lack appropriate transparency and control over their own Personally Identifiable Information (PII). We explore the issues of medical record exchange, analyze them and suggest appropriate solutions in the form of a new model to mitigate them. The vulnerabilities, ranging from critical to minor, include the possibility of Man-in-The-Middle (MiTM) and supply chain attacks, weak cryptography, repudiable transactions, single points of failure (SPOF), and poor access controls. A novel model will be presented in this research for healthcare data sharing which applies the best security practices. The proposed unified model will counter the listed vulnerabilities. It automates the healthcare processes in decentralized architecture by utilizing the smart contracts for B2C transactions such as medicine purchase. The model is based on the Blockchain and zero-knowledge proofs. It is made with novel controls which represent the latest advancements in cybersecurity. It has the potential of setting a new cornerstone.

Simple Summary: In order to advance cancer research and personalized care, the Allegheny Health Network Cancer Institute (AHNCI) established a clinical data program (CDP) consisting of a comprehensive biobank and data repository. This includes details on socio-demographic characteristics, diagnosis, tumor characteristics, treatments, and prognosis. By understanding individual patient characteristics, such as genetics, lifestyle, and environmental factors, researchers can determine more effective treatments and preventive interventions. The CDP aids in predicting therapy responses and clinical outcomes through the utilization of cancer-related biomarkers across various disease sites. The CDP supports the initiative by providing comprehensive patient information, such as demographic characteristics, diagnosis details, and treatment responses, which, when combined with genomic data, can enhance the understanding of disease progression and treatment outcomes, thereby facilitating personalized care and precision medicine. Advancing cancer treatment relies on the rapid translation of new scientific discoveries to patient care. To facilitate this, an oncology biobank and data repository program, also referred to as the "Moonshot" program, was launched in 2021 within the Integrated Network Cancer Program of the Allegheny Health Network. A clinical data program (CDP) and biospecimen repository were established, and patient data and blood and tissue samples have been collected prospectively. To date, the study has accrued 2920 patients, predominantly female (61%) and Caucasian (90%), with a mean age of 64 ± 13 years. The most common cancer sites were the endometrium/uterus (12%), lung/bronchus (12%), breast (11%), and colon/rectum (11%). Of patients diagnosed with cancer, 34% were diagnosed at stage I, 25% at stage II, 26% at stage III, and 15% at stage IV. The CDP is designed to support our initiative in advancing personalized cancer research by providing a comprehensive array of patient data, encompassing demographic characteristics, diagnostic details, and treatment responses. The "Moonshot" initiative aims to predict therapy responses and clinical outcomes through cancer-related biomarkers. The CDP facilitates this initiative by fostering data sharing, enabling comparative analyses, and informing the development of novel diagnostic and therapeutic methods. [ABSTRACT FROM AUTHOR]

Simple Summary: Neuroendocrine neoplasms' (NENs) rarity and heterogeneity represent a clinical challenge. Somatostatin receptor (SST) positron emission tomography/computed tomography (PET/CT) availability and different reimbursement policies across countries account for its heterogenous employment on a single-case basis. The aim of this study was to prospectively collect data of the real-life use of and indications for [68Ga-DOTA0-1NaI3]octreotide ([68Ga]Ga-DOTANOC) PET/CT in a prospective 5-year electronic archive at a single center. Overall, more than 2000 scans were included. This systematic data collection in a high-volume diagnostic center represents a reliable cohort reflecting the trends of [68Ga]Ga-DOTANOC PET/CT use across different clinical indications and primary tumor sites. The recent introduction of novel treatments for advanced neuroendocrine tumors (NETs) and the well-established impact of clinical case discussion within dedicated multidisciplinary teams indicates the need to promote the centralization of rare diseases, such as NENs (neuroendocrine neoplasms). Data on the real-life use of and indications for [68Ga]Ga-DOTANOC PET/CT were collected from a prospective monocentric 5-year electronic archive including consecutive patients with confirmed and suspected NETs (September 2017 to May 2022). Overall, 2082 [68Ga]Ga-DOTANOC PET/CT scans (1685 confirmed NETs, 397 suspected NETs) were performed in 1537 patients. A high positivity rate was observed across different clinical settings (approximately 70%). Approximately 910/2082 scans were requested by the local oncology ward (851 confirmed NETs, 59 suspected NETs). The following observations were found: (i) the detection rate across all indications was 73.2% (higher for staging, peptide receptor radioligand therapy (PRRT) selection, and treatment response assessment); (ii) in suspected NETs, PET was more often positive when based on radiological findings. This systematic data collection in a high-volume diagnostic center represents a reliable cohort reflecting the global trends in the use of [68Ga]Ga-DOTANOC PET/CT for different clinical indications and primary tumor sites, but prompts the need for further multicenter data sharing in such a rare and slowly progressive disease setting. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We examined the association between electronic health information sharing and repeat imaging in readmissions among older adults with and without Alzheimer disease (AD). STUDY DESIGN: Cohort study using national Medicare data. METHODS: Among Medicare beneficiaries with 30-day readmissions in 2018, we examined repeat imaging on the same body system during the readmission. This was evaluated between fragmented and nonfragmented (same-hospital) readmissions and across categories of electronic information sharing via health information exchanges (HIEs) in fragmented readmissions: admission and readmission hospitals share the same HIE, admission and readmission hospitals participate in different HIEs, one or both do not participate in HIE, or HIE data missing. This relationship was evaluated using unadjusted and adjusted logistic regression. RESULTS: Overall, 14.3% of beneficiaries experienced repeat imaging during their readmission. Compared with nonfragmented readmissions, fragmented readmissions were associated with 5% higher odds of repeat imaging on the same body system in older adults without AD. This was not mitigated by the presence of electronic information sharing: Fragmented readmissions to hospitals that shared an HIE had 6% higher odds of repeat imaging (adjusted OR, 1.06; 95% CI, 1.00-1.13). There was no difference seen in the odds of repeat imaging for older adults with AD. CONCLUSIONS: Despite substantial investment, HIEs as currently deployed and used are not associated with decreased odds of repeat imaging in readmissions. [ABSTRACT FROM AUTHOR]

Background: Physiotherapy private practitioners represent a growing proportion of Australia's primary care workforce; however, they face significant barriers in integrating seamlessly within interprofessional teams. Historically, the landscape of primary care in Australia has been one where many physiotherapists work in monoprofessional private practice facilities at dispersed locations, potentially limiting collaborative and coordinated care. The aim of this study was to investigate strategies recommended by physiotherapists to promote effective interprofessional collaborative practice (IPCP) within the Australian private practice setting. Methods: Using interpretive description as the guiding methodological framework, semi-structured interviews were conducted with 28 physiotherapists in 10 private practice sites in Queensland, Australia. Results: Data analysis produced three themes that characterised physiotherapy private practitioners' recommendations to improve IPCP: (a) the need for improved funding and compensation, particularly addressing the limitations of the Medicare Chronic Disease Management program; (b) the development of integrated and secure digital communication systems to facilitate better information exchange; and (c) prioritising professional development and training to enhance collaboration. Conclusions: This research lays the groundwork for informed policy making to advance person-centred care and support the integration of services in the Australian healthcare system. The findings from this study indicate that promoting effective IPCP in physiotherapy private practice requires a comprehensive strategy that addresses systemic funding and compensation issues, enhances digital communication systems and optimises interprofessional education and training. Physiotherapists working in primary care are becoming increasingly important members of interprofessional healthcare teams. This research outlines key strategies from the perspective of Queensland physiotherapy private practitioners, including reforming funding structures, leveraging digital communication and improving education and training initiatives, to promote effective interprofessional collaborative practice. The insights from this study underscore the broader complexities within Australia's healthcare system and emphasise the need for strategic changes to achieve collaboration in ensuring optimal patient care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted the United States' lack of a nationwide infrastructure for collecting, sharing, and using health data, especially for secondary uses (e.g., population health management and public health). The federal government is taking several important steps to upgrade the nation's health data ecosystem—notably, the Centers for Disease Control and Prevention's Data Modernization Initiative and the Office of the National Coordinator for Health Information Technology's Trusted Exchange Framework and Common Agreement. However, substantial barriers remain. Inconsistent regulations, infrastructure, and governance across federal and state levels and between states significantly impede the exchange and analysis of health data. Siloed systems and insufficient funding block effective integration of clinical, public health, and social determinants data within and between states. In this analytic essay, we propose strategies to develop a nationwide health data ecosystem. We focus on providing federal guidance and incentives to develop state-designated entities responsible for the collection, integration, and analysis of clinical, public health, social determinants of health, claims, administrative, and other relevant data. These recommendations include a regulatory clearinghouse, federal guidance, model legislation and templated regulation, funding to incentive enterprise architecture, regulatory sandboxes, and a 3-pronged research agenda. (Am J Public Health. 2024;114(2):209–217. https://doi.org/10.2105/AJPH.2023.307477) [ABSTRACT FROM AUTHOR]

Summary: In today's world, information security plays a key role in data storage and communication owing to the modern evolution of digitized data interchange in electronic mode. Cryptography is a widely preferred technique for securing transmitted information by transforming the original text into cipher text. A few cryptographic techniques have the inability to protect the data which are vulnerable to a distinct class of attacks. Therefore, a reliable cryptographic technique is necessitated for enlarging information security. In this paper, a new hybrid cryptanalysis (HCA) model has been proposed to acquire optimal cryptanalysis of data encryption standard (DES). It combines linear cryptanalysis (LCA) and neural cryptanalysis (NCA) for enhancing the performance of the cryptographic system with minimal time complexity. Primarily, the HCA model employs LCA to break cryptographic codes by analyzing linear approximations of the cryptographic algorithm. NCA is then applied with the aid of a deep neural network for identifying patterns in larger datasets. These patterns can be further utilized to break encryption. The efficacy of the proposed HCA model will be assessed through the assessment of three different datasets. The results manifest that the accuracy of the proposed model is increased up to 97.66% and the time needed to break encryption can be reduced. [ABSTRACT FROM AUTHOR]