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The use of data and computer systems as the subject and means of committing a crime is one of the manifestations of the negative link between these technologies and criminal law. The purpose of this research is to identify the challenges of the Iranian police in the search and seizure of data and the system in the prevention and detection of crime. The current research is applied in terms of its purpose, and descriptive-analytical in terms of its type and in the category of qualitative research. By using library resources and interviews with university experts, data has been collected and analyzed by qualitative content analysis method. The findings indicate that the police faces challenges in the search and seizure of data and the system with two types of challenges including: The The challenges are in the field of protecting the privacy of individuals and in the field of legislative limitations and loopholes. Therefore, the elimination of legislative gaps in the field of privacy and police powers and their access to databases for the prevention and detection of crime are effective in solving the challenges of the police in inspecting and confiscating data and systems in Iran. [ABSTRACT FROM AUTHOR]

The current digital era forces all parties to make changes an transformations, including the government. Tha government in its services continues to transform following the times from what was originally a face-to-face service and came directly or what is commonly referred to as offline (outside the network) to transform into online services (in the network) using only electronic media such as computers, laptops, and cellphones. Digital transformation has several risks that can occur, suc as data leakage, data abuse, account abuse, and so on. This study aims to determine Government Service from legal aspects and Digital Risk Mitigation. This study used a qualitative research method with a descriptive approach, while the data collection technique was carried out by means of a literature study through exploration of journals, books, laws and other information relevant to the study. The results of the research show that the legal aspect in the implementation of government services in Indonesia is the need for prenventive legal protection as a prevention of various risks. One of them is Article 28G paragraph (1) of the 1945 Constitution of the Republic of Indonesia. Meanwhile, in terms of mitigating the risk of digital transformation in government services, it is the standardization of information security on official ICT devices to avoid or minimize the risk of blood leakage, abuse data, as well as account abuse. [ABSTRACT FROM AUTHOR]

Collision analysis utilizing electronic data recorders, videos, traffic signal timing data, and other electronic records adds valuable input but can be a challenge to tie together due to the lack of a finite time stamp or common recording rate. However, overlapping data streams that have a common point-in-time identifier can be resolved. A strategic approach was developed by the author for unifying and validating the vehicle positions and time-distance reconstruction. The method outlines the steps for establishing known data points, forming a common time line, identifying overlapping information, and linking together independent records. A case study demonstrates a crash at a traffic signal-controlled intersection in which each vehicle entered on their respective green lights without conflict; however, the collision still occurred. The crash reconstruction will highlight driver options and demonstrate the value of combining multiple data streams into one time line. [ABSTRACT FROM AUTHOR]

Background: Electronic health records (EHRs), considered one of the crucial advances in technological health-care delivery, have made medical details easier to procure from anywhere. It has a distinct edge over paper records, and medical literature also reveals that implementing EHRs is instrumental in refining the documentation quality. With this study, we understand its utility and prevalence in the current scenario. Aim: The current study investigated the knowledge and perception of EHR sand computer-based patient maintenance among Indian dentists. We also highlighted the current state of EHR in India while discussing the financial and legal barriers. Materials and Methods: A cross-sectional survey was done to assess the awareness and perception of EHRs among randomly selected dentists practicing in India. The questionnaire with three sections and 33 questions was distributed through Google Forms through E-mail to contacts and promoted on social media among various dental community groups. Results: We found that majorly private practices (30.4%) and multispecialty dental colleges (39%) opted for electronic dental records (EDRs). Largely, Indian dentists were utilizing hybrid formats which depicted their inclination to evolve with the everyday-upgrading digital dentistry. However, 47.5% of practitioners still fear their use due to the risk of data loss. Conclusions: The increasing prevalence of EDRs is a promise toward an absolute diagnosis, preventing medical errors with their availability at the point of care, reducing repetitive laboratory tests, and consequently the financial burden on patients. [ABSTRACT FROM AUTHOR]

AbstractDespite the expanding digitisation of individual health data, informed consent for the collection and use of health data is seldom explicitly sought in public sector clinics in South Africa. This study aims to identify perceptions of informed consent practices for health data capture, access, and use in Gauteng and the Western Cape provinces of South Africa. Data collection from September to December 2021 included in-depth interviews with healthcare providers (n = 12) and women (n = 62) attending maternity services. Study findings suggest that most patients were not aware that their data were being used for purposes beyond the individualised provision of medical care. Understanding the concept of anonymised use of electronic health data was at times challenging for patients who understood their data in the limited context of paper-based folders and booklets. When asked about preferences for electronic data, patients overwhelmingly were in favour of digitisation. They viewed electronic access to their health data as facilitating rapid and continuous access to health information. Patients were additionally asked about preferences, including delivery of health information, onward health data use, and recontacting. Understanding of these use cases varied and was often challenging to convey to participants who understood their health data in the context of information inputted into their paper folders. Future systems need to be established to collect informed consent for onward health data use. In light of perceived ties to the care received, these systems need to ensure that patient preferences do not impede the content nor quality of care received.

Background: Electronic health records (EHRs), considered one of the crucial advances in technological health-care delivery, have made medical details easier to procure from anywhere. It has a distinct edge over paper records, and medical literature also reveals that implementing EHRs is instrumental in refining the documentation quality. With this study, we understand its utility and prevalence in the current scenario. Aim: The current study investigated the knowledge and perception of EHR sand computer-based patient maintenance among Indian dentists. We also highlighted the current state of EHR in India while discussing the financial and legal barriers. Materials and Methods: A cross-sectional survey was done to assess the awareness and perception of EHRs among randomly selected dentists practicing in India. The questionnaire with three sections and 33 questions was distributed through Google Forms through E-mail to contacts and promoted on social media among various dental community groups. Results: We found that majorly private practices (30.4%) and multispecialty dental colleges (39%) opted for electronic dental records (EDRs). Largely, Indian dentists were utilizing hybrid formats which depicted their inclination to evolve with the everyday-upgrading digital dentistry. However, 47.5% of practitioners still fear their use due to the risk of data loss. Conclusions: The increasing prevalence of EDRs is a promise toward an absolute diagnosis, preventing medical errors with their availability at the point of care, reducing repetitive laboratory tests, and consequently the financial burden on patients.

Background: Children with medical complexity (CMC) are individuals with complex chronic conditions who have substantial health care needs, functional limitations, and significant use of health care. By nature of their health status, they have many care providers across multiple settings, making information sharing critical to their health and safety. Connecting2gether (C2), a weband mobile-based patient-facing platform, was codeveloped with families to support and empower parental caregivers, improve information sharing, and facilitate care delivery. C2 also provided a live platform coach to conduct parental feedback and coaching sessions, which included answering questions, providing advice on usage, and addressing technological issues. Objective: This study was conducted to understand the experience of parental caregivers using the C2 platform and the role of the live platform coach. This study is a subset of a larger study assessing the feasibility of C2 in the care of CMC. Methods: Parental caregivers (n=33) participated in biweekly sessions to provide feedback and receive real-time platform use support from a trained research team member acting as a live platform coach. Parental caregivers were asked about the utility and usability of C2's features. Questions, platform issues, and feedback were recorded on a standardized electronic data collection tool. A thematic analysis was performed to analyze parental comments, and codes were categorized into key themes. The number of comments corresponding with each code was quantified. Results: A total of 166 parental feedback and coaching sessions were conducted, with an average of 5 sessions per parental caregiver (range 1-7). There were 33 (85%) parental caregivers that participated in at least one coaching session. Technical issues and difficulties navigating C2 were addressed in real time during the sessions to encourage platform engagement. Four key themes were identified: (1) live platform coach, (2) barriers to platform usage and technical challenges, (3) platform requests and modifications, and (4) parent partnership and empowerment. Conclusions: Parental caregivers describe C2 as a valuable tool, acting as a facilitator for enhanced care coordination and communication. Parental caregiver feedback showed that the live platform coach was a critical tool in educating on platform use and addressing technological concerns. Further study of the use of the C2 platform and its role in the care of CMC is needed to understand the possible benefits and cost-effectiveness of this technology. [ABSTRACT FROM AUTHOR]

Healthcare-associated foodborne outbreaks (HA-FBOs) can cause significant morbidity and mortality, affecting particularly vulnerable hospital populations. Electronic records of food served in healthcare facilities (HCFs) could be useful for timely investigations of HA-FBOs. We explored the availability and usability of electronic food menu data to support investigations of HA-FBOs through a survey among 35 HCFs in Germany (n = 13) and in Italy (n = 22). Large variability was reported in the storage time of menu data (from no storage up to 10 years) and their formats, including paper, electronic (PDF, Word, Excel), or fully searchable databases (15/22 in Italian HCFs, 3/13 in German HCFs). Food products that may present a risk to vulnerable persons – including deli salads, raw/fermented sausage products, soft cheese, smoked fish or frozen berries – were offered on the menu of all HCFs in Germany, and one-third of the Italian HCFs. The usability of electronic food menu data for the prevention or investigation of HA-FBOs may be suboptimal in a large number of HCFs in Germany, as well as in some HCFs in Italy. Standardised collection for use of electronic food menu data might help discover the association between illnesses and food eaten during outbreak investigations. Hospital hygienists, food safety and public health authorities should collaborate to increase implementation of food safety guidelines. [ABSTRACT FROM AUTHOR]

Background: Using electronic data for cardiovascular risk stratification could help in prioritising healthcare access and optimise cardiovascular prevention. Aims: To determine whether assessment of absolute cardiovascular risk (Australian absolute cardiovascular disease risk (ACVDR)) and short‐term ischaemic risk (History, ECG, Age, Risk factors, and Troponin (HEART) score) is possible from available data in Electronic Medical Record (EMR) and My Health Record (MHR) of patients presenting with acute cardiac symptoms to a Rapid Access Cardiology Clinic (RACC). Methods: Audit of EMR and MHR on 200 randomly selected adults who presented to RACC between 1 March 2017 and 4 February 2020. The main outcomes were the proportion of patients for which ACVDR score and HEART score could be calculated. Results: Mean age was 55.2 ± 17.8 years and 43% were female. Most (85%) were referred from emergency for chest pain (52%). Forty‐six percent had hypertension, 35% obesity, 20% diabetes mellitus, 17% ischaemic heart disease and 18% were current smokers. There was no significant difference in MHR accessibility with age, gender and number of comorbidities. An ACVDR score could be estimated for 17.5% (EMR) and 0% (MHR) of patients. None had complete data to estimate HEART score in either EMR or MHR. Most commonly missing variables for ACVDR score were blood pressure (MHR) and high‐density lipoprotein cholesterol (EMR), and for HEART score the missing variables were body mass index and comorbidities (MHR and EMR). Conclusions: Significant gaps are apparent in electronic medical data capture of key variables to perform cardiovascular risk assessment. Medical data capture should prioritise the collection of clinically important data to help address gaps in cardiovascular management. [ABSTRACT FROM AUTHOR]

Background: There are 15,632 nursing homes (NHs) in the United States. NHs continue to receive significant policy attention due to high costs and poor outcomes of care. One strategy for improving NH care is use of health information technology (HIT). A central concept of this study is HIT maturity, which is used to identify adoption trends in HIT capabilities, use and integration within resident care, clinical support, and administrative activities. This concept is guided by the Nolan stage theory, which postulates that a system such as HIT moves through a series of measurable stages. HIT maturity is an important component of the rapidly changing NH landscape, which is being affected by policies generated to protect residents, in part because of the pandemic. Objective: The aim of this study is to identify structural disparities in NH HIT maturity and see if it is moderated by commonly used organizational characteristics. Methods: NHs (n=6123, >20%) were randomly recruited from each state using Nursing Home Compare data. Investigators used a validated HIT maturity survey with 9 subscales including HIT capabilities, extent of HIT use, and degree of HIT integration in resident care, clinical support, and administrative activities. Each subscale had a possible HIT maturity score of 0-100. Total HIT maturity, with a possible score of 0-900, was calculated using the 9 subscales (3 x 3 matrix). Total HIT maturity scores equate 1 of 7 HIT maturity stages (stages 0-6) for each facility. Dependent variables included HIT maturity scores. We included 5 independent variables (ie, ownership, chain status, location, number of beds, and occupancy rates). Unadjusted and adjusted cumulative odds ratios were calculated using regression models. Results: Our sample (n=719) had a larger proportion of smaller facilities and a smaller proportion of larger facilities than the national nursing home population. Integrated clinical support technology had the lowest HIT maturity score compared to resident care HIT capabilities. The majority (n=486, 60.7%) of NHs report stage 3 or lower with limited capabilities to communicate about care delivery outside their facility. Larger NHs in metropolitan areas had higher odds of HIT maturity. The number of certified beds and NH location were significantly associated with HIT maturity stage while ownership, chain status, and occupancy rate were not. Conclusions: NH structural disparities were recognized through differences in HIT maturity stage. Structural disparities in this sample appear most evident in HIT maturity, measuring integration of clinical support technologies for laboratory, pharmacy, and radiology services. Ongoing assessments of NH structural disparities is crucial given 1.35 million Americans receive care in these facilities annually. Leaders must be willing to promote equal opportunities across the spectrum of health care services to incentivize and enhance HIT adoption to balance structural disparities and improve resident outcomes. [ABSTRACT FROM AUTHOR]

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Background: There is a global emphasis on expanding data collection for joint replacement procedures beyond implant attributes and progression to revision surgery. Patient-reported outcome measures (PROMs) are increasingly considered as an important measure of surgical outcomes from a patient's perspective. However, a major limitation preventing wider use of PROMs data in national data collection has been the inability to systematically collect and share electronic information with relevant stakeholders in a comprehensive and financially sustainable manner. Objective: This study reports on the development of an electronic data capture and reporting system by a national registry for the collection of PROMs and the processes used to identify and overcome barriers to implementation and uptake. The study also aims to provide a cost breakdown of establishing and maintaining a nationwide electronic PROMs program. Methods: Between 2018 and 2020, 3 governance and advisory committees were established to develop and implement a PROMs pilot program nested within a nationwide joint replacement registry. The program involved electronic collection of preoperative and 6-month postoperative data for hip, knee, or shoulder replacement surgery from 44 Australian hospitals. Resource requirements for the program included a project manager, software developers, data manager, and statistician. An online platform was tested, refined, and implemented for electronic PROMs collection with scalability considered for future expansion to all Australian hospitals and additional data fields. Technical capabilities included different access for multiple user types, patient registration, automatic reminders via SMS text messages and email, online consent, and patient outcome real-time dashboards accessible for different user groups (surgeons, patients, hospitals, and project stakeholders). Results: During the PROMs pilot period there were 19,699 primary procedures undertaken with 10,204 registered procedures in the electronic system. This equated to 51.80% of people who had a joint replacement at participating hospitals during this period. Patient registration and data collection were efficient (20-30 seconds and 10-12 minutes, respectively). Engagement with the reporting dashboards (as a proportion of those who viewed their dashboard) varied by user group: 197/277 (71.1%) hospital administrators, 68/129 (52.7%) project stakeholders, 177/391 (45.3%) surgeons, and 1138/8840 patients (12.9%). Cost analysis determined an overall cost per patient of Aus $7-15 (approximately US $5-12) for 2 PROMs collections per joint replacement procedure once the program was established. Conclusions: Successful implementation of an orthopedic PROMs program with planned scalability for a broader national rollout requires significant funding and staffing resources. However, this expenditure can be considered worthwhile, given that collection and reporting of PROMs can drive health care improvement processes. Further consideration of strategies to improve stakeholder engagement with electronic reporting dashboards (particularly for patients and surgeons) will be critical to the ongoing success of a national PROMs program. [ABSTRACT FROM AUTHOR]

Tanja R Zijp,1 Daan J Touw,1–3 Job FM van Boven1,3 1Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; 2Department of Pharmaceutical Analysis, University of Groningen, Groningen Research Institute of Pharmacy, Groningen, the Netherlands; 3Medication Adherence Expertise Center of the Northern Netherlands (MAECON), Groningen, the NetherlandsCorrespondence: Job FM van BovenUniversity Medical Center Groningen, Hanzeplein 1 (Internal Postcode EB70), Groningen 9700 RB, the NetherlandsTel +31503617893Email j.f.m.van.boven@umcg.nlPurpose: Smart medication adherence monitoring devices can provide objective and granular drug utilization data and help patients engaging with their treatment. In this proof-of-concept study, the acceptability and technical robustness of a novel smart pill bottle prototype (SPBP) were assessed in order to allow further optimization.Methods: The SPBP is an app-controlled automatic dispense system, capturing real-time data on a web-based platform, which sends text reminders and measures storage conditions. A heterogeneous group of ten volunteers was asked to dispense placebo capsules with the SPBP and to follow a predefined dosing schedule for a trial period of 2 weeks. Afterwards, a questionnaire was filled out during a short interview. Primary outcome was dispense adherence as measured by the bottle. Other study outcomes included system acceptability (System Usability Scale [SUS]), self-reported adherence (MARS) and technical robustness of the bottle’s mechanics (electronic pill dispenser) and sensors (bottle temperature).Results: The overall dispense adherence rate as measured by the SPBP was 88%. All participants completed the study and four participants had an adherence rate of 100% during the study. The dispense adherence rates corresponded well with participants’ self-reported adherence with an average MARS total score of 23.6 (out of 25). Participants judged the system easy to use, with a mean SUS score of 79.3 (range: 57.5– 97.5). The overall mean temperature difference between the bottle sensor and calibrated external sensor was − 0.82°C (range: − 1.37°C to − 0.21°C).Conclusion: The SPBP was well accepted and this study provides data for further optimization and follow-up studies. Smart adherence technologies such as these may change the way healthcare professionals, trialists and patients manage medication adherence.Keywords: smart device, real-time monitoring, medication management, electronic data, medication dispenser, mobile app

In the face of the era of big data, how to ensure the authenticity of electronic data has become an important practical issue. Online preservation methods based on hash operation, time stamp, and blockchain technology can effectively guarantee the authenticity and security of electronic data. Blockchains are inherently traceable, de-centralized, and difficult to tamper with, which can be enough served as the basic technology of electronic data certification. Preservation by blockchain mainly includes the following links: platform registration and identity authentication, generation and transmission of electronic data, and storage of electronic data. Preservation by blockchain has higher security than centralized online security because of distributed storage. However, it should be acknowledged that the preservation by blockchain is not without risk. The court should adhere to the principle of individual review of each case and review the electronic data from its generation, transmission, reception, storage, and collection.

Copyright of Belügyi Szemle / Academic Journal of Internal Affairs is the property of Ministry of Interior of Hungary and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Forensic Science & Technology is the property of Institute of Forensic Science, Ministry of Public Security and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Predicting progression in diabetic kidney disease (DKD) is critical to improving outcomes. We sought to develop/validate a machine-learned, prognostic risk score (KidneyIntelX™) combining electronic health records (EHR) and biomarkers. Methods: This is an observational cohort study of patients with prevalent DKD/banked plasma from two EHR-linked biobanks. A random forest model was trained, and performance (AUC, positive and negative predictive values [PPV/NPV], and net reclassification index [NRI]) was compared with that of a clinical model and Kidney Disease: Improving Global Outcomes (KDIGO) categories for predicting a composite outcome of eGFR decline of ≥5 ml/min per year, ≥40% sustained decline, or kidney failure within 5 years. Results: In 1146 patients, the median age was 63 years, 51% were female, the baseline eGFR was 54 ml min−1 [1.73 m]−2, the urine albumin to creatinine ratio (uACR) was 6.9 mg/mmol, follow-up was 4.3 years and 21% had the composite endpoint. On cross-validation in derivation (n = 686), KidneyIntelX had an AUC of 0.77 (95% CI 0.74, 0.79). In validation (n = 460), the AUC was 0.77 (95% CI 0.76, 0.79). By comparison, the AUC for the clinical model was 0.62 (95% CI 0.61, 0.63) in derivation and 0.61 (95% CI 0.60, 0.63) in validation. Using derivation cut-offs, KidneyIntelX stratified 46%, 37% and 17% of the validation cohort into low-, intermediate- and high-risk groups for the composite kidney endpoint, respectively. The PPV for progressive decline in kidney function in the high-risk group was 61% for KidneyIntelX vs 40% for the highest risk strata by KDIGO categorisation (p < 0.001). Only 10% of those scored as low risk by KidneyIntelX experienced progression (i.e., NPV of 90%). The NRIevent for the high-risk group was 41% (p < 0.05). Conclusions: KidneyIntelX improved prediction of kidney outcomes over KDIGO and clinical models in individuals with early stages of DKD. [ABSTRACT FROM AUTHOR]

Copyright of Kırıkkale University Journal of Social Sciences is the property of Kirikkale University Journal of Social Science (KUJSS) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Transition: Journal of Economic & Politics of Transition / Tranzicija: Časopis za Ekonomiju i Politiku Tranzicije is the property of Ekonomski Institut Tuzla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the continuous progress of science and technology, the Internet has gradually entered every field of daily life. In addition to the information generated by the Internet in the form of digitization, it has become the main media for people to store information. In the field of criminal offenses, the network is likely to be used to perpetrate criminal schemes, implement crimes, or help hinder investigations afterward. These acts will leave an electronic data trail, such as WeChat information, emails, or blogs. After a crime occurs, an evidence investigator should accurately, timely, and comprehensively obtain all electronic data related to the case by collecting, extracting, and transferring this data according to the law, and examining the authenticity, legality, and relevance of the evidence. Through a comprehensive review, the investigator should clarify the relationship between the electronic data and the facts to be proved and make full use of the obtained electronic evidence in criminal proceedings.

The recordings made by technical means have not constituted, at least in civil matters, ever since the appearance of the devices that made them possible, an admissible evidence, not being regulated as such by the legislator in the past. In the new regulations, starting with the Law No 217/2003, including in the new Civil Procedure Code, in the conditions of the extended use of electronic means, both in the institutional framework and in the private life, the daily realities have imposed the use of the recordings with technical means as evidence. However, by operating a generalization, the possibility that the data of any kind to be fixed on a computer-based media has led to the penetration of this kind of probation both in the evidence with written documents, in the form of computer-based written documents, and in that of material means of evidence. The inclusion of the recordings, generically speaking, also in the category of material means of evidence generates problems both in terms of identifying their legal nature, with implications on their administration and storage regime, and in terms of establishing their admissibility conditions. The latter also raise the question of establishing the extent of the probationary area related thereto, respectively whether it should be restricted only to proving those legal relations which the facts of legal relevance involve, as well as which categories among these fall within the scope of circumstances likely to be proved in this way. For this purpose, but also in order to establish the meaning of the phrases that individualize such evidence, as the civil processual legislation is lapidary, it was necessary an incursion into the criminal processual one, a necessary approach inclusively in order to establish the legal regime related thereto. Finally, the issue of the legal regime of their preservation was also addressed. Two generic conclusions were distinguished, namely that, by this type of evidence, only legal facts can be proved, especially those generating legal liability, and that such evidence is admissible, in principle, under the conditions of the admissibility of the evidence with witnesses. [ABSTRACT FROM AUTHOR]

Background: Journey to 9 Plus (J9) is an integrated reproductive, maternal, neonatal, and child health approach to care that has at its core the goal of decreasing the rate of maternal and neonatal morbidity and mortality in rural Haiti. For the maximum effectiveness of this program, it is necessary that the data system be of the highest quality. OpenMRS, an electronic medical record (EMR) system, has been in place since 2013 throughout a tertiary referral hospital, the Hôpital Universitaire de Mirebalais, in Haiti and has been expanded for J9 data collection and reporting. The J9 program monthly reports showed that staff had limited time and capacity to perform double charting, which contributed to incomplete and inconsistent reports. Initial evaluation of the quality of EMR data entry showed that only 18% (58/325) of the J9 antenatal visits were being documented electronically at the start of this quality improvement project., Objective: This study aimed to improve the electronic documentation of outpatient antenatal care from 18% (58/325) to 85% in the EMR by J9 staff from November 2020 to September 2021. The experiences that this quality improvement project team encountered could help others improve electronic data collection as well as the transition from paper to electronic documentation within a burgeoning health care system., Methods: A continuous quality improvement strategy was undertaken as the best approach to improve the EMR data collection at Hôpital Universitaire de Mirebalais. The team used several continuous quality improvement tools to conduct this project: (1) a root cause analysis using Ishikawa and Pareto diagrams, (2) baseline evaluation measurements, and (3) Plan-Do-Study-Act improvement cycles to document incremental changes and the results of each change., Results: At the beginning of the quality improvement project in November 2020, the baseline data entry for antenatal visits was 18% (58/325). Ten months of improvement strategies resulted in an average of 89% (272/304) of antenatal visits documented in the EMR at point of care every month., Conclusions: The experiences that this quality improvement project team encountered can contribute to the transition from paper to electronic documentation within burgeoning health care systems. Essential to success was having a strong and dedicated nursing leadership to transition from paper to electronic data and motivated nursing staff to perform data collection to improve the quality of data and thus, the reports on patient outcomes. Engaging the nursing team closely in the design and implementation of EMR and quality improvement processes ensures long-term success while centering nurses as key change agents in patient care systems., (©Meredith Casella Jean-Baptiste, Thamar Monide Vital Julmiste, Ellen Ball. Originally published in JMIR Formative Research (https://formative.jmir.org), 14.06.2024.)

Background: Occupational noise-induced hearing loss (ONIHL) is a complex, but preventable, health problem for South African miners. Meticulously collected data should be made use of to design interventions to address this health issue. Objectives: A single mine’s electronic data were reviewed in a secondary data review to determine, from the records, factors that hearing conservation practitioners deemed useful for identifying ‘at risk’ miners and to establish factors that would pave the way for the integration of the 2014 hearing conservation programme (HCP) milestones into the mine’s current proactive data management system (PDMS). The objectives of this article were to establish how miners with published risk factors associated with ONIHL were managed by the mine’s hearing conservation practitioners as part of the HCP; to determine if the mine’s hearing conservation practitioners could estimate miners’ risk of ONIHL using baseline percentage loss of hearing (PLH) as a hearing conservation measure; and to estimate the contribution of noise exposure to ONIHL risk. Method: In a secondary data review design, records in a platinum mine’s two electronic data sets were reviewed: the first contained diagnostic audiometry records (N = 1938) and the second comprised a subset of miners diagnosed with ONIHL (n = 73). Data were available for the period 2014–2017 and included demographic, occupational, audiometry and ONIHL diagnosis data. Miners’ risk factors associated with ONIHL were identified using the functional risk management structure. A logistic regression model was used for the baseline PLH margins of 0% – 40% (in 5% increments) to estimate the adjusted predictions for miners at risk of developing ONIHL. The contribution of noise exposure as a risk for ONIHL was estimated using a two-way sample proportion test. Results: The mean age of the miners (all male candidates) was 47 ± 8.5 years; more than 80% had worked for longer than 10 years. Valid baseline audiometry records were available for only 34% (n = 669) of the miners. Miners with a 0% baseline PLH had a 20% predicted risk of ONIHL, and a 45% predicted risk if they had a 40% baseline PLH – these employees were referred. The noise exposure risk rankings revealed that 64.9% (n = 1250) of the miners were exposed to 91 dBA – 105 dBA noise exposure levels and that 59 (80.8%) diagnosed with ONIHL were exposed to noise levels of up to 104 dBA. Conclusion: These findings indicate significant gaps in the mine’s PDMS, requiring attention. Nonetheless, the mine’s current data capturing may be used to identify miners at risk of developing ONIHL. The PLH referral cut-off point (≥2.5%) used by the mine’s hearing conservation practitioners, when used in conjunction with baseline PLH shifts, was the major factor in early identification of ONIHL in miners exposed to ≥85 dBA noise. An inclusive integrative data management programme that includes the medical surveillance data set of the miners’ noise exposure levels, occupations, ages and medical treatments for tuberculosis and human immunodeficiency syndrome is recommended, as these are important risk indicators for developing ONIHL, particularly within the South African context.

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Although informative, the literature related to Supply Chain Management Systems (SCMS) needs to be developed further to provide insight related to the realized benefits of adopting firms. Specifically, there is a need to analyse empirically and systematically the potential benefits and variables that explain the differences in benefit variation. To contribute to this need, the study analysed SCMS benefits in four steps. First, drawing from survey responses of a diverse group of manufacturing plants, the study sought evidence of the claimed benefits found in the literature. Second, the study built on the claims and findings of previous researchers to formulate and test hypotheses related to factors that help explain differences in benefits. Third, once the explanatory variables were analysed in isolation, they were then analysed for the incremental effects. Finally, based on the results of the first three steps, the study refined the results to produce a synthesized explanatory SCMS benefit model. [ABSTRACT FROM AUTHOR]