Pub Date : 2019-12-05DOI: 10.1177/1833358319887743
B. Ehsani-Moghaddam, Ken Martin, J. Queenan
Data quality (DQ) is the degree to which a given dataset meets a user’s requirements. In the primary healthcare setting, poor quality data can lead to poor patient care, negatively affect the validity and reproducibility of research results and limit the value that such data may have for public health surveillance. To extract reliable and useful information from a large quantity of data and to make more effective and informed decisions, data should be as clean and free of errors as possible. Moreover, because DQ is defined within the context of different user requirements that often change, DQ should be considered to be an emergent construct. As such, we cannot expect that a sufficient level of DQ will last forever. Therefore, the quality of clinical data should be constantly assessed and reassessed in an iterative fashion to ensure that appropriate levels of quality are sustained in an acceptable and transparent manner. This document is based on our hands-on experiences dealing with DQ improvement for the Canadian Primary Care Sentinel Surveillance Network database. The DQ dimensions that are discussed here are accuracy and precision, completeness and comprehensiveness, consistency, timeliness, uniqueness, data cleaning and coherence.
{"title":"Data quality in healthcare: A report of practical experience with the Canadian Primary Care Sentinel Surveillance Network data","authors":"B. Ehsani-Moghaddam, Ken Martin, J. Queenan","doi":"10.1177/1833358319887743","DOIUrl":"https://doi.org/10.1177/1833358319887743","url":null,"abstract":"Data quality (DQ) is the degree to which a given dataset meets a user’s requirements. In the primary healthcare setting, poor quality data can lead to poor patient care, negatively affect the validity and reproducibility of research results and limit the value that such data may have for public health surveillance. To extract reliable and useful information from a large quantity of data and to make more effective and informed decisions, data should be as clean and free of errors as possible. Moreover, because DQ is defined within the context of different user requirements that often change, DQ should be considered to be an emergent construct. As such, we cannot expect that a sufficient level of DQ will last forever. Therefore, the quality of clinical data should be constantly assessed and reassessed in an iterative fashion to ensure that appropriate levels of quality are sustained in an acceptable and transparent manner. This document is based on our hands-on experiences dealing with DQ improvement for the Canadian Primary Care Sentinel Surveillance Network database. The DQ dimensions that are discussed here are accuracy and precision, completeness and comprehensiveness, consistency, timeliness, uniqueness, data cleaning and coherence.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"50 1","pages":"88 - 92"},"PeriodicalIF":3.2,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319887743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47859011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-29DOI: 10.1177/1833358319885223
Thomas Cloney, Jessele Vinluan, Andrew Chen, C. Retegan, P. McCahy
Background: Clinical audits can vary in their effectiveness depending on how the information is provided and the relationship between those giving and receiving feedback. In the Australian state of Victoria, the Victorian Audit of Surgical Mortality (VASM) is a state-wide mortality audit that, prior to this study, did not have a bidirectional feedback mechanism in place to gauge perception of the audit held by its stakeholders. Objective: We aimed to investigate the perceived quality of the audit’s information and the effectiveness of the audit’s communication strategies from the stakeholder population. Methods: We used a mixed methods approach to provide open-ended explorations into stakeholders’ views while also providing structured tools for conducting annual reviews. The qualitative data were analysed using an inductive content analysis. Results: Between 2015 and 2017, 240 VASM stakeholders were contacted, of whom 82 (34.2%) agreed to be interviewed. The VASM’s data were perceived to be of high quality and used in a variety of ways. The audit’s communication strategies were seen to be adequate but could be more targeted to the stakeholder. There is a perception that the audit might not be relevant to hospital stakeholders that are not themselves clinicians, despite direct involvement with the audit. Conclusion: This study helps to explain the role the audit plays among its stakeholders and offers three overarching recommendations for improvement strategies: produce data sharing strategies that are relevant to rural or highly specialised surgical centres, improve communication to be targeted at stakeholders and explore methods to provide feedback to hospital management with more individualised feedback.
{"title":"Stakeholder’s perceived value of surgical audit data provided by the Victorian Audit of Surgical Mortality","authors":"Thomas Cloney, Jessele Vinluan, Andrew Chen, C. Retegan, P. McCahy","doi":"10.1177/1833358319885223","DOIUrl":"https://doi.org/10.1177/1833358319885223","url":null,"abstract":"Background: Clinical audits can vary in their effectiveness depending on how the information is provided and the relationship between those giving and receiving feedback. In the Australian state of Victoria, the Victorian Audit of Surgical Mortality (VASM) is a state-wide mortality audit that, prior to this study, did not have a bidirectional feedback mechanism in place to gauge perception of the audit held by its stakeholders. Objective: We aimed to investigate the perceived quality of the audit’s information and the effectiveness of the audit’s communication strategies from the stakeholder population. Methods: We used a mixed methods approach to provide open-ended explorations into stakeholders’ views while also providing structured tools for conducting annual reviews. The qualitative data were analysed using an inductive content analysis. Results: Between 2015 and 2017, 240 VASM stakeholders were contacted, of whom 82 (34.2%) agreed to be interviewed. The VASM’s data were perceived to be of high quality and used in a variety of ways. The audit’s communication strategies were seen to be adequate but could be more targeted to the stakeholder. There is a perception that the audit might not be relevant to hospital stakeholders that are not themselves clinicians, despite direct involvement with the audit. Conclusion: This study helps to explain the role the audit plays among its stakeholders and offers three overarching recommendations for improvement strategies: produce data sharing strategies that are relevant to rural or highly specialised surgical centres, improve communication to be targeted at stakeholders and explore methods to provide feedback to hospital management with more individualised feedback.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"50 1","pages":"55 - 63"},"PeriodicalIF":3.2,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319885223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42477146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-09DOI: 10.1177/1833358319872820
R. Safdari, H. Rezaeizadeh, G. Arji, A. Abbassian, Mehrshad Mokhtaran, R. Dehghan, Sara Shekalyou
Background: Classification of disease and interventions in traditional medicine (TM) is necessary for standardised coding of information. Currently, in Iran, there is no standard electronic classification system for disease and interventions in TM. Objective: The current study aimed to develop a national framework for the classification of disease and intervention in Persian medicine based on expert opinion. Method: A descriptive cross-sectional study was carried out in 2018. The existing systems for the classification of disease and interventions in TM were reviewed in detail, and some of the structural and content characteristics were extracted for the development of the classification of Iranian traditional medicine. Based on these features, a self-administered questionnaire was developed. Study participants (25) were experts in the field of Persian medicine and health information management in Tehran medical universities. Results: Main axes for the classification of disease and interventions were determined. The most important applications of the classification system were related to clinical coding, policymaking, reporting of mortality and morbidity data, cost analysis and determining the quality indicators. Half of the participants (50%) stated that the classification system should be designed by maintaining the main axis of the World Health Organization classification system and changing the subgroups if necessary. A computer-assisted coding system for TM was proposed for the current study. Conclusion: Development of this classification system will provide nationally comparable data that can be widely used by governments, national organisations and academic researchers.
{"title":"The necessity to develop a national classification system for Iranian traditional medicine","authors":"R. Safdari, H. Rezaeizadeh, G. Arji, A. Abbassian, Mehrshad Mokhtaran, R. Dehghan, Sara Shekalyou","doi":"10.1177/1833358319872820","DOIUrl":"https://doi.org/10.1177/1833358319872820","url":null,"abstract":"Background: Classification of disease and interventions in traditional medicine (TM) is necessary for standardised coding of information. Currently, in Iran, there is no standard electronic classification system for disease and interventions in TM. Objective: The current study aimed to develop a national framework for the classification of disease and intervention in Persian medicine based on expert opinion. Method: A descriptive cross-sectional study was carried out in 2018. The existing systems for the classification of disease and interventions in TM were reviewed in detail, and some of the structural and content characteristics were extracted for the development of the classification of Iranian traditional medicine. Based on these features, a self-administered questionnaire was developed. Study participants (25) were experts in the field of Persian medicine and health information management in Tehran medical universities. Results: Main axes for the classification of disease and interventions were determined. The most important applications of the classification system were related to clinical coding, policymaking, reporting of mortality and morbidity data, cost analysis and determining the quality indicators. Half of the participants (50%) stated that the classification system should be designed by maintaining the main axis of the World Health Organization classification system and changing the subgroups if necessary. A computer-assisted coding system for TM was proposed for the current study. Conclusion: Development of this classification system will provide nationally comparable data that can be widely used by governments, national organisations and academic researchers.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"50 1","pages":"128 - 139"},"PeriodicalIF":3.2,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319872820","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49427577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1177/1833358319841511
Meredith Makeham
The expansion of My Health Record marks an important change in Australia’s healthcare system. In February 2019, a My Health Record was created for people, unless they chose not to have one. This opt-out participation model resulted in a large number of Australians now having access to My Health Record, with approximately 90.1% of those eligible for Medicare participating in the system at the time of record creation. While a national electronic summary record has been available since July 2012, the move to an opt-out system with the ongoing option to permanently delete their record at any time offers Australians an important choice about how they wish to interact with their personal health information. There has been a global move to digitise health systems and data over recent years to improve the way clinicians access accurate health information at the point of care. This is hardly surprising given the critical importance of access to high-quality data in delivering safer care and better health outcomes for our patients. Some countries around the world are now developing digital services that allow people to access their own health information. The growth of these “personal health record” systems (Tang et al., 2006) – like Australia’s My Health Record – represent an important change for people, empowering them to play a more active and informed role in managing their health in partnership with their healthcare providers. The My Health Record system is a secure online record, accessible to and controlled by the healthcare consumer, containing summary information from their registered and connected healthcare providers. The information includes shared health summaries from general practice containing medicines, allergies and diagnoses; hospital discharge summaries; pharmacy dispense records; event summaries and documents from specialists and allied healthcare providers; and pathology and diagnostic imaging reports. In addition, people can view their records within the Australian Immunisation Register and Australian Organ Donor registry, access Medicare and Pharmaceutical Benefits Scheme billing information and upload their own Advance Care Plans. Healthcare providers who are securely connected to the system and directly providing care to the My Health Record recipient are allowed to view and upload information to the record for their patients. This is a model that overcomes some of the traditional communication barriers that prevent a healthcare provider – and individuals – from accessing information contained within health system siloes. This could also be life-saving in an emergency situation where information about key diagnoses, medicines and allergies may be critical. Empowering people with access to their own health information and reducing risk in an emergency through My Health Record are important benefits to acknowledge. However, there are many other benefits associated with personal health records that have been demonstrated in a variety
“我的健康记录”的扩展标志着澳大利亚医疗保健系统的一个重要变化。2019年2月，“我的健康记录”为人们创建，除非他们选择不创建。这种选择退出参与模式导致大量澳大利亚人现在可以访问我的健康记录，大约90.1%符合医疗保险资格的人在记录创建时参与了该系统。虽然自2012年7月以来，全国电子摘要记录已经可用，但向选择退出系统的转变，随时可以永久删除他们的记录，为澳大利亚人提供了一个重要的选择，即他们希望如何与他们的个人健康信息互动。近年来，全球已开始将卫生系统和数据数字化，以改善临床医生在护理点获取准确卫生信息的方式。鉴于获取高质量数据对于为患者提供更安全的护理和更好的健康结果至关重要，这并不令人惊讶。世界上一些国家正在开发数字服务，使人们能够获取自己的健康信息。这些“个人健康记录”系统(Tang et al.， 2006)的发展——就像澳大利亚的“我的健康记录”——代表了人们的一个重要变化，使他们能够与医疗保健提供者合作，在管理自己的健康方面发挥更积极和知情的作用。“我的健康记录”系统是一个安全的在线记录，可由医疗保健消费者访问和控制，其中包含来自其注册和连接的医疗保健提供者的摘要信息。这些信息包括共享的健康摘要，包括药物、过敏和诊断;出院摘要;药房配药记录;来自专家和联合医疗保健提供者的事件摘要和文档;以及病理和诊断影像报告。此外，人们可以在澳大利亚免疫登记和澳大利亚器官捐赠登记中查看他们的记录，访问医疗保险和药品福利计划的账单信息，并上传他们自己的预先护理计划。允许安全地连接到系统并直接向My Health Record接收者提供护理的医疗保健提供者查看其患者的信息并将其上传到记录中。这种模式克服了一些传统的沟通障碍，这些障碍阻碍了卫生保健提供者和个人获取卫生系统孤岛中包含的信息。在紧急情况下，关于关键诊断、药物和过敏的信息可能至关重要，这也可以挽救生命。通过“我的健康记录”，使人们能够获得自己的健康信息并减少紧急情况下的风险，这些都是值得承认的重要好处。然而，在世界各地的各种临床环境中，已经证明了与个人健康记录相关的许多其他好处(Bell等人，2017;加拿大卫生信息网，2018;Nohr et al.， 2016, 2017)。这些措施包括提高对药物治疗方案的理解和遵守，这对人们的安全和更好的健康结果都起着重要作用(Delbanco等人，2012年)。其他可能的好处包括更好的协调护理，因为临床医生可以更容易地与彼此和患者分享信息;提高医疗保健提供者的时间效率，因为他们可以立即查看患者以前未知或难以获取的健康信息;以及为卫生系统带来的经济效益和其他效率，例如当卫生保健提供者看到已经进行了不必要的重复调查时，减少了重复调查。国际上也有大量证据表明，缺乏支持临床信息共享的系统会对患者造成严重的安全威胁和本可避免的伤害，并导致系统效率低下。据估计，澳大利亚初级保健中超过20%的药物不良事件是可以预防的(Miller et al.， 2006)。在澳大利亚，每年大约有230,000人因
{"title":"My Health Record: Connecting Australians with their own health information","authors":"Meredith Makeham","doi":"10.1177/1833358319841511","DOIUrl":"https://doi.org/10.1177/1833358319841511","url":null,"abstract":"The expansion of My Health Record marks an important change in Australia’s healthcare system. In February 2019, a My Health Record was created for people, unless they chose not to have one. This opt-out participation model resulted in a large number of Australians now having access to My Health Record, with approximately 90.1% of those eligible for Medicare participating in the system at the time of record creation. While a national electronic summary record has been available since July 2012, the move to an opt-out system with the ongoing option to permanently delete their record at any time offers Australians an important choice about how they wish to interact with their personal health information. There has been a global move to digitise health systems and data over recent years to improve the way clinicians access accurate health information at the point of care. This is hardly surprising given the critical importance of access to high-quality data in delivering safer care and better health outcomes for our patients. Some countries around the world are now developing digital services that allow people to access their own health information. The growth of these “personal health record” systems (Tang et al., 2006) – like Australia’s My Health Record – represent an important change for people, empowering them to play a more active and informed role in managing their health in partnership with their healthcare providers. The My Health Record system is a secure online record, accessible to and controlled by the healthcare consumer, containing summary information from their registered and connected healthcare providers. The information includes shared health summaries from general practice containing medicines, allergies and diagnoses; hospital discharge summaries; pharmacy dispense records; event summaries and documents from specialists and allied healthcare providers; and pathology and diagnostic imaging reports. In addition, people can view their records within the Australian Immunisation Register and Australian Organ Donor registry, access Medicare and Pharmaceutical Benefits Scheme billing information and upload their own Advance Care Plans. Healthcare providers who are securely connected to the system and directly providing care to the My Health Record recipient are allowed to view and upload information to the record for their patients. This is a model that overcomes some of the traditional communication barriers that prevent a healthcare provider – and individuals – from accessing information contained within health system siloes. This could also be life-saving in an emergency situation where information about key diagnoses, medicines and allergies may be critical. Empowering people with access to their own health information and reducing risk in an emergency through My Health Record are important benefits to acknowledge. However, there are many other benefits associated with personal health records that have been demonstrated in a variety","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"48 1","pages":"113 - 115"},"PeriodicalIF":3.2,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319841511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42297237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-15DOI: 10.1177/1833358319868445
Morteza Hemmat, H. Ayatollahi, M. Maleki, F. Saghafi
Background: Policymakers require a systematic approach when planning for information technology needs in healthcare. Objective: The aim of this study was to obtain experts’ predictions of future health information technology (HIT) needs until 2025 for Iran in relation to the relative importance of key technologies, expected timeframe of realisation, areas that may be impacted upon and obstacles to achieving these goals. Method: This article presents results from the third phase (a Delphi study) of a larger mixed-method study. Policymakers from the Iranian Ministry of Health and faculty members from different medical universities across the country who were expert in the field of HIT were invited to participate (n = 61). Results: Participants (39) completed the first-round questionnaire and 24 completed the second. The development of personal health records (n = 32, 82.0%), the development of clinical decision-making systems (n = 30, 76.9%) and the use of business intelligence for collecting and analysing clinical and financial data (n = 32, 82.0%) were predicted to occur after 2025. The healthcare areas predicted to experience the greatest impact from most HITs were facilitating patient–provider communication and improving healthcare quality. Key barriers to achieving HITs were related to weaknesses in planning and limited financial resources for most technologies. Conclusion: By identifying the areas of impact and the barriers to achieving the HIT goals, more accurate planning is possible and resources can be allocated according to priorities.
{"title":"Health information technology foresight for Iran: A Delphi study of experts’ views to inform future policymaking","authors":"Morteza Hemmat, H. Ayatollahi, M. Maleki, F. Saghafi","doi":"10.1177/1833358319868445","DOIUrl":"https://doi.org/10.1177/1833358319868445","url":null,"abstract":"Background: Policymakers require a systematic approach when planning for information technology needs in healthcare. Objective: The aim of this study was to obtain experts’ predictions of future health information technology (HIT) needs until 2025 for Iran in relation to the relative importance of key technologies, expected timeframe of realisation, areas that may be impacted upon and obstacles to achieving these goals. Method: This article presents results from the third phase (a Delphi study) of a larger mixed-method study. Policymakers from the Iranian Ministry of Health and faculty members from different medical universities across the country who were expert in the field of HIT were invited to participate (n = 61). Results: Participants (39) completed the first-round questionnaire and 24 completed the second. The development of personal health records (n = 32, 82.0%), the development of clinical decision-making systems (n = 30, 76.9%) and the use of business intelligence for collecting and analysing clinical and financial data (n = 32, 82.0%) were predicted to occur after 2025. The healthcare areas predicted to experience the greatest impact from most HITs were facilitating patient–provider communication and improving healthcare quality. Key barriers to achieving HITs were related to weaknesses in planning and limited financial resources for most technologies. Conclusion: By identifying the areas of impact and the barriers to achieving the HIT goals, more accurate planning is possible and resources can be allocated according to priorities.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"50 1","pages":"76 - 87"},"PeriodicalIF":3.2,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319868445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43270355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-01DOI: 10.1177/1833358316671264
M. Sher, Paul C. Talley, T. Cheng, Kuang-Ming Kuo
Purpose: The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients’ privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. Method: We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Results: Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Conclusion: Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.
{"title":"How can hospitals better protect the privacy of electronic medical records? Perspectives from staff members of health information management departments","authors":"M. Sher, Paul C. Talley, T. Cheng, Kuang-Ming Kuo","doi":"10.1177/1833358316671264","DOIUrl":"https://doi.org/10.1177/1833358316671264","url":null,"abstract":"Purpose: The adoption of electronic medical records (EMR) is expected to better improve overall healthcare quality and to offset the financial pressure of excessive administrative burden. However, safeguarding EMR against potentially hostile security breaches from both inside and outside healthcare facilities has created increased patients’ privacy concerns from all sides. The aim of our study was to examine the influencing factors of privacy protection for EMR by healthcare professionals. Method: We used survey methodology to collect questionnaire responses from staff members in health information management departments among nine Taiwanese hospitals active in EMR utilisation. A total of 209 valid responses were collected in 2014. We used partial least squares for analysing the collected data. Results: Perceived benefits, perceived barriers, self-efficacy and cues to action were found to have a significant association with intention to protect EMR privacy, while perceived susceptibility and perceived severity were not. Conclusion: Based on the findings obtained, we suggest that hospitals should provide continuous ethics awareness training to relevant staff and design more effective strategies for improving the protection of EMR privacy in their charge. Further practical and research implications are also discussed.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"46 1","pages":"87 - 95"},"PeriodicalIF":3.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358316671264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48931173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-01DOI: 10.1177/1833358316669888
S. Barnett, Joan Henderson, A. Hodgkins, C. Harrison, Abhijeet Ghosh, Bridget R Dijkmans-Hadley, H. Britt, Andrew D Bonney
Background: Electronic medical data (EMD) from electronic health records of general practice computer systems have enormous research potential, yet many variables are unreliable. Objective: The aim of this study was to compare selected data variables from general practice EMD with a reliable, representative national dataset (Bettering the Evaluation and Care of Health (BEACH)) in order to validate their use for primary care research. Method: EMD variables were compared with encounter data from the nationally representative BEACH program using χ2 tests and robust 95% confidence intervals to test their validity (measure what they reportedly measure). The variables focused on for this study were patient age, sex, smoking status and medications prescribed at the visit. Results: The EMD sample from six general practices in the Illawarra region of New South Wales, Australia, yielded data on 196,515 patient encounters. Details of 90,553 encounters were recorded in the 2013 BEACH dataset from 924 general practitioners. No significant differences in patient age (p = 0.36) or sex (p = 0.39) were found. EMD had a lower rate of current smokers and higher average scripts per visit, but similar prescribing distribution patterns. Conclusion: Validating EMD variables offers avenues for improving primary care delivery and measuring outcomes of care to inform clinical practice and health policy.
背景：来自全科医学计算机系统电子健康记录的电子医疗数据（EMD）具有巨大的研究潜力，但许多变量是不可靠的。目的：本研究的目的是将来自全科医学EMD的选定数据变量与可靠、有代表性的国家数据集（Bettering The Evaluation and Care of Health（BEACH））进行比较，以验证其在初级保健研究中的应用。方法：使用χ2检验和稳健的95%置信区间将EMD变量与具有全国代表性的BEACH项目的遭遇数据进行比较，以检验其有效性（测量他们所测量的值）。这项研究关注的变量是患者年龄、性别、吸烟状况和就诊时开具的药物。结果：来自澳大利亚新南威尔士州伊拉瓦拉地区六家普通诊所的EMD样本产生了196515名患者的遭遇数据。2013年BEACH数据集中记录了来自924名全科医生的90553次遭遇的细节。患者年龄（p=0.36）或性别（p=0.39）无显著差异。EMD目前吸烟者的比率较低，每次就诊的平均脚本较高，但处方分布模式相似。结论：验证EMD变量为改善初级保健提供了途径，并测量了护理结果，为临床实践和卫生政策提供了信息。
{"title":"A valuable approach to the use of electronic medical data in primary care research: Panning for gold","authors":"S. Barnett, Joan Henderson, A. Hodgkins, C. Harrison, Abhijeet Ghosh, Bridget R Dijkmans-Hadley, H. Britt, Andrew D Bonney","doi":"10.1177/1833358316669888","DOIUrl":"https://doi.org/10.1177/1833358316669888","url":null,"abstract":"Background: Electronic medical data (EMD) from electronic health records of general practice computer systems have enormous research potential, yet many variables are unreliable. Objective: The aim of this study was to compare selected data variables from general practice EMD with a reliable, representative national dataset (Bettering the Evaluation and Care of Health (BEACH)) in order to validate their use for primary care research. Method: EMD variables were compared with encounter data from the nationally representative BEACH program using χ2 tests and robust 95% confidence intervals to test their validity (measure what they reportedly measure). The variables focused on for this study were patient age, sex, smoking status and medications prescribed at the visit. Results: The EMD sample from six general practices in the Illawarra region of New South Wales, Australia, yielded data on 196,515 patient encounters. Details of 90,553 encounters were recorded in the 2013 BEACH dataset from 924 general practitioners. No significant differences in patient age (p = 0.36) or sex (p = 0.39) were found. EMD had a lower rate of current smokers and higher average scripts per visit, but similar prescribing distribution patterns. Conclusion: Validating EMD variables offers avenues for improving primary care delivery and measuring outcomes of care to inform clinical practice and health policy.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"46 1","pages":"51 - 57"},"PeriodicalIF":3.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358316669888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44174946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-01DOI: 10.1177/1833358316678957
E. Munyisia, D. Reid, Robert Yu
Background: Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. Objective: This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. Methods: An audit was carried out on healthcare workers’ (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system. Results: Of the 6919 data entries in the electronic documentation system, 7.5% (518) had errors, 68.7% of the errors were related to a wrong primary activity, 14.5% were due to a wrong activity category, 14.5% were as a result of a wrong combination of primary activity and modality of care, 1.9% were due to inaccurate information on a client’s presence during service delivery and 0.4% were related to a wrong modality of care. Conclusion: Data entry errors may affect the amount of funding received by a healthcare organisation, which in turn may affect the quality of treatment provided to clients due to the possibility of underfunding the organisation. To reduce errors or achieve an error-free environment, there is a need to improve the naming convention of data elements, their descriptions and alignment with the national standard classification of outpatient services. It is also important to support healthcare workers in their data entry by embedding safeguards in the electronic documentation system such as flags for inaccurate data elements.
{"title":"Accuracy of outpatient service data for activity-based funding in New South Wales, Australia","authors":"E. Munyisia, D. Reid, Robert Yu","doi":"10.1177/1833358316678957","DOIUrl":"https://doi.org/10.1177/1833358316678957","url":null,"abstract":"Background: Despite increasing research on activity-based funding (ABF), there is no empirical evidence on the accuracy of outpatient service data for payment. Objective: This study aimed to identify data entry errors affecting ABF in two drug and alcohol outpatient clinic services in Australia. Methods: An audit was carried out on healthcare workers’ (doctors, nurses, psychologists, social workers, counsellors, and aboriginal health education officers) data entry errors in an outpatient electronic documentation system. Results: Of the 6919 data entries in the electronic documentation system, 7.5% (518) had errors, 68.7% of the errors were related to a wrong primary activity, 14.5% were due to a wrong activity category, 14.5% were as a result of a wrong combination of primary activity and modality of care, 1.9% were due to inaccurate information on a client’s presence during service delivery and 0.4% were related to a wrong modality of care. Conclusion: Data entry errors may affect the amount of funding received by a healthcare organisation, which in turn may affect the quality of treatment provided to clients due to the possibility of underfunding the organisation. To reduce errors or achieve an error-free environment, there is a need to improve the naming convention of data elements, their descriptions and alignment with the national standard classification of outpatient services. It is also important to support healthcare workers in their data entry by embedding safeguards in the electronic documentation system such as flags for inaccurate data elements.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":"46 1","pages":"78 - 86"},"PeriodicalIF":3.2,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358316678957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46258774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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