Health information management : journal of the Health Information Management Association of Australia最新文献

Background: Hospital electronic health record (EHR) systems contain extensive data of varying quality and suitability for research. Identifying research suitable data from hospital systems is rarely performed using a structured approach. Objective: To define a core set of research suitable data, from multiple hospital datasets and systems for the National Centre for Healthy Ageing Data Platform. Method: Candidate data were identified based on: published literature, researcher survey and quality audit. We recruited researchers and clinicians to participate in a modified Delphi method to achieve consensus on the core data. Live online surveys were conducted across 11 datasets. Participants rated the relevance of each data item using a Likert scale and provide additional feedback. Acceptance criteria were set at >70% agreement. Items meeting this threshold were included in the core dataset. Results: The end user group contained 16 university and 17 clinician researchers. An initial 144 data items were presented for consideration. Experts provided additional details for specialised items. Consensus to include an item was reached after one (n = 127) or two (n = 3) rounds with an additional three items identified by end-users. The final core dataset included 133 items across all 11 datasets. Conclusion: Our approach proved effective in reaching consensus among diverse researchers, ensuring that the selected data items are relevant for a range of purposes. Implications for health information management practice: Having a core dataset will support targeted activities that ensure these items are accurate, readily accessible and used appropriately to support patient care, administrative tasks and research.

Background: The success of disease registry systems (DRSs) depends on developing software that aligns with the registry's specific needs.

Objective: This study focuses on localising the Checklist with Items for Patient Registry sOftware Systems (CIPROS) to facilitate the DRS assessment.

Method: This applied and cross-sectional study was carried out in 2023 in six phases. The first phase involved translating the CIPROS checklist. In the second phase, experts validated the face validity of the checklist. The third phase focused on calculating the content validity ratio (CVR) and content validity index (CVI) for each item. In the fourth phase, the items removed earlier were reassessed. In the fifth phase, definitions for each item were proposed. The sixth phase encompassed calculating the reliability of the localised checklist. For the data analysis, descriptive statistics were computed using SPSS software.

Results: The original checklist included 12 aspects and 72 items. After evaluating the CVR and CVI indicators, 40 items were validated. By reassessing the deleted items, the localised checklist was created, composed of 56 items categorised into 11 aspects.

Conclusion: The localised tool would support the authorities responsible for DRSs when making software purchasing decisions. Additionally, it would be advantageous for policymakers by helping them establish the criteria for DRS assessment.Implications for health information management practice:Localising the registry assessment tool will facilitate its use; providing descriptions of assessment tool items leads to a uniform understanding and ease of use of the tool.

Background: As the healthcare delivery landscape evolves and the impact of digital technologies and transformations becomes increasingly apparent, a competent healthcare management workforce, confident in the capabilities to employ and effectively incorporate digital health technologies into health service delivery is imperative.

Objectives: The article explores the perceptions and experiences of middle-level health managers in their responsibilities and competency requirements in the context of digital health transformation.

Method: Six focus groups were conducted with mid-level managers recruited across Australian public hospitals in 2023. Braun et al (2019) six-phase, reflexive thematic analysis approach was used to distinguish, explore, organise and advance insight into themes and categories of the factors emerging.

Results: Findings indicated that the digital competencies managers are required to demonstrate include a much broader and expanded competence across eight identified competencies.

Discussion: The unique attributes identified highlight and underscore the importance of enhancing digital competencies for health service managers to lead and manage in the digital health context.

Conclusion: This study reveals two key areas of health service manager competency enhancement required: (i) competence in digital data management and security, and (ii) the management of digital technologies in practice. These findings can inform institutional competency frameworks that guide the development of management capability in the digital health environment, as well as illuminate the system and human resource implications for organisations to facilitate the application of these competencies in the workplace and optimise the benefits of digital health.Implications for health information management practice:The competency enhancements detailed have implications for health service, digital and information management regarding institutional competency frameworks and systems requirements that may need to be upgraded, expanded or introduced, and the continuous professional development that may need to be provided within the institutional or accreditation authorities to health service managers and health information managers.

Background: The World Health Organization's (WHO's) International Statistical Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11) is a modern classification system that provides enhanced granularity and flexibility for capturing clinical and health system data. For Canada, transitioning from ICD-10-CA, the Canadian modification, to ICD-11 poses opportunities and challenges. To explore these opportunities and challenges more thoroughly, a backward crosswalk was developed to evaluate statistical continuity. This approach helped identify the benefits of ICD-11, while also highlighting potential implications for health systems, case mix, and national health indicator reporting.

Objective: To examine how bidirectional crosswalks between ICD-10-CA and ICD-11 can support Canada's transition to ICD-11; and demonstrate how these crosswalks can be utilised in a Canadian-specific use case.

Method: 14,652 ICD-11 Mortality and Morbidity Statistics (2022 release) codes were mapped to version 2022 ICD-10-CA codes. Each mapping was reviewed to determine the relationship between the ICD-11 and ICD-10-CA codes, categorising them as equivalent to, broader than or narrower than the source ICD-11 codes. The bidirectional crosswalks were applied to a Canadian use case to demonstrate level of specificity between ICD-10-CA and ICD-11 codes.

Results: 26% of the ICD-10-CA target codes were equivalent to a single ICD-11 code, 65% were broader, 9% were narrower and 0.03% had no applicable ICD-11 map. Findings from the Canadian use case showed that 55% of the ICD-11 target codes were equivalent to or narrower than their ICD-10-CA source codes in the forward crosswalk, and 57% of ICD-11 congenital anomaly concepts had greater specificity in the backward crosswalk.

Conclusion: The backward crosswalk assessment highlights the benefits of ICD-11's increased specificity, which has the potential to enhance healthcare data in Canada. However, these findings must be considered alongside the forward crosswalk analysis, which noted a loss in specificity.Implications for health information management practice:As demonstrated in a Canadian use case example, bidirectional crosswalks can be leveraged to better understand the impact of ICD-11 adoption.

Background: As digital technologies advance, vast amounts of routinely collected health data are increasingly available for quality improvement and research. However, concerns persist around the reuse of personal health information. Understanding public attitudes and knowledge is essential to building social licence and enabling ethical, large-scale data use.

Objective: This study explores key research themes in sharing health data for secondary use since 2020, highlighting major topics, emerging research frontiers and future directions for practice.

Method: An analysis of 95 publications from Web of Science, PubMed and Scopus was conducted using scientometric methods. Citation, co-citation and keyword co-occurrence analyses, along with strategic diagrams, were performed using VOSviewer to identify thematic clusters.

Results: Research has shifted from early exploratory studies to more multidisciplinary and technology-focused approaches. Key themes include digital tool adoption, integrated data systems and ethical data sharing solutions. The concept of consent has seen the most theoretical development, while public attitudes - particularly around ethical and sociocultural issues - remain underexplored but crucial.

Conclusion: Ethical governance, transparency and community engagement are central to advancing health data sharing. Building public trust and securing a social licence are foundational to success, especially as challenges around consent, data linkage and public perception remain.Implications for health information management practice:This analysis provides insight into public willingness to share health data for secondary data use and offers guidance for fostering a strong social licence while building public trust. Strengthening these trust and engagement frameworks is vital to achieving ethical data use and maximising the potential health system benefits of secondary data use.

Background: Digitalisation of health care has been ongoing for decades resulting in huge amounts of data that can be repurposed from clinical to administrative and strategic use. However, to be useful and meaningful, data require work by data professionals about whom we do not know much.

Objective: The aim of this study is to investigate the diversity and characteristics of data professionals working in Denmark's five regional healthcare organisations. To achieve the objective of knowing more about who the data professionals in health care are and what they do, we conducted a survey in the regions overseeing hospitals in Denmark. This supplements a previous study at a large, national healthcare data organisation, and together the two studies provide a comprehensive overview of who the data professionals in Denmark are.

Method: An explorative mixed-method approach combining a non-probability technique for design of an open survey with an unknown target population, and 10 semi-structured interviews was applied.

Results: We report on the educational backgrounds, work identities, competences, knowledge areas and how data professionals acquire their skills. There is a striking variety in all of these, though educational backgrounds in social or health sciences, work identities as data analysts and competences and knowledge areas around data and health care dominate. Skills and knowledge are primarily acquired through job experience and current employment.

Conclusion: Data work is conducted by many kinds of data professionals throughout the healthcare sector from specialised data units to data workers at hospital wards.Implications for health information management practice:Initiatives to become data-driven in health care needs to support skill acquisition as part of employment and be available for a broad group of people.

Background: This study extended prior research on employment outcomes of the 2012-2016 and 2017-2021 health information manager (HIM) graduate cohorts from La Trobe University, Australia.

Objectives: (1) To classify graduates' early-career pathways, applying two classificatory methodologies, employing (a) position title (methodology 1), (b) self-reported knowledge and skills-based duties (methodology 2); (2) To compare outcomes of the methodologies; (3) To examine graduates' duties within the profession's established knowledge-skills domains and inform understanding of HIMs' roles.

Method: Residual data from prior cross-sectional studies were applied to early-career graduate HIM positions, using the two classificatory methodologies.

Results: Methodology 1 showed a greater proportion of roles under the "Health Information Management" domain. Methodology 2 revealed more roles aligned with the "Health Information Systems" and "Data Management and Analytics" domains. A longitudinal increase in health systems implementation, system documentation development, database management, and IT system support and maintenance characterised increasing "technologisation" of HIM roles ("Health Information Systems" domain). Clinical coding of admitted episodes ("Health Classification" domain) was the most frequently reported skill utilised in HIMs' first post-graduation position, offset by a slight, longitudinal decrease in clinical coding engagement. The 2017-2021 cohorts progressively reduced involvement in clinical coding roles, instead utilising more skills in the "Health Information Systems" and "Data Management and Analytics" domains. Methodology 1 showed a cohort 1 to cohort 2 increase in graduates assigned to the "Data Management and Analytics" domain (10.2-16.6%); Methodology 2 showed a simultaneous decrease (22.0-15.1%), arguably influenced by artefactual differences. The apparent decline in the "Data Management and Analytics" domain should be viewed cautiously owing to HIMs' increasingly data-driven work.

Conclusion: Reliance on job title may oversimplify or misrepresent the scope of HIMs' duties. Choice of classificatory methodology significantly impacts upon the domain to which HIMs' roles are categorised. The findings support a skill- and duty-based methodology for accurate capture of evolving HIM roles.Implications for health information management practice:This research provides valuable insights into HIM workforce trends, and foundations for (a) longitudinal career pathway and skills mapping and (b) a visual tool (career map) to support the profession's visibility, promotion, and development of illustrative career trajectories.

Background: The regulatory and legal contexts of health information systems (HIS) play a crucial role in the generation and utilisation of health information. However, in many low- and middle-income countries, the regulatory framework for HIS remains underdeveloped, often hindering effective data management and system implementation. Objective: To evaluate how HIS policies, strategy and protocols guide the use of the health management information system (HMIS) for HIV and AIDS monitoring and evaluation (M&E) in Ethiopia. Method: An evaluation study using qualitative document analysis was adopted. Purposive criterion sampling was used to select government policy documents. Data extraction tool and management strategy were implemented. Atlas.Ti version 8 was used for content analysis. Results: Ten documents met the required criteria. The guidelines in the documents emphasised data quality assessment through data quality assurance techniques, data quality tracking of completeness and timeliness logbook and District Health Information System Version 2 (DHIS2) checks. Evidence from documents revealed broad guidance in terms of the implementation of M&E processes. Content showed clear definitions of information use at different levels and strategies to promote culture of data use. Conclusion: The study revealed that Ethiopia has an adequate regulatory framework for HIS to support the implementation of the HMIS in M&E of the HIV and AIDS program. However, the documents also acknowledge challenges with the implementation of these guidelines. Implications for health information management practice: This work highlights the importance of HIS and HMIS to the entire health system, and the vital role played by health information managers (HIMs) in managing the resources, people, protocols, and datasets essential for a functional information system, and for ensuring secure access to data for evidence-based decision-making.

Background: Effective communication is crucial in health care, and the referral process is central to ensuring smooth patient transitions between providers. To enhance this process, electronic referral (e-referral) systems have been designed, aiming to improve efficiency, accuracy and accessibility. However, despite their widespread implementation, limited research has been conducted on the usability of these systems and the satisfaction levels among healthcare professionals.

Objectives: This study aimed to assess the usability of e-referral systems, measure user satisfaction and identify any challenges faced by healthcare professionals in the public healthcare sector, focusing specifically on physicians and health information management (HIM) technicians in Oman.

Method: A cross-sectional study was conducted by using a self-administered online survey among physicians and HIM technicians in Muscat Governorate. A sample size of 243 participants was selected through convenience sampling techniques. Closed-ended questions assessed usability, satisfaction and challenges related to the e-referral system.

Results: The study found a moderate level of familiarity with the Ministry of Health's referral guidelines, with 70.3% of participants reporting moderate familiarity. Regarding the e-referral system's usability, 45.3% of users expressed a neutral perception. Satisfaction levels varied across system features: 46.1% of participants were satisfied with the interface and design, while 38.3% reported satisfaction with navigation. Satisfaction with technical support also differed between groups, with 48.0% of physicians satisfied compared to 31.7% of HIM technicians.

Conclusion: This study expands current knowledge on e-referral systems by shedding light on their usability, satisfaction levels of users, and challenges encountered within the public healthcare system in Oman. Results underscore the necessity for tailored strategies to improve system functionality and enhance user experience, paving the way for more efficient healthcare processes.Implications for health information management practice:The study underscores the critical role of physicians and HIM technicians in optimising the functionality and usability of e-referral systems. Given these findings, various targeted interventions such as enhanced training programs and increased stakeholder engagement in system design are essential. These measures could improve system adoption, streamline referral workflows and ultimately contribute to more efficient and coordinated patient care within Oman's public healthcare sector.