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Electronic Health Records (EHRs) have been identified as a key tool to collect data for healthcare research. However, EHR data must be of sufficient quality to support quality research results. Island Health, BC, Canada has invested and continues to invest in the development of solutions to address the quality of its EHR data and support high quality healthcare studies. This paper examines Island Health's data quality engine, its development and its successful implementation.

A web-based system can provide access to real-time data and information. Healthcare is moving towards digitizing patients' medical information and securely exchanging it through web-based systems. In one of Ontario's health regions, Nurse Led Outreach Teams (NLOT) provide emergency mobile nursing services to help reduce unnecessary transfers from long-term care homes to emergency departments. Currently the NLOT team uses a Microsoft Access database to keep track of the health information on the residents that they serve. The Access database lacks scalability, portability, and interoperability. The objective of this study is the development of a web-based database using Oracle Application Express that is easily accessible from mobile devices. The web-based database will allow NLOT nurses to enter and access resident information anytime and from anywhere.

The objective of this study is to apply data mining techniques to determine factors that are commonly associated with liver cancer incidence, using an anonymized data set of 6064 patients from the British Columbia Cancer Agency (BCCA). The association rules indicate that in BC the patient demographic factors associated with increased liver cancer include: age ranges 60-69, male gender, and geographic location in the Greater Vancouver area. The main factors associated with decreased survivability in BC were being male and in the age range 70-79. In the Yukon, being male and in the age range 60-69 was the main factor associated with both increased incidence of liver cancer and decreased survivability.

Regular monitoring of blood pressure of a patient can improve hypertension diagnosis and treatment. The objective of this study is to design and implement a cloud computing based blood pressure data management system that allows patients, nurses, physicians, and researchers to access data through the Internet anytime, anywhere and via any device.

Information overload and irrelevant information are major obstacles for drawing conclusions on the personal health status and taking adequate medical actions. The objective of this study is to design a recommendation-based mobile web application to assist patient efficiently search online health information at anytime, anywhere and via any devices. In the system, we use a collaborative filtering approach to recommend health information to users.

This systematic review examines a total of eighteen studies on the use of health information technologies to improve public health. Health information technologies are tools that allow for the management of health information in computerized systems. Health information technology, including electronic health records, computers/emails, social media, and cellphones/text messaging are becoming widespread and readily accessible to populations around the globe. In this review, the use of these technologies and interventions are discussed and evaluated for their potential to improve public health. This review found some good-quality evidence on the use of electronic health records and little good-quality evidence on the use of email, social media, cell phones and text messaging to improve healthcare, illustrating the need for further study in these areas.

The objective of this study is to propose a Cloud Computing based platform for sleep behavior and chronic disease collaborative research. The platform consists of two main components: (1) a sensing bed sheet with textile sensors to automatically record patient's sleep behaviors and vital signs, and (2) a service-oriented cloud computing architecture (SOCCA) that provides a data repository and allows for sharing and analysis of collected data. Also, we describe our systematic approach to implementing the SOCCA. We believe that the new cloud-based platform can provide nurse and other health professional researchers located in differing geographic locations with a cost effective, flexible, secure and privacy-preserved research environment.

In this paper we describe the effects of hands-on exposure to an educational electronic health record (EHR) system upon undergraduate health informatics (HI) student competency development. We undertook a quasi-experimental study (i.e. pre-test, post-test design), where students were given the opportunity to do hands-on work with an educational EHR over a 10 week period. HI student competencies were measured pre and post educational EHR exposure. Several HI student competencies improved significantly following hands-on work with the EHR. As well, students provided more in-depth and higher quality case study answers after working with the educational EHR.

Integrating the Nurse Practitioner (NP) role into clinical practice settings is new in British Columbia (BC), Canada. Encounter codes are unique numeric codes assigned to specific types of patient care services performed by NPs. In this study we apply knowledge discovery techniques to analyze the encounter codes extracted from the BC Ministry of Health database to understand the most common practice activities carried out by NPs and what diseases patients sought care for from NPs. The analysis produced important information about NPs' practice patterns. This work leads to a better understanding of NP practice patterns in BC.

Electronic health records and related technologies are being increasingly deployed throughout the world. It is expected that upon graduation health professionals will be able to use these technologies in effective and efficient ways. However, educating health professional students about such technologies has lagged behind. There is a need for software that will allow medical, nursing and health informatics students access to this important software to learn how it works and how to use it effectively. Furthermore, electronic health record educational software that is accessed should provide a range of functions including allowing instructors to build patient cases. Such software should also allow for simulation of a course of a patient's stay and the ability to allow instructors to monitor student use of electronic health records. In this paper we describe our work in developing the requirements for an educational electronic health record to support education about this important technology. We also describe a prototype system being developed based on the requirements gathered.

There is a need to develop cost effective ways to bring hands-on education about essential information technologies, such as electronic health record (EHR) systems to nursing students, nursing faculty and practitioners. This is especially the case as worldwide there is an increased deployment of these systems and they are transforming the practice of healthcare. However, due to technical, financial and knowledge limitations, many nursing schools and programs do not have an adequate way to bring such technology into their classes and curricula. In this paper we describe an approach to developing Web-based EHR education that allows students from any Web-accessible location to access and work with real EHR systems remotely over the Internet for learning purposes. In this paper we describe our work in moving this approach to a cloud-based solution to allow access to EHRs for educational purposes from any location with Web access and to do so in a way that is both educationally sound and cost effective.

The objective of this study is to assess the feasibility of applying knowledge discovery techniques to identifying nurse practitioner practice patterns and enacted scope of practice. For the research, we plan to use data extracted from a Ministry of Health database. The data items are focused around: nurse practitioner demographics, health authorities, and encounter types. This analysis produces patterns that indicate relationships between the demographics, scope of practice and practice settings of nurse practitioners working in British Columbia.

Computer devices using touch-enabled technology are becoming more prevalent today. The application of a touch screen high definition surgical monitor could allow not only high definition video from an endoscopic camera to be displayed, but also the display and interaction with relevant patient and health related data. However, this technology has not been quickly embraced by all health care organizations. Although traditional keyboard or mouse-based software programs may function flawlessly on a touch-based device, many are not practical due to the usage of small buttons, fonts and very complex menu systems. This paper describes an approach taken to overcome these problems. A real case study was used to demonstrate the novelty and efficiency of the proposed method.

The purpose of this paper is to determine the effects of hands-on exposure to an educational electronic health record (EHR) system upon undergraduate health informatics (HI) student competency development. We undertook a quasi-experimental study (i.e. pre-test, post-test design), where students were given the opportunity to do hands-on work with an educational EHR over a 10 week period. HI student competencies were measured pre and post educational EHR exposure. Several HI student competencies improved significantly following hands-on work with the EHR. As well, students provided more higher quality case study answerfollowing EHR use.

Unlabelled: Medication reconciliation (MedRec) is an important task that occurs in a variety of different contexts. Similar to other healthcare practices, MedRec is transitioning from being a paper-based process to one that is performed electronically. This paper will provide a scoping review of the prevalent research topics from both contextual and human factors perspectives., Methods: PubMed and CINAHL were searched for all articles including the term "medication reconciliation". The 139 articles that met inclusion criteria were reviewed for themes and findings., Results: Three primary themes surfaced through this analysis: a) The contextual factors of MedRec, b) information technology (IT) in MedRec, and c) obstacles and opportunities for improving MedRec., Discussion: MedRec is performed in a variety of settings. The transition to electronic MedRec (eMedRec) has the potential to mitigate errors associated with a paper-based system but also creates opportunities for new technology-induced errors to occur. Interoperability with other health information systems is ideal. Additionally, Process standardization and workflow are important considerations when transitioning to eMedRec., Conclusion: As the process of medication reconciliation transitions from a paper-based to an electronic task, it is imperative to minimize the opportunity for human error and maximize the effectiveness of the system as a whole. Further, it is important for research to continue to explore original strategies for IT to enhance medication reconciliation.

The paper describes the authors' work in the area of health informatics (HI) education involving emerging health information technologies. A range of information technologies promise to modernize health care. Foremost among these are electronic health records (EHRs), which are expected to significantly improve and streamline health care practice. Major national and international efforts are currently underway to increase EHR adoption. However, there have been numerous issues affecting the widespread use of such information technology, ranging from a complex array of technical problems to social issues. This paper describes work in the integration of information technologies directly into the education and training of HI students at both the undergraduate and graduate level. This has included work in (a) the development of Web-based computer tools and platforms to allow students to have hands-on access to the latest technologies and (b) development of interdisciplinary educational models that can be used to guide integrating information technologies into HI education. The paper describes approaches that allow for remote hands-on access by HI students to a range of EHRs and related technology. To date, this work has been applied in HI education in a variety of ways. Several approaches for integration of this essential technology into HI education and training are discussed, along with future directions for the integration of EHR technology into improving and informing the education of future health and HI professionals.

The objective of this study is to assess the feasibility of a data mining association analysis technique, the FP Growth algorithm, for the detection of associations of liver cancer, geographic location and demographic of patients. For the research, we are planning to use data extracted from electronic health record systems of three healthcare organizations in different geographic locations (Canada, Taiwan and Mongolia). The data are arranged into 'transactions' which contain a set of data items focused around cancer diseases, geographic locations and patient demographics. This analysis produces association rules that indicate what combinations of demographics, geographic locations and patient characteristics lead to liver cancer.

Primary care data represents the complete biopsychosocial profile of the patient and has recently become available for secondary analysis in Ontario. This study involved extracting de-identified primary care data and analyzing it with natural language processing to extract UMLS codes. These codes were used to statistically relate inappropriate emergency room use to biopsychosocial concepts with logistic regression. The concepts of pain and mental health were statistically significant. This technique demonstrates a creative use of primary care data. It could be used to analyze system use in other health care settings.

The use of e-Learning in educational institutes has rapidly increased along with the development of information and communication technology (ICT). In healthcare, more medical educators are using e-Learning to support their curriculum design, delivery and evaluation. However, no systematic work exists on characterizing a collective set of Critical Success Factors (CSFs) for implementing e-Learning in the healthcare education institutions. The aim of this paper is to study the CSFs of implementing healthcare e-Learning.

This paper compares the interoperability approaches of three countries: Taiwan, Denmark and Canada. The work maps out how various countries have addressed the interoperability problems as well as what factors affect decisions and the result, and in what manner. The key findings are as follows: (1) The federal government's ability to mandate standards affects choice of interoperability strategy; (2) E-Health status influences choice of interoperability strategy; (3) Differences in geography, population, and demographics affect the selection of national strategies towards interoperability.

In this paper, we discuss cloud computing, the current state of cloud computing in healthcare, and the challenges and opportunities of adopting cloud computing in healthcare. A Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis was used to evaluate the feasibility of adopting this computing model in healthcare. The paper concludes that cloud computing could have huge benefits for healthcare but there are a number of issues that will need to be addressed before its widespread use in healthcare.

The objective of this study is to design and implement a common-gateway oriented mediator to solve the health data interoperability problems that exist among heterogeneous health information systems. The proposed mediator has three main components: (1) a Synonym Dictionary (SD) that stores a set of global metadata and terminologies to serve as the mapping intermediary, (2) a Semantic Mapping Engine (SME) that can be used to map metadata and instance semantics, and (3) a DB-to-XML module that translates source health data stored in a database into XML format and back. A routine admission notification data exchange scenario is used to test the efficiency and feasibility of the proposed mediator. The study results show that the proposed mediator can make health information exchange more efficient.

The objective of this paper is to describe a framework for system testing in response to the need to ensure both the usability and safety of healthcare information systems. The approach includes consideration of methods that include both conventional computer software testing approaches (i.e. technology-centric approaches) and extends conventional testing to include consideration of system impact in terms of both usability and workflow (i.e. user-centric testing approaches) prior to system release. The paper describes these main approaches. It is argued that both technology and user-centered approaches should be employed before the release of a complex health information system in order to ensure that it is safe and does not inadvertently introduce error.

The objective of this research is to assess the suitability of the Apriori association analysis algorithm for the detection of adverse drug reactions (ADR) in health care data. The Apriori algorithm is used to perform association analysis on the characteristics of patients, the drugs they are taking, their primary diagnosis, co-morbid conditions, and the ADRs or adverse events (AE) they experience. This analysis produces association rules that indicate what combinations of medications and patient characteristics lead to ADRs. A simple data set is used to demonstrate the feasibility and effectiveness of the algorithm.

It is proposed that the A3 problem solving process be used by hospital staff to improve its healthcare workflow. A hypothetical case study is given to demonstrate the applicability and benefits of the methodology. The research results show that A3 is a useful tool for healthcare organizations seeking to continuously improve their healthcare service quality.

The House of Quality (HOQ) model is proposed to improve health care quality control. A hypothetical case study is given to demonstrate the applicability and benefits of using the proposed methodology. The benefit and drawback analysis of HOQ are also addressed. Concluding remarks and proposals for further research are presented at the end of this paper.

In this paper the authors propose and describe a Resource Description Framework (RDF)-based mediator designed to solve the health data interoperability problem that exists among heterogeneous health information systems (e.g., Electronic Health Records). The RDF-based mediator framework has three main components: (1) the Synonym Dictionary (SD) that can be used to map metadata semantics, (2) the CXTR module that can translate source XML-based health documents into RDF-XML format, and (3) the CRTX module that can translate an RDF-XML document into a target XML-based health document. The proposed mediator is expected to make health information exchange more efficient.

In this paper, we provide a methodology for integrating the House of Quality (HOQ), a process tool, with Toyota A3 reports to effectively identify the priorities and root causes of poor efficiency in a Post Anesthesia Care Unit's (PACU) workflow. The A3 report allowed us to identify the workflow waste, and the HOQ helped us to identify and prioritize the critical root causes of poor workflow that could be improved by technology.