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Background: ICD-11 was officially released at the World Health Assembly on 25 May 2019. Objective: To find effective ways to increase the accuracy of coding for diagnostic terms in Korea for a stable transition from Korean modification of ICD-10 (7th Revision of Korean Classification of Disease, KCD-7) to ICD-11. Method: A total of 27 skilled Korean health information managers performed KCD-7 and ICD-11 coding simultaneously (line coding [56]; case coding [17]). Accuracy rates and percentage agreements were calculated, and granularity and difficulty of the ICD-11 were rated by participants. Results: The average accuracy rate of line coding was 71.6 % in ICD-11 and 80.2% in KCD-7, which was similar to results in other studies. The mean percentage agreements for ICD-11 and KCD-7 for line coding were 64.2% and 72.1%, respectively; while for case coding it was 15.3% and 26.6%. Selection criteria for the case scenarios may have influenced the low agreements in case coding. Cluster coding, changes of terms in ICD-11 and removal of codes used in ICD-10 contributed to low agreement in ICD-11 (46.6% of participants reported that granularity of ICD-11 was similar to ICD-10, while 36.9% reported that ICD-11 had finer granularity). In terms of difficulty, 15.3% of participants found line coding difficult and 10.9% found case coding difficult. Conclusion: Provision of more detailed reference guidelines and efficient training for coding professionals by the World Health Organization would enable ICD-11 to be an excellent tool for gathering relevant information about diseases in Korea. [ABSTRACT FROM AUTHOR]

Background: Stroke is a high-cost condition. Detailed patient-level assessments of the costs of care received and outcomes achieved provide useful information for organisation and optimisation of the health system. Objectives: To describe the costs of hospital care for stroke and transient ischaemic attack (TIA) and investigate factors associated with costs. Methods: Retrospective cohort study using data from the Australian Stroke Clinical Registry (AuSCR) collected between 2009 and 2013 linked to hospital administrative data and clinical costing data in Queensland. Clinical costing data include standardised assignment of costs from hospitals that contribute to the National Hospital Costing programme. Patient-level costs for each hospital admission were described according to the demographic, clinical and treatment characteristics of patients. Multivariable median regression with clustering by hospital was used to determine factors associated with greater costs. Results: Among 22 hospitals, clinical costing data were available for 3909 of 5522 patient admissions in the AuSCR (71%). Compared to those without clinical costing data, patients with clinical costing data were more often aged <65 years (30% with cost data vs 24% without cost data, p < 0.001) and male (56% with cost data vs 49% without cost data, p < 0.001). Median cost of an acute episode was $7945 (interquartile range $4176 to $14970) and the median length of stay was 5 days (interquartile range 2 to 10 days). The most expensive cost buckets were related to medical (n = 3897, median cost $1577), nursing (n = 3908, median cost $2478) and critical care (n = 434, median cost $3064). Factors associated with greater total costs were a diagnosis of intracerebral haemorrhage, greater socioeconomic position, in-hospital stroke and prior history of stroke. Conclusion: Medical and nursing costs were incurred by most patients admitted with stroke or TIA, and were relatively more expensive on average than other cost buckets such as imaging and allied health. Implications: Scaling this data linkage to national data collections may provide valuable insights into activity-based funding at public hospitals. Regular report of these costs should be encouraged to optimise economic evaluations. [ABSTRACT FROM AUTHOR]

Background: Governments have responsibility for ensuring the quality and fitness-for-purpose of personal health data provided to them. While these health information assets are used widely for research, this secondary usage has received minimal research attention. Objective: This study aimed to investigate the secondary uses, in research, of population health and administrative datasets (information assets) of the Department of Health (DoH), Victoria, Australia. The objectives were to (i) identify research based on these datasets published between 2008 and 2020; (ii) describe the data quality studies published between 2008 and 2020 for each dataset and (iii) evaluate "fitness-for-purpose" of the published research. Method: Using a modified scoping review, research publications from 2008 to 2020 based on information assets related to health service provision and containing person-level data were reviewed. Publications were summarised by data quality and purpose-categories based on a taxonomy of data use. Fitness-for-purpose was evaluated by comparing the publicly stated purpose(s) for which each information asset was collected, with the purpose(s) assigned to the published research. Results: Of the >1000 information assets, 28 were utilised in 756 publications: 54% were utilised for general research purposes, 14% for patient safety, 10% for quality of care and 39% included data quality-related publications. Almost 85% of publications used information assets that were fit-for-purpose. Conclusion: The DoH information assets were used widely for secondary purposes, with the majority identified as fit-for-purpose. We recommend that data custodians, including governments, provide information on data quality and transparency on data use of their health information assets. [ABSTRACT FROM AUTHOR]

Background: Family violence homicide (FVH) is a major public health and social problem in Australia. FVH trend rates are key outcomes that determine the effectiveness of current management practices and policy directions. Data source–related methodological problems affect FVH research and policy and the reliable measurement of homicide trends. Objective: This study aimed to determine data reliability and temporal trends of Victorian FVH rates and sex and relationship patterns. Method: FVH rates per 100,000 persons in Victoria were compared between the National Coronial Information System (NCIS), Coroners Court of Victoria (CCoV) Homicide Register, and the National Homicide Monitoring Program (NHMP). Trends for 2001–2017 were analysed using Joinpoint regression. Crude rates were determined by sex and relationship categories using annual frequencies and Australian Bureau of Statistics population estimates. Results: NCIS closed FVH cases totalled 360, and an apparent downward trend in the FVH rate was identified. However, CCoV and NHMP rates trended upwards. While NCIS and CCoV were case-based, NHMP was incident-based, contributing to rate variations. The NCIS-derived trend was particularly impacted by unavailable case data, potential coding errors and entry backlog. Neither CCoV nor NHMP provided victim-age in their public domain data to enable age-adjusted rate comparison. Conclusion: Current datasets have limitations for FVH trend determination; most notably lag times for NCIS data. Implications: This study identified an indicative upward trend in FVH rates in Victoria, suggesting insufficiency of current management and policy settings for its prevention and control. [ABSTRACT FROM AUTHOR]

Background: Improving the quality of coded data requires the identification and evaluation of the root causes of clinical coding problems to inform appropriate solutions. Objective: The objective of this study was to identify the root causes of clinical coding problems. Method: Twenty-one clinical coders from three cities in Iran were interviewed. The five formal categories in Ishikawa's cause-and-effect diagram were applied as pre-determined themes for the data analysis. Results: The study indicated 16 root causes of clinical coding problems in the five main themes: (i) policies, protocols, and processes (lack of clinical documentation guidelines; lack of audit of clinical coding and feedback to clinical coders; the long interval between documentation and clinical coding; and not using coded data for reimbursement; (ii) individual factors (shortage of clinical coders; low-skilled clinical coders; clinical coders' insufficient communication with physicians; and the lack of continuing education; (iii) equipment and materials (incomplete medical records; lack of access to electronic medical records and electronic coding support tools; (iv) working environment (lack of an appropriate, dynamic, and motivational workspace; and (v) management factors (mangers' inattention to the importance of coding and clinical documentation; and to providing the required staff support. Conclusion: The study identified 16 root causes of clinical coding problems that stand in the way of clinical coding quality improvement. Implications: The quality of clinical coding could be improved by hospital managers and health policymakers taking these problems into account to develop strategies and implement solutions that target the root causes of clinical coding problems. [ABSTRACT FROM AUTHOR]

Risk management is a set of measures involving the definition of environmental factors leading to uncertainty under control - targeted actions to resolve and avoid the danger it poses. The main objective of the study is to examine the processes in the health structure for the implementation of the activities taking place in it, under conditions of risk. Defining mechanisms by which management will be able to create an optimal working environment that will ensure stability and safe conditions for employees to achieve organizational goals. A survey of health professionals from hospital medical institutions in. Varna, a regulatory analysis has been conducted. The results are graphically illustrated. Results and discussion: due to the changes in the regulatory framework, a 100% reorganization was required in terms of the administration of the patients ' medical records, but faced a number of difficulties due to the spe)cifics of their work and the exceptions described in the medical standard in obstetrics and gynecology. The work-load in which medical professionals work is defined as high at 55.78%. The main risks to the structure related to structure, resources and activities are defined. The need to audit activities is identified and a risk management model and a model to support the development of staff in the organization is proposed. Finally, process auditing is made possible by Risk Management, which requires responsible management de)cisions, preserving and creating value – quality and safety of medical care, of the working environment and min)imizing risks from and outside the environment (hospital structure). [ABSTRACT FROM AUTHOR]

BACKGROUND: Whole-process management is a novel approach widely applied in industry and commerce; however, it is not widely used in the management of medical records in hospitals. OBJECTIVE: The purpose of this study is to investigate the application of whole-process control in the administration of a hospital's medical records department to achieve refined management of medical records. METHODS: Whole-process control is a management measure that begins with process conception and implementation and includes control over all processes. The control group included medical records that were created prior to the implementation of whole-process control, i.e., those created between June 1 and December 31, 2020. The observation group included medical records that were created after the implementation of whole-process control. The behavior of the medical records staff (in terms of medical record collection, sorting, entry, inquiry, and supply) and the final quality of the medical records (the number of grade-A medical records and their front-page quality) were compared between the two groups, and subjective judgments related to staff satisfaction were reviewed. RESULTS: The implementation of whole-process control improved the behavior of the medical records staff. The final quality of the medical records was also improved, as was the job satisfaction of the medical records staff. CONCLUSION: Implementing whole-process control improved the management of medical records and quality of medical records. [ABSTRACT FROM AUTHOR]

Aim and Objectives: The aim of the study was to obtain information on documentation of patient record maintenance among private dental practitioners in Bangalore city". The objective was to assess the knowledge, attitude and behavior regarding documentation and patient record maintenance among private dental practitioners in Bangalore city. Method: A self-administered questionnaire survey was conducted in August-September 2021 among Dentists engaged in active clinical practices in private clinics/hospitals in Bangalore city, India [N=470]. Results: A response rate of 86.4% [n=411] was obtained.73% of them were aware of the documentation of patient records as per Laws, Ethics and Jurisprudence act of 1997. 53% of them documented patient records in their clinical practice and 64% mentioned that only they have access to patient records.13% mentioned that they include patient consent as a part of documentation. Although 73% of them said that they were aware of all the guidelines, a large proportion of respondents lack knowledge about the minimum time period for which patient records should be maintained in their possession. 21% of them felt that patient record keeping is not necessary and the most common problem cited for documentation of patient records was lack of time to give attention to the records. Conclusion: Dentists needs more information and should spare more time for documentation of patient records. [ABSTRACT FROM AUTHOR]

The article focuses on the circumstances under which patients and doctors may need to amend or delete entries in medical records. Topics include the guidelines for correcting health information when a patient requests changes, the process for addressing requests related to clinical information or diagnoses, and the importance of ensuring that medical records serve the patient's best interests while maintaining continuity of care.

Background: In 2019, the World Health Organization, set a target to halve the burden of snakebite, by 2030, and identified 'health systems strengthening' as a key pillar of action. In India, the country with most snakebite deaths, the Union Government identified (in September 2022) training of health workers as a priority action area. In this policy context, we provide empirical evidence by analysing the most recent nationwide survey data (District Level Household and Facility Survey − 4), to assess structural capacity and continuum of snakebite care in primary health care system in India. Methodology: We evaluated structural capacity for snakebite care under six domains: medicines, equipment, infrastructure, human resources, governance and finance, and health management information systems (HMIS). We categorised states (aspirant, performer, front-runner, achiever) based on the proportion of primary health centres (PHC) and community health centres (CHC), attaining highest possible domain score. We assessed continuum of snakebite care, district-wise, under five domains (connectivity to PHC, structural capacity of PHC, referral from PHC to higher facility, structural capacity of CHC, referral from CHC to higher facility) as adequate or not. Results: No state excelled (front-runner or achiever) in all six domains of structural capacity in PHCs or CHCs. The broader domains (physical infrastructure, human resources for health, HMIS) were weaker compared to snakebite care medicines in most states/UTs, at both PHC and CHC levels. CHCs faced greater concerns regarding human resources and equipment availability than PHCs in many states. Among PHCs, physical infrastructure and HMIS were aspirational in all 29 assessed states, while medicines, equipment, human resources, and governance and finance were aspirational in 8 (27.6%), 2 (6.9%), 17 (58.6%), and 12 (41.4%) states respectively. For CHCs, physical infrastructure was aspirational in all 30 assessed states/UTs, whereas HMIS, medicines, equipment, human resources, and governance and finance were aspirational in 29 (96.7%), 11 (36.7%), 27 (90%), 26 (86.7%), and 3 (10%) states respectively. No district had adequate continuum of snakebite care in all domains. Except for transport availability from CHC to higher facilities (48% of districts adequate) and transport availability from PHC to higher facilities (11% of districts adequate), fewer than 2% of districts were adequate in all other domains. Conclusion: Comprehensive strengthening of primary health care, across all domains, and throughout the continuum of care, instead of a piece-meal approach towards health systems strengthening, is necessitated to reduce snakebite burden in India, and possibly other high-burden nations with weak health systems. Health facility surveys are necessitated for this purpose. [ABSTRACT FROM AUTHOR]

Enabling athletes to achieve peak performances while also maintaining high levels of health is contextually complex. We aim to describe what a 'health system' is and apply the essential functions of stewardship, financing, provision of services and resource generation to an Australian high-performance sport context. We introduce a fifth function that health systems should not detract from athletes' ability to achieve their sports goals. We describe how these functions aim to achieve four overall outcomes of safeguarding the health of the athletes, responding to expectations, providing financial and social protection against the costs of ill health, and efficient use of resources. Lastly, we conclude with key challenges and potential solutions for developing an integrated health system within the overall performance system in high-performance sport. [ABSTRACT FROM AUTHOR]

Objective The inter-laboratory comparison results of occupational health testing laboratories in Gansu Province were analyzed to evaluate the testing capabilities and quality of occupational health testing laboratories in the province. Methods Laboratories participating in the inter-laboratory comparison of occupational health technical service organizations in Gansu Province during the period of 2019-2021 were selected for the study, and the test results of the levels of organic substances, metals, and inorganic non-metallic chemicals in the air of the workplaces, metal chemicals in biological materials, and the levels of free silica in dust were statistically analyzed. Results A total of 272 comparison items were conducted from 2019 to 2021, and 242 items were reported and 220 were qualified, for a qualification rate of 90.9%. The qualification rates of organic substances, metals, and inorganic non-metallic chemicals in the air of the workplaces, metal chemicals in biological materials, and the levels of free silica in dust were 91.4%, 88.6%, 97.9%, 92.9%, and 80.8%, respectively. There was no statistically significant difference in the qualification rate between grade A and grade B institutions or between public and private institutions (P > 0.05). The qualification rate and the number of participating institutions increased year by year over this time, with the qualification rate increasing from 82.69% to 93.48% and the number of institutions increasing from 13 to 28. Conclusions The testing level of occupational health technical service organization laboratories in Gansu Province was good; however, the overall quality and level of laboratory testing still need to be improved, and investment in and management of various laboratories should be increased. [ABSTRACT FROM AUTHOR]

Team-based primary care has been shown to be an important initiative for transforming primary care to achieve whole-person care, enhance health equity, and reduce provider burnout. Organizational approaches have been explored to better implement team-based care but a thorough understanding of the role of system functions is lacking. We aimed to identify the combinations of system functionalities in primary care practices that most enable effective teamwork. We used a novel method, qualitative comparative analysis (QCA), to identify cross-case patterns in 19 primary care practices in the Harvard Academic Innovations Collaborative (AIC), an initiative for transforming primary care practices by establishing teams and implementing team-based care. QCA findings identified that primary care practices with strong team dynamics exhibited strengths in three operational care process functionalities, including management of abnormal test results, cancer screening and medication management for high-priority patients, care transitions, and in health information technology (HIT) functionality. HIT functionality alone was not sufficient to achieve the desired outcomes. System functionalities in a primary care practice that support physicians and their teams in identifying patients with urgent and complex acute illnesses requiring immediate response and care and overcoming barriers to collaboration within and across institutional settings, may be essential for sustaining strong team-based primary care. [ABSTRACT FROM AUTHOR]

The article offers information on the importance of incorporating occupational health data into electronic health records (EHRs) for all clinicians caring for workers. The topics covered include the support of the American College of Occupational and Environmental Medicine (ACOEM) for collecting and sharing occupational health information in EHRs, the criteria for EHR systems to effectively share this information, and the recommendations for recording and using occupational information in EHRs.

As foundation doctors, we have often found ourselves informing patients that a certain aspect of their medical information cannot be immediately found, either because it is on an electronic system we cannot access, or it is in a hospital that is unlinked to our own. Unsurprisingly, this frequently leaves patients flabbergasted and confused. We started to wonder: if patients' data are entered onto an electronic system: where do those data go? If medical data are searched for, where do those data come from? Why are there so many hidden sources of information that clinicians cannot access? In an ever-increasing digital sphere, electronic data will be the future of holistic health and social care planning, impacting every clinician's day-to-day role. From electronic healthcare records to the use of artificial intelligence solutions, this article will serve as an introduction to how data flows in modern healthcare systems. [ABSTRACT FROM AUTHOR]

Auditing -- in all its forms -- is of particular importance to ensure efficient, transparent and accountable management of health funds and to ensure the provision of quality medical services to patients. The authors, through the present work, reveal - based on the study of specialized literature and reports issued by some specialized institutions - that both internal and external public audit is intended to prevent fraud, thus protecting resources and ensuring the provision of medical services of quality for patients, but also to help identify errors in the funds management process, so that they can be properly corrected and thus ensure an efficient management of resources intended for health insurance in Romania. Equally important is the fact that the audit contributes to increasing transparency in the use of health funds, improving the performance of the health system and ensuring compliance with the rules and regulations in force regarding the management of health funds, so as to avoid unnecessary expenses and ensure the provision of quality medical services. The structure of this paper includes, following this introductory part (1): Management of health insurance funds and ensuring the financing of medical services in Romania (2); Findings of the external public audit regarding the management of health insurance funds (3) and Conclusions (4). [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper investigates the feasibility and the perception of the nurse's role as the palliative care coordinator. Background: Integrated care is a global imperative in all healthcare improvement processes. Due to Andrija Štampar's success in the organisation of public health services, Croatia today has more than hundred years of experience in care integration. The palliative care system has been continuously developing since 2014 as an integrated care model, with nurses as care coordinators. Methods: The study used a mixed methodology based on pragmatic research principles, including an analysis of strategic and policy documents and reports, and thematic analysis of focus group conducted with palliative care coordinators, following COREQ checklist. Results: Although a legal, professional and financial regulation of nurse coordinators has been achieved, a number of implementation challenges remain. These challenges arise as a result of long‐term fragmentation of the health and social care, and can be found in both horizontal and vertical integration of care, that is in the dimensions of functional, clinical, cultural and social integration. Conclusions: Nurses play a central role in care coordination. Coordination and integration promote professionalisation with clear roles and tasks. However, even with the legal, professional and financial implementation of the nurse coordinator model, it has to be further promoted as an equally important job in the healthcare system, with nurses as competent professionals in charge of care coordination. Relevance to clinical practice: Palliative care provides a range of individualised, coordinated services that meet the medical and non‐medical needs of seriously ill patients. Described model of palliative care in Croatia is particularly important because it was developed as an integrated part of health care (and partly social welfare) system, indicating with the nurse's role as palliative care coordinator that coordination is a continuous process that requires a dedicated professional role. [ABSTRACT FROM AUTHOR]

Purpose: The importance of champion leaders including tech-savvy leaders to digital government has been highlighted in the literature. Meanwhile, what was in the authors' interest to explore was the role of business-savvy leaders or non-governmental digital champions as units of analysis, those who mobilized people's interest in digitalization and bypassed governmental barriers through this popular mobilization. They could be considered policy entrepreneurs for understanding policy change in the digitalization of the health sector. This study sought to shed light on the barriers and drivers of digital health in Iran. Design/methodology/approach: The researchers conducted interviews with actors of digital health businesses in Iran, including the Health Information Technology Center affiliated to the Ministry of Health and Medical Education (MOHME) administrative body and authorities, private companies active in digital health and health service providers. The purposive sampling method was applied, and 15 experts with relevant and valuable experiences as well as maximum variation to obtain representativeness and rich data were interviewed. Trustworthiness criteria were also used to assure the quality of the results. The data were analyzed based on directed content analysis using the MAXQDA10 software. Findings: It was found out how popular diffusion was effective to overcome barriers to health digitalization. Access to the internet and diffusion of information technology helped the net-enabled businesses to connect directly to people and provide services to them. Diffusion of these services forced the public sector to adjust itself, and thus MOHME banned digital consultation services because of the so-called "insecure and unknown physicians", following the increased popularity of digital services diffusion, but they were not able to resist popular diffusion of new technology. Hence, it was allowed to work. The main barriers to telemedicine spreading in Iran have been divided into five main categories including government incapacity for digital health governance, conflict of interest, professional obligations for information transparency, protection of patients' rights and data security and privacy. Originality/value: As a game changer in digital health governance in Iran, popular diffusion will determine the future of digital health. To the best of the authors' knowledge, this study is among the first ones to explore digital health governance in relation to the private digital health business in Iran with a public policy approach. [ABSTRACT FROM AUTHOR]

Wellness Cloud serves as a foundation for mobile health management services, enabling users to input health-related data and check their health records for preventive purposes. In explaining why citizens might adopt this service, human factors must be considered, particularly motivation. Therefore, this study proposes a theoretical research model to explain citizens' behavioural intentions when using Wellness Cloud. The roles of basic psychological needs, intrinsic motivators, extrinsic motivators, and health beliefs in forming their motivations were examined. The results indicated that extrinsic motivators (performance expectancy and effort expectancy), one intrinsic motivator (perceived playfulness), and health beliefs (perceived susceptibility and cues to action) had positive effects on people's behavioural intentions. The intrinsic motivator also had positive effects on the extrinsic motivators. Additionally, three psychological needs were shown to have positive effects on intrinsic and extrinsic motivators. The findings provide valuable implications for encouraging citizens to adopt Wellness Cloud. [ABSTRACT FROM AUTHOR]

It is important to examine gaps in online health-related activities (OHAs) between socially advantaged and disadvantaged groups, considering that emerging information and communication technologies may bring about social disparities in their adoption and possibly expand preexisting health disparities. We thus examined whether digital divide occurs in the area of OHAs, including engagement with a very recent technology. To be more specific, we explored the effects of education, income, and race/ethnicity on OHAs, such as online health information seeking, social media use for health, and health information technologies (HITs) utilization. Moreover, given the importance of socio-contextual factors in digital divide, we examined how social support interacts with education, income, and race/ethnicity, and jointly influences OHAs. Using data from the 2017 Health Information National Trends Survey, we found the effects of education on several OHAs. Income only affected HITs utilization that had just started to diffuse across the U.S. society. We also identified reinforcing effects of social support and education on HITs utilization, and reinforcing effects of social support and income on online health information seeking. The implications of these findings for health communication and public health research were discussed. [ABSTRACT FROM AUTHOR]

To analyze the factors influencing the future health emergency management of communities in Zhejiang Province and summarize the health emergency management pathways. Methods Based on policy releases and official reports on future community health emergency management in Zhejiang Province, the first batch of 24"future communities" in Zhejiang Province were used as the research objects. The fs/QCA 3.0 software was used to assign values to the factors influencing future community health emergency management, as well as consistency scores and combined coverage scores. Results The number and capacity of health personnel, the degree of digitalization, health emergency plans, emergency supplies storage and security, and health emergency sites are the main influencing factors for future community emergency management. The consistency scores were 0.93, 0.78, 0.69, 0.65, and 0.34 in that order. Number and capacity of health personnel * degree of digital construction *-original coverage rate of health emergency sites is 0.54. Number and capacity of health personnel* emergency supplies stockpile and security * health emergency plan * -original coverage rate of health emergency sites is 0.32. Conclusions The number and capacity of health personnel is a necessary condition for evaluating the future of community health emergency management. The design of the pathway for grassroots community health emergency management needs to further focus on and plan for the number and capacity of health personnel, the stockpiling and securing of emergency supplies, and health emergency plans, as well as digitally empowering the various bodies of community health emergency management in conjunction with digital construction to improve the capacity and effectiveness of community health emergency management. [ABSTRACT FROM AUTHOR]

The recently passed Privacy Legislation Amendment (Enforcement and Other Measures) Act 2022 (Cth) introduced important changes to the Australian Privacy Act 1988 (Cth) which increase penalties for serious and repeated interferences with privacy and strengthen the investigative and enforcement powers of the Information Commissioner. The amendments were made subsequent to a number of high profile data breaches and represent the first set of changes to the Privacy Act following the review of the Act commenced by the Attorney-General in October 2020. The submissions made to the review emphasized the need for more effective enforcement mechanisms to increase individuals' control over their personal information and as a form of deterrence. This article reviews the recent amendments to the Privacy Act and explains their effect. It comments upon the relevance of the amendments for health and medical data and other data collected in the context of healthcare, and refers to the Attorney-General's Department's review of the Privacy Act regarding other proposals relating to enforcement which have not as yet been put into effect in legislation. [ABSTRACT FROM AUTHOR]

As journalists dealt with a nonstop news cycle in the early months of the COVID-19 pandemic, many of their newspapers faced a financial crisis as advertising revenue sharply declined during economic shutdowns. Unable to rely on their centuries-old, advertising-centric business model, U.S. community newspapers had to turn to other means to survive. This study features oral histories with 24 journalists and state newspaper association directors in six states for a deeper understanding of how community newspapers handled the financial crisis on top of a public health crisis in early 2020. Through our interviews, journalists at locally-owned newspapers described a variety of strategies, ranging from public- to market-funded, that they used in order to keep publishing. For many, this meant accepting government funding through the Paycheck Protection Program despite the industry's longtime prior resistance to a public-funding model. Community newspapers also turned to donations, grants, and other creative market strategies. However, even after the disruptions of COVID-19 presented new revenue options, community journalists say a complex road still exists for changing their business model. [ABSTRACT FROM AUTHOR]

The farmland around the industrial areas in the Upper Yellow River is crucial for agricultural production but is vulnerable to contamination from the surrounding industries. This research focused on analyzing the spatial distribution and environmental risks of heavy metal pollution in the farmland around the Ganhe Industrial Park in the Qinghai–Tibet Plateau. A total of 138 surface soil samples were collected, and the concentration of seven heavy metals (Cd, As, Pb, Cr, Cu, Ni, and Zn) was analyzed using the random forest (RF) model. Pollution indicators, including the pollution index and Nemero index, were used to evaluate the pollution levels of soil heavy metals. The human health and ecological risks were estimated using the hazard index (HI) and the potential ecological risk index (RI). Cd and Zn were identified as the primary soil pollutants in the study area, with Cd being more concentrated than other heavy metals. Heavy metal contamination was most severe in the central–eastern region of the study area, with a ring-shaped distribution, which correlated with the presence of zinc smelting and chemical plants. Furthermore, the study revealed that soil heavy metal contamination posed a health threat to the local population, with children being particularly vulnerable to non-carcinogenic risks when the HI was 1.21 and to potential carcinogenic risks when the CR was 2.27 × 10−5. Additionally, heavy metal pollution caused a moderate to high ecological risk in 56.4% of the samples. The results highlighted the severe impact of soil heavy metal pollution on the delicate ecosystem of the Upper Yellow River and Qinghai–Tibet Plateau. The government should take action to improve soil environment management and prevent heavy metal pollution to protect the health of the local population and the ecological environment. [ABSTRACT FROM AUTHOR]

The effective management of medical records is essential in the ordinary and emergency operations of healthcare providers. This work uses blockchain to develop a smart contract algorithm for users of a medical record platform. This algorithm provides immutable execution and addresses authentication and reliability issues to control access to healthcare platforms. An executable distributed code is used to build the smart contract algorithm. In the proposed algorithm, management operations of the clinical history are carried out and integrated in an automated way in a distributed environment. Solidity is the programming language used to create the algorithm for a private and permissioned architecture with a proposed consensus algorithm requiring significantly less computational power using a 22% faster hash function. [ABSTRACT FROM AUTHOR]

Common data models solve many challenges of standardizing electronic health record (EHR) data but are unable to semantically integrate all of the resources needed for deep phenotyping. Open Biological and Biomedical Ontology (OBO) Foundry ontologies provide computable representations of biological knowledge and enable the integration of heterogeneous data. However, mapping EHR data to OBO ontologies requires significant manual curation and domain expertise. We introduce OMOP2OBO, an algorithm for mapping Observational Medical Outcomes Partnership (OMOP) vocabularies to OBO ontologies. Using OMOP2OBO, we produced mappings for 92,367 conditions, 8611 drug ingredients, and 10,673 measurement results, which covered 68–99% of concepts used in clinical practice when examined across 24 hospitals. When used to phenotype rare disease patients, the mappings helped systematically identify undiagnosed patients who might benefit from genetic testing. By aligning OMOP vocabularies to OBO ontologies our algorithm presents new opportunities to advance EHR-based deep phenotyping. [ABSTRACT FROM AUTHOR]

The fundamental importance of informed consent as a prerequisite for the lawfulness of the medical act is an indisputable cornerstone of clinical practice. However, the provision of effective information and the collection of informed consent presents important critical issues in the underage patient, even considering that in general terms he or she does not have the power to directly express consent, which must be provided by parents or legal guardians. These critical issues are amplified in the context of telemedicine. The present study aims, through a scoping review of the literature of the past 10 years, to outline the operational practices adopted in the collection of informed consent from children in the context of telemedicine and to identify solutions devised to address the critical issues related to the provision of adequate information to the child in this particular care setting. The results of the research show that the activity of delivering adequate information to the child, itself complex, is made even more complex by the particular setting of telemedicine, which, however, could be effectively exploited to facilitate communication with the child patient. [ABSTRACT FROM AUTHOR]

This article uses the concept of sociotechnical imaginaries to explore how public hospitals are being reimagined and reconfigured by promissory digital health. Drawing on interviews with 42 senior leaders and staff from a large NHS hospital organisation, the article describes the imaginary of a data‐driven hospital and the tensions of its operationalisation. These relate to data quality, data curation and data access, and reflect a discord between the organisation's commitment to immediate patient care and its research aspirations. These tensions, however, serve to invigorate, rather than undermine, the sociotechnical imaginary of a data‐driven hospital, as they prompt the translation of a general data‐driven imaginary into specific sociotechnical arrangements. The article argues that the potency of the data‐driven hospital imaginary must be understood in terms of its enchanting qualities: it has the capacity to excite hospital staff and to align distinct and potentially diverging hopes and expectations regarding the societal role of public hospitals. The article concludes by suggesting that the entrenchment of the data‐driven imaginary can be partly explained by its strategic utility for severely resource‐constrained healthcare organisations: it provides a means for organisations to position themselves towards a viable future in an otherwise dire health‐care context. [ABSTRACT FROM AUTHOR]

Background: Numbers of clinical documentation integrity specialists (CDIS) and CDI programs have increased rapidly. CDIS review patient records concurrently with patient admissions and visits to ensure that information is accurate, complete and non-ambiguous, and query clinicians when they see opportunities for improving data. The occupation was initially focused on improving data for reimbursement, but rapid changes to clinical coding requirements, technologies and payment systems led to a quickly evolving role for CDI programs and changes in CDIS practice. Objective: This case study seeks to uncover the ongoing innovation and adaptation occurring in a CDI program by tracing the evolution of a single CDI program over time. Method: We present a case study of the CDI program at the HonorHealth hospital system in Arizona. Results: The HonorHealth CDI program holds a unique hybrid expertise and role within the healthcare organisation that allows it to rapidly adapt to support emergent demands both internal and external to the organisation, such as supporting accurate data collection for the COVID-19 pandemic. Conclusion: CDIS are a vital component in present data-intensive resourcing efforts. The hybrid expertise of CDIS and capacity for adaption and relationship building has enabled the HonorHealth CDI program to adapt rapidly to meet a growing array of clinical documentation integrity needs, including emergent needs during the COVID-19 pandemic. Implications: The HonorHealth case study can guide other CDI programs in adaptation of the CDI role and practices in response to changing organisational needs. [ABSTRACT FROM AUTHOR]

Health information permeates healthcare delivery from point-of-care, across the continuum of care and throughout the healthcare system's policy, population health, research, planning and funding arenas. Health information managers (HIMs) expertly manage that information. This commentary theorises the health information management profession for the first time. Its purpose is to identify and contextualise, via a historiographical account, the societal and political drivers that have shaped contemporary Australian health information management and HIMs' scientific work. It seeks to build our knowledge of the socio-political influences on the profession's emergence and development, and the projected drivers of its future. Eight critical, socio-political drivers were identified and are addressed in temporaneous order. Scientific medicine has reflected the influences on medicine in the past century and a half of the medical record and other technologies, laboratory-based sciences, evidence-based medicine and evidence-based health. Standardisation has underpinned and guided the profession's practice. The hegemony of non-medical healthcare managers and resource- and performance-related accountabilities emerged in the 1960s, as did the efficiencies of bureaucratisation in healthcare and post-bureaucratic shifts to textualisation and technogovernance. Technologisation has driven constant change in health information management, as have the forces of the fast-paced risk society. Since the 1980s, the health consumer movement has propelled regulatory mechanisms that accord patients' access rights to their medical records and mandate information privacy protections. Finally, a nascent commodification of health information has emerged. These forces exert ongoing impacts on the profession. They will, we conclude, singularly and collectively continue to shape its discourses and direction. [ABSTRACT FROM AUTHOR]

Background: The new International Classification of Diseases, Eleventh Revision for Mortality and Morbidity Statistics (ICD-11) was developed and released by the World Health Organization (WHO) in June 2018. Because ICD-11 incorporates new codes and features, training materials for coding with ICD-11 are urgently needed prior to its implementation. Objective: This study outlines the development of ICD-11 training materials, training processes and experiences of clinical coders while learning to code using ICD-11. Method: Six certified clinical coders were recruited to code inpatient charts using ICD-11. Training materials were developed with input from experts from the Canadian Institute for Health Information and the WHO, and the clinical coders were trained to use the new classification. Monthly team meetings were conducted to enable discussions on coding issues and to select the correct ICD-11 codes. The training experience was evaluated using qualitative interviews, a questionnaire and a coding quiz. Results: total of 3011 charts were coded using ICD-11. In general, clinical coders provided positive feedback regarding the training program. The average score for the coding quiz (multiple choice, True/False) was 84%, suggesting that the training program was effective. Feedback from the coders enabled the ICD-11 code content, electronic tooling and terminologies to be updated. Conclusion: This study provides a detailed account of the processes involved with training clinical coders to use ICD-11. Important findings from the interviews were reported at the annual WHO conferences, and these findings helped improve the ICD-11 browser and reference guide. [ABSTRACT FROM AUTHOR]

Background: Patient involvement in decision-making plays a prominent role in improving the quality of healthcare. Despite this, shared decision-making is not routinely implemented. However, electronic assessment tools that capture patients' history, symptoms, opinions and values prior to their medical appointment are used by healthcare professionals during patient consultations to facilitate shared decision-making. Objective: To assess the effectiveness of electronic assessment tools to improve the shared decision-making process. Method: A systematic review was conducted following PRISMA guidelines. Published literature was searched on MEDLINE, EMBASE and PsycINFO to identify potentially relevant studies. Data were extracted and analysed narratively. Results: Seventeen articles, representing 4004 participants, were included in this review. The main findings were significant improvement in patient–provider communication and provider management of patient condition in the intervention group compared to the control group. In contrast, patient–provider satisfaction and time efficiency were assessed by relatively few included studies, and the effects of these outcomes were inconclusive. Conclusion: This review found that communication and healthcare professional's management of a patient's condition improves because of the use of electronic questionnaires. This is encouraging because the process of shared decision-making is reliant on high-quality communication between healthcare professionals and patients. Implications: We found that this intervention is especially important for people with chronic diseases, as they need to establish a long-term relationship with their healthcare provider and agree to a treatment plan that aligns with their values. More rigorous research with validated instruments is required. [ABSTRACT FROM AUTHOR]

Background: Electronic medical record notes have been determined to be lacking in quality, accessibility and content. Structured note templates could provide a way to improve these aspects, particularly with regard to data availability for research and quality improvement. Objective: To determine whether the implementation of a standardised template for hernia documentation can improve data completeness and timeliness. Method: Retrospective review of clinic notes of 30 patients, 15 prior to implementation of a standardised note template and 15 after implementation of the template. The number of the 21 Americas Hernia Society Quality Collaborative (AHSQC) variables which were present in the notes was recorded, as was the time that the consultation ended and the time that the note was submitted. Results: Mean number of variables collected prior to implementation of the template was 5.9 ± 1.6 vs. 20 ± 0.4 after implementation (p < 0.001). In the pre-implementation group, 20% of the notes were completed after the day of the visit, while all of the notes in the post-implementation group were completed on the same day as the visit (p = 0.367). Conclusion: Implementation of a structured note template resulted in significantly improved capture of specific database variables within clinical notes. Structured note templates are an effective tool to improve data capture from the clinical setting for research and quality improvement. [ABSTRACT FROM AUTHOR]

The article calls for the development of an informatics-competent and capable nursing workforce to address knowledge and competency gaps. Suggestions are presented for new hire orientation, ongoing healthcare information technology (HIT) education, nurse residency programs, clinical ladders to increase retention and career advancement, job descriptions, and for super users and facility-based educators/mentors.

Background Consistent application of self-management is important in efforts to improve the quality of life and health status of hypertensive patients. Electronic health is here to facilitate self-management of hypertensive patients and provide health information to health workers in real time and promote lifestyle modifications. The purpose of this study was to analyze the influence of electronic health-based self-management on blood pressure control in hypertensive patients. Subjects and Method: : This study is a meta-analysis using PICO namely Population: Hypertensive patients; Intervention: Self-management based on electronic health; Comparison: No selfmanagement based on electronic health; Outcome: Systolic and diastolic blood pressure. This study uses articles from several databases, i.e Pubmed, Google Scholar, Science Direct and the Cochrane Library using the following keywords “Hypertension” OR “Hypertensive” OR “Blood Pressure” OR “High Blood Pressure” AND “Self Management” OR “Self Care” OR “Self Monitoring” AND “Electronic Health” OR “eHealth” OR “Telemedicine” OR “Telehealth” OR “mHealth” OR “Mobile Health” OR “Mobile Application” OR “Message Text” OR “Phone Calls”. Articles included in the research are articles that use English with an RCT study design whose publication is within the period of 2012- 2022. The steps in the systematic review are carried out based on the PRISMA flow diagram guidelines. Quantitative analysis was carried out using Review Manager (Revman) 5.3. Results: There were 9 articles from South Africa, America, South Korea, Spanish, England, Scotland, and Honduras, with a sample size of 3,071 hypertensive patients concluded that electronic health-based self-management could reduce systolic blood pressure by 0.38 units and was statistically significant (SMD= -0.38; 95% CI = -0.55 to -0.20; p<0.001 ). The meta-analysis synthesized 9 studies with a total sample size = 2.095 hypertensive patients concluded that electronic healthbased self-management could reduce diastolic blood pressure by 0.21 units and was statistically significant (SMD= -0.21; 95% CI = -0.29 to -0.12; p< 0.001). Conclusion: Electronic health-based self-management can reduce systolic and diastolic blood pressure control in hypertensive patients. [ABSTRACT FROM AUTHOR]

Background & Aims: Introduction: Autism Spectrum Disorder (ASD) is a neurological developmental disorder characterized by impaired social interactions, stereotypic movements and repetitive and limited behaviors and interests. Given the increasing statistics of autism in children in the world and in Iran, the extent of problems and burdens that this disorder creates for the child, family and society, it is a necessity to identify the causes and factors related to ASD. Moreover, data on this disorder are limited nationally and geographical differences are rarely assessed. To conduct great research on autism spectrum disorders requires a large number of samples to identify the epidemiological trend of the disorder. Registrations are one of the efficient methods that can provide this data in a long time and on a large scale. The purpose of this study is to describe the steps of designing and launching an autism registration system in Tehran, which can be a prelude to creating a system at the national level. Methods: In this study, the aim was to present a protocol to design and launch a registry for patients with autism spectrum disorders in Tehran for clinical and research purposes. The entered population in this system includes individuals (including children over 6 months and adults) with previous diagnosis or new diagnosis referred to the certain centers (Child Psychiatric Clinic of Tehran Psychiatric Institute, Ali Asghar Children's Hospital, Razi Hospital and Roozbeh Hospital) and also, physicians' offices who are members of the program's strategic committee. Patients are admitted to the program if the diagnosis of ASD is confirmed by a pediatrician, child neurologist, psychiatrist, neurologist, psychiatrist, neurologist, child psychologist according to the DSM-5 diagnostic criteria. Then personal and demographics information and clinical and laboratory findings will be recorded by data entry experts in the system. Patients will be followed up by telephone or through coming back of the patients to the certain centers. Data analysis is done in accordance with the objectives of the registration program and is performed based on conventional statistical methods. Also, an annual report of the profiles of registered patients is sent to the beneficiaries of the program at the end of each year, including the Vice Chancellor for Research of the participating universities, the Ministry of Health, and related associations and groups. Initially, stakeholders in the field of autism spectrum disorders from different and related specialties were identified from partner universities of medical sciences in Tehran (Iran, Tehran, Welfare Sciences) and various centers accepting autism spectrum patients and the Strategic Committee for Autism Registration as a subset of the Vice Chancellor for Research was established in 1398 in Iran University of Medical Sciences. The Strategic Committee is responsible for developing guidelines and executive protocols consisting of experts in the fields of general psychology, child psychology, social medicine, epidemiology, information technology, health informatics and health information management, as well as the executive committee and executive groups for follow-up and conducting decisions of Strategic Committee was considered. Data Management and Information Technology (IT) Department was Responsible for Software Design; Data collection and quality control group was responsible for data collection, quality control, feedback and data correction; The epidemiology and data analysis team was also responsible for designing and conducting the data analysis program. The population entered in this system includes people (including children over 6 months and adults) with previous diagnosis or new diagnosis of the referral centers. A child is considered to have diagnostic criteria for autism spectrum disorders according to the DSM 5 Diagnostic Guide if he or she has serious impairments in communication and social interactions as well as a limited and repetitive pattern of behavior, interests, and activities. Patients enrolled in the program have been diagnosed with ASD by a pediatrician, child psychiatrist, pediatric neurologist, psychiatrist, or neurologist. Child Psychiatric Clinic of Tehran Psychiatric Institute, Ali Asghar Children's Hospital, Razi Hospital and Roozbeh Hospital and also physicians' offices who are members of the program's strategic committee are covered now. Based on the objectives of the Strategic Committee and literature review for the design of registration systems, the following data collection was considered: - Personal and socio-demographic characteristics (such as name, age, gender, ethnicity, parents' relatives, place of birth and residence, birth rank, education) - Clinical information (such as history of developmental delay, name of the disorder, presence of seizures, presence of mental retardation and other psychiatric diagnoses, personal and family history of the disorder) - Laboratory and imaging finding Then personal and demographics information and clinical and laboratory findings will be recorded by data entry experts in the system. Patients will be followed up by telephone or through coming back of the patients to the certain centers. Data analysis is done in accordance with the objectives of the registration program and is performed based on conventional statistical methods. Also, an annual report of the profiles of registered patients is sent to the beneficiaries of the program at the end of each year, including the Vice Chancellor for Research of the participating universities, the Ministry of Health, and related associations and groups. In order to validate and evaluate the feasibility and ease of implementation of the data collection form, this form was piloted in several centers and then based on the results of experimental implementation, the questions were reviewed and finalized. After compiling the final version of the data collection form, the software registry system was designed for the web. In order to maintain data security, a separate access and a specific access level for each user is determined and hosted on the servers of Iran University of Medical Sciences .Data analysis is done in accordance with the objectives of the registry and is performed based on the required statistical methods. Also, an annual report on the profile of registered patients of the registry is sent to the beneficiaries of the program at the end of each year, including the Vice Chancellor for Research of the participating universities, the Ministry of Health and related associations and groups. In 2014, the Deputy Minister of Research at the Ministry of Health and Medical Education (MOHME) of Iran decided to establish registration systems for various diseases and health consequences (4). In this regard, the launch of a clinical-research registry in autism in Tehran was considered .Setting up an autism spectrum disorder information registry in Tehran as a preliminary study for its establishment at the national level can help to integrate research activities and create a research network and prevent incoherence, rework and waste of time and energy in related research activities in the country. In addition to the direct use of data for research activities, such systems can also be used to identify patients eligible for clinical trials. In addition, it is possible to study the natural course of this disorder, track individuals and help increase the country's indigenous knowledge based on local and regional information. In addition, launching a program to record the autism spectrum disorders will help policymakers and health planners in the country to decide and plan for it. In addition, is not possible for policy makers to plan in an integrated, comprehensive, accurate and up-todate way without having access to such online information systems. In the long run, this study aims to record all ASD information across the country in this system to eliminate the huge challenges of patients, physicians and health decision makers and also Smoothing the way for research further. Conclusion: Establishing registry systems, especially chronic diseases seems to be a need for work so that health policy makers can make the right policies and plans to improve the level of health. One of the most important features of registries is the enrolling of patients in the time period and the possibility of increasing the collection of patients in the country. Due to the relatively high prevalence large number of causes and increasing high financial burden of autism spectrum disorders that it imposes on society, it is a suitable c case to evaluate prevalence, environmental and genetic factors through recording all clinical and epidemiological information [ABSTRACT FROM AUTHOR]

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