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18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scans in the first 49 patients referred with either possible brain tumour or brain tumour recurrence were reviewed. FDG-PET imaging was reported with reference to anatomical imaging. Based on the report the FDG study was classified as either positive or negative for the presence of tumour. Thirty-eight cases were included in the analysis, 21 having pathological data and 17 with diagnostic clinical follow up. Eleven were excluded, as they had inadequate follow-up data. Of the 21 cases with pathology, 18 were shown to have tumour. In this group there were five false-negative scans and two false-positive PET scans. Seventeen cases were assessed by clinical follow up, nine were considered to have been tumour. There were two false negatives with one false positive. The overall sensitivity, specificity and positive and negative predictive values were 74, 73, 87 and 53% respectively. This is similar to figures previously quoted in published work. Despite relatively limited numbers, the utility of FDG PET imaging in our hands is similar to published reports. With a positive predictive value of 87%, a positive FDG study indicates a high likelihood that there is brain tumour present. A negative study does not exclude the presence of tumour. [ABSTRACT FROM AUTHOR]

Background: Australian nursing programs aim to introduce students to digital health requirements for practice. However, innovation in digital health is more dynamic than education providers' ability to respond. It is uncertain whether what is taught and demonstrated in nursing programs meets the needs and expectations of clinicians with regard to the capability of the nurse graduates., Objective: This study aims to identify gaps in the National Nursing and Midwifery Digital Health Capability Framework , based on the perspectives of clinical nurses, and in nurse educators' confidence and knowledge to teach. The findings will direct a future co-design process., Methods: This study triangulated the findings from 2 studies of the Digital Awareness in Simulated Health project and the National Nursing and Midwifery Digital Capability Framework. The first was a qualitative study that considered the experiences of nurses with digital health technologies during the COVID-19 pandemic, and the second was a survey of nurse educators who identified their confidence and knowledge to teach and demonstrate digital health concepts., Results: The results were categorized by and presented from the perspectives of nurse clinicians, nurse graduates, and nurse educators. Findings were listed against each of the framework capabilities, and omissions from the framework were identified. A series of statements and questions were formulated from the gap analysis to direct a future co-design process with nursing stakeholders to develop a digital health capability curriculum for nurse educators., Conclusions: Further work to evaluate nursing digital health opportunities for nurse educators is indicated by the gaps identified in this study., (© Karen Livesay, Ruby Walter, Sacha Petersen, Robab Abdolkhani, Lin Zhao, Kerryn Butler-Henderson. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

Aim: This study explored the knowledge and confidence levels of nursing academics in teaching both the theories and practical skills of digital health in undergraduate nursing programs., Design: A cross-sectional study., Methods: A structured online survey was distributed among nursing academics across Australian universities. The survey included two sections: (1) the participants' demographics and their nursing and digital health teaching experience; (2) likert scales asking the participants to rate their knowledge and confidence to teach the theories and practical skills of four main themes; digital health technologies, information exchange, quality and digital professionalism., Results: One hundred and nineteen nursing academics completed part one, and 97 individuals completed part two of the survey. Only 6% (n = 5) of the participants reported having formal training in digital health. Digital health was mainly taught as a module (n = 57, 45.9%), and assessments of theory or practical application of digital health in the nursing curriculum were uncommon, with 79 (69.9%) responding that there was no digital health assessment in their entry to practice nursing programs. Among the four core digital health themes, the participants rated high on knowledge of digital professionalism (22.4% significant knowledge vs. 5.9% no knowledge) but low on information exchange (30% significant knowledge vs. 28.3% no knowledge). Statistically significant (p < .001) associations were found between different themes of digital health knowledge and the level of confidence in teaching its application. Nursing academics with more than 15 years of teaching experience had a significantly higher level of knowledge and confidence in teaching digital health content compared with those with fewer years of teaching experience., Conclusion: There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Nursing academics need to upskill in digital health to prepare the future workforce to be capable in digitally enabled health care settings., Implications for the Profession: Nursing academics have a limited level of digital knowledge and confidence in preparing future nurses to work in increasingly technology-driven health care environments. Addressing this competency gap and providing sufficient support for nursing academics in this regard is essential., Impact: What problem did the study address? Level of knowledge and confidence among nursing academics to teach digital health in nursing practice. What were the main findings? There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Where and on whom will the research have an impact? Professional nursing education globally., Reporting Method: The STROBE guideline was used to guide the reporting of the study., Patient or Public Contribution: The call for participation from nursing academics across Australia provided an introductory statement about the project, its aim and scope, and the contact information of the principal researcher. A participant information sheet was shared with the call providing a detailed explanation of participation. Nursing academics across Australia participated in the survey through the link embedded in the participation invite., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: The Global Specialist Digital Health Workforce Census is the largest workforce survey of the specialist roles that support the development, use, management, and governance of health data, health information, health knowledge, and health technology., Objective: This paper aims to present an analysis of the roles and functions reported by respondents in the 2023 census., Methods: The 2023 census was deployed using Qualtrics and was open from July 1 to August 13, 2023. A broad definition was provided to guide respondents about who is in the specialist digital health workforce. Anyone who self-identifies as being part of this workforce could undertake the survey. The data was analyzed using descriptive statistical analysis and thematic analysis of the functions respondents reported in their roles., Results: A total of 1103 respondents completed the census, with data reported about their demographic information and their roles. The majority of respondents lived in Australia (n=870, 78.9%) or New Zealand (n=130, 11.8%), with most (n=620, 56.3%) aged 35-54 years and identifying as female (n=720, 65.3%). The top four occupational specialties were health informatics (n=179, 20.2%), health information management (n=175, 19.8%), health information technology (n=128, 14.4%), and health librarianship (n=104, 11.7%). Nearly all (n=797, 90%) participants identified as a manager or professional. Less than half (430/1019, 42.2%) had a formal qualification in a specialist digital health area, and only one-quarter (244/938, 26%) held a credential in a digital health area. While two-thirds (502/763, 65.7%) reported undertaking professional development in the last year, most were self-directed activities, such as seeking information or consuming online content. Work undertaken by specialist digital health workers could be classified as either leadership, functional, occupational, or technological., Conclusions: Future specialist digital health workforce capability frameworks should include the aspects of leadership, function, occupation, and technology. This largely unqualified workforce is undertaking little formal professional development to upskill them to continue to support the safe delivery and management of health and care through the use of digital data and technology., (© Kerryn Butler-Henderson, Kathleen Gray, Salma Arabi. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

The COVID-19 pandemic has reshaped technology-enhanced services in health and care organizations globally. As the world pivots towards a post-COVID-19 environment, it is essential to examine emerging trends amongst thought leaders in the health information technology sector. This study queried Twitter feeds of IMIA Fellows from 2013 through 2022, utilizing combinations of sentiment analysis, latent dirichlet allocation, and document analysis methods. The results provided a glimpse of positive sentiment year upon year, with the most negative sentiment prevalent in 2020, due to the onset of the pandemic. The findings from this study can be strategically used to analyze emerging trends in digital health, as well as to shape health IT thought leadership in the post-pandemic landscape.

The Australian Health Informatics Competency Framework (AHICF) guides the healthcare workforce in identifying the required competencies to perform as a health informatician, and more definitively defines the foundational body of knowledge on which the discipline is based. The aim of this paper is to describe the conceptual foundations in developing the AHICF v1.0, detail the methods used to revise and publish AHICF v2.0, and explore the certification and workforce outcomes achieved. This paper contributes to the competency framework and certification discourse, and knowledge of the increasing importance and recognition of health informaticians through certification. Further, implications for workforce training and education, career advancement and recruitment strategies, are also discussed.

It is imperative to build clinician trust to reuse ever-growing amounts of rich clinical data. Utilising a proprietary, structured electronic health record, we address data quality by assessing the plausibility of chiropractors, physical therapists and osteopaths' data entry to help determine if the data is fit for use in predicting outcomes of work-related musculoskeletal disorders using machine learning. For most variables assessed, individual clinician data entry positively correlated to the clinician group's data entry, indicating data is fit for reuse. However, from the clinician's perspective, there were inconsistencies, which could lead to data mistrust. When assessing data quality in EHR studies, it is crucial to engage clinicians with their deep understanding of EHR use, as improvement suggestions could be made. Clinicians should be considered local knowledge experts.

The Certified Health Informatician Australasian (CHIA) is an assessment of a candidate's capabilities measured using a core set of health informatics competencies. The aim of this paper is to describe the outcomes of the first eight years since the program's launch. This paper contributes to the competency framework and certification discourse, and knowledge of the increasing importance and recognition of health informaticians through certification. An analysis of results and possible contributing factors is discussed.

Background: Digital health technology is progressively transforming physiotherapy practice. Despite a maturing body of literature relating to physiotherapy digital health capability, research examining digital health physiotherapy competency standards is both lacking and lagging., Objective: Examine international professional practice competency standards for physiotherapists to identify themes common to digital health practice competency, published by international peak organizations governing physiotherapy practice., Methods: Systematic meta-synthesis of international peak organization physiotherapy practice competency standards. The study was undertaken over nine stages. Competency statements related to digital health were extracted, and further coded into resultant themes., Results: Eleven documents were analyzed. Fifty-two statements explicitly referenced digital health competency. Identified themes were as follows: 1) digital health data governance; 2) digital health data translation; and 3) digital health technologies. Where digital health-related competency statements do exist, they are skewed toward health information management activities., Conclusions: Digital health practice is currently under-represented in competency standards for physiotherapists. Workforce advancement in light of the burgeoning impact of digital health will prompt further updates to professional competency standards set by our peak organizations. This will have a flow on effect, whereby education providers (e.g. universities and other professional development providers) should consider curriculum and training that prepares individuals for digitally enabled practice.

Digital health technologies are a proposed solution to improve healthcare delivery and reduce pressures on the healthcare system, but these technologies are new to much of the health workforce. This perspective paper highlights lessons learned from the global experience of rapid digital transformation of health workforces, including fostering a culture of learning, ensuring accreditation and recognition, and adopting a transdisciplinary approach. Evidence-based actions are proposed to address recommendations to (1) ensure foundational workforce digital health capability and (2) build specialist digital health career pathways. Australia must take a national approach and strategically leverage strong collaborations across sectors including healthcare, education and government to ensure a consistent, regulated and sustainable digital workforce capability.

Background: The COVID-19 pandemic has accelerated the use of digital health innovations, which has greatly impacted nursing practice. However, little is known about the use of digital health services by nurses and how this has changed during the pandemic., Objective: This study explored the sociotechnical challenges that nurses encountered in using digital health services implemented during the pandemic and, accordingly, what digital health capabilities they expect from the emerging workforce., Methods: Five groups of nurses, including chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and nurse representatives in government bodies across Australia were interviewed. They were asked about their experience of digital health during the pandemic, their sociotechnical challenges, and their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analyzed based on 8 sociotechnical themes, including technical challenges, nurse-technology interaction, clinical content management, training and human resources, communication and workflow, internal policies and guidelines, external factors, and effectiveness assessment of digital health for postpandemic use., Results: Sixteen participants were interviewed. Human factors and clinical workflow challenges were highly mentioned. Nurses' lack of knowledge and involvement in digital health implementation and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions beyond documentation, such as data analytics and decision-making., Conclusions: Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts among policy makers, vendors, and clinical and academic industries can leverage digital health capabilities in the nursing workforce., (©Karen Livesay, Sacha Petersen, Ruby Walter, Lin Zhao, Kerryn Butler-Henderson, Robab Abdolkhani. Originally published in JMIR Nursing (https://nursing.jmir.org), 16.08.2023.)

The COVID-19 pandemic has significantly affected the higher education sector in Singapore. Existing tertiary studies seeking to understand the intraperiod response to COVID-19 often focus on single institutions, jurisdictions or stakeholder groups. This study is the first in-depth qualitative multi-stakeholder examination of the higher education environment in Singapore during the COVID-19 pandemic. It explored the perceptions of the quality of digital pedagogy during COVID-19, how universities have adapted because of the pandemic, and how leaders, teaching staff and students have been affected by the management and educational changes via 13 semi-structured interviews across six Singapore higher education institutions. Through purposive sampling, we explore current stakeholder perceptions, structural education changes, and personal learning and teaching impacts of COVID-19. Applying Braun and Clarke's approach to thematic analysis, we inductively uncovered four major themes: the Singapore government's approach to COVID-19 and its effects on delivery; academic leadership approaches; education technology; and well-being. This article is critical as a key foundation to understand how Singapore is responding with unique geopolitical differences. We discuss the practical implications of our research for current university faculty and students during and beyond the pandemic, and outline opportunities for future research., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Competing Interests: J.A. is a member of the Platform for AI Ethics, Netherlands Institute for Standardization (NEN), member of the NEN 7542 workgroup on standardization of medication process data and contract reviewer for the European Commission. S.A.-A. has received consulting fees from AstraZeneca, Agilent Biotechnologies, and Diazyme. A.D.B. has received grants or contracts from NIH and NSF, payment or honoraria from Adelphi University, and travel support from Microsoft. A.J.B. is a cofounder of and consultant to Personalis and NuMedii; consultant to Mango Tree Corporation, and in the recent past, Samsung, 10x Genomics, Helix, Pathway Genomics, and Verinata (Illumina); has served on paid advisory panels or boards for Geisinger Health, Regenstrief Institute, Gerson Lehman Group, AlphaSights, Covance, Novartis, Genentech, and Merck, and Roche; is a shareholder in Personalis and NuMedii; is a minor shareholder in Apple, Meta (Facebook), Alphabet (Google), Microsoft, Amazon, Snap, 10x Genomics, Illumina, Regeneron, Sanofi, Pfizer, Royalty Pharma, Moderna, Sutro, Doximity, BioNtech, Invitae, Pacific Biosciences, Editas Medicine, Nuna Health, Assay Depot, and Vet24seven, and several other non–health-related companies and mutual funds; and has received honoraria and travel reimbursement for invited talks from Johnson and Johnson, Roche, Genentech, Pfizer, Merck, Lilly, Takeda, Varian, Mars, Siemens, Optum, Abbott, Celgene, AstraZeneca, AbbVie, Westat, and many academic institutions, medical or disease specific foundations and associations, and health systems. A.J.B. receives royalty payments through Stanford University, for several patents and other disclosures licensed to NuMedii and Personalis. A.J.B.'s research has been funded by NIH, Peraton (as the prime on an NIH contract), Genentech, Johnson and Johnson, FDA, Robert Wood Johnson Foundation, Leon Lowenstein Foundation, Intervalien Foundation, Priscilla Chan and Mark Zuckerberg, the Barbara and Gerson Bakar Foundation, and in the recent past, the March of Dimes, Juvenile Diabetes Research Foundation, California Governor's Office of Planning and Research, California Institute for Regenerative Medicine, L'Oreal, and Progenity. A.B.C. has received consulting fees from Invitae Corporation. J.K.C. has received grants or contracts from the Office of Rural Health and Office of Healthcare and Equity, VHA. P.L.E. has received grants or contracts from NLM, NIAAA, and NCATS. Oluseyi Fayanju has received grants or contracts from GetSmarter. L.J.F. serves as a consultant to the American Psychiatric Association, has received travel support in relation to that role, and has also received grant support from NIMH. B.R.J. has received stock or stock options from Consent Vault, LLC. V.N.-J. occupies leadership or fiduciary roles with the Academy of Breastfeeding Medicine and West Central Illinois Breastfeeding Task Force. Ross Koppel has received consulting fees from advisors who contemplate investment in EHR companies, payment or honoraria from University at Buffalo, payment for expert testimony from the U.S. Department of Justice, stock or stock options from TrekIT, and occupies editor roles with the Journal of Applied Clinical Informatics and the International Journal of Medical Informatics. B.K. has received payment or honoraria from the Fall DeVos Medical Ethics Colloquy, and travel support to attend CSHI and AMIA conferences. C.U.L. has received royalties or licenses from Springer, has participated in a Data Safety monitoring board conducted by Lipika Samal at Harvard, and has received stock or stock options from Markel and Celanese. Z.C.L. has received consulting fees from Atrius Health, travel support from the University of Washington, Atrius Health, and Jackson Health System. R.J.M. has supported the present manuscript as a Texas Health Resources Clinical Scholar, has received grants or contracts from the Centers for Disease Control and Prevention, Sergey Brin Family Foundation, and Verily Life Sciences, payment or honoraria from Clinical Infectious Diseases, and occupies a leadership role with the Infectious Diseases Society of America. E.R.M. has received grants or contracts from the National Institute on Drug Abuse, the American Medical Association, and the Agency for Healthcare Research and Quality. A.B.N. has received grants or contracts from Royal Phillips and Eli Lilly, consulting fees from Intuity Medical, Roche, Eli Lilly, Sanofi, Greenberg Traurig, and Medtronic, payment or honoraria from The Doctors Company and TCOYD, and payment for expert testimony from AMFS. L.L.N. has received grants or contracts from GetPreCiSe, Florida State University, AHRQ, Baptist Memorial Healthcare Corporation, IBM Watson Health, and NIH/NIDDK. Deepti Pandita has received travel support from AMIA, has a patent pending with WellPulse app, and is a board member of AMIA. Raghuveer Puttagunta is a board member of Pennsylvania Medical Society. Angela Ryan is a member of AMIA and vice chair of the Australasian Institute of Digital Health. K.M.R. occupies a leadership role with the Society of Hospital Medicine Public Policy Committee. Neda Ratanawongsa occupies a leadership role with the San Francisco General Foundation. K.A.S. has received grants from Meds360 and Anonymous Foundation, honoraria from Stanford, travel support from the Society of Family Planning, and is a volunteer board member of the Society of Family Planning. Vignesh Subbian has received a grant from the National Science Foundation and occupies a leadership role with the AMIA ELSI Working Group. Ida Sim is a scientific advisor with Myovant Sciences. A.S. has received grants from NCATS Chicago Institute for Translational Medicine and PCORI Capricorn CRN, occupies leadership roles with the American Medical Informatics Association and IEEE Standards Association, and owns stock from Pfizer, Moderna, and J.B.S. holds leadership roles in AMIA and in the American College of Medical Informatics (ACMI), has received research funding from NIH and the Greenwall Foundation, and honoraria or consulting fees from the University of Kentucky, the University of Wisconsin, and the Icahn Mount Sinai School of Medicine. Peter Winkelstein has received a grant or contract from CTSA. J.X. has participated on a Data Safety Monitoring Board or Advisory Board with AfaSci, Inc. and Develo. C.Z. has received grants or contracts from CVS Foundation and Ariadne Labs, royalties, or licenses from UpToDate, consulting fees from Blue Cross Blue Shield of Massachusetts, and occupies leadership or fiduciary roles with the American Heart Association, Society for Maternal Fetal Medicine, and ACOG.

Background: The COVID-19 pandemic has accelerated the uptake of digital health innovations due to the availability of various technologies and the urgent health care need for treatment and prevention. Although numerous studies have investigated digital health adoption and the associated challenges and strategies during the pandemic, there is a lack of evidence on the impact on the nursing workforce., Objective: This study aims to identify the impact of digital health transformation driven by COVID-19 on nurses., Methods: The online software Covidence was used to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Relevant scientific health and computing databases were searched for papers published from January 2020 to November 2021. Using the 8D sociotechnical approach for digital health in health care systems, the papers were analyzed to identify gaps in applying digital health in nursing practice., Results: In total, 21 papers were selected for content analysis. The analysis identified a paucity of research that quantifies the impact of the digital health transformation on nurses during the pandemic. Most of the initiatives were teleconsultation, followed by tele-intensive care unit (tele-ICU), and only 1 (5%) study explored electronic medical record (EMR) systems. Among the sociotechnical elements, the human-related factor was the most explored and the system measurement was the least studied item., Conclusions: The review identified a significant gap in research on how implementing digital health solutions has impacted nurses during the COVID-19 pandemic. This gap needs to be addressed by further research to provide strategies for empowering the nursing workforce to be actively involved in digital health design, development, implementation, use, and evaluation., (©Robab Abdolkhani, Sacha Petersen, Ruby Walter, Lin Zhao, Kerryn Butler-Henderson, Karen Livesay. Originally published in JMIR Nursing (https://nursing.jmir.org), 30.08.2022.)

Patients who want to know how to access their medical records from a health organization's website have certain expectations about what must be included to assist in this process. The purpose of this article is to detail patient expectations of a health care organization website when searching for information on how to apply for access to their medical records. Using expectation confirmation theory, a survey was developed to ask patients, as consumers of health care, about their expectations when accessing websites. The results revealed that patients want websites to be safe and secure and have help available if there are questions about the website or search functionality. In order to improve the patient experience, health care providers need to understand these expectations from the patient perspective about this information-seeking exercise.

Background: The importance of high-quality health information for patient safety has been established in the literature, yet the impact of the professionals who are the custodians of health information is absent., Objectives: This article presents the results of a systematic literature review examining the impact of the Health Information Management (HIM) profession on patient safety., Methods: A PRISMA approach was adopted for the review of selected databases and specific journals. Titles identified as relating to HIM and patient quality were screened using Covidence ® by title and abstract, followed by full text. The quality of selected articles was assessed and thematically analysed., Results: Analysis of the 8 included articles found that the key themes from the non-empirical research were data quality, information governance, corporate governance, skills and knowledge required for HIM professionals., Discussion: Most publications focussed on HIM professional involvement in maintaining standards for data quality and health records, but not the professional qualifications themselves., Conclusions: There are links between patient safety and health records, and between health records and HIM professional work. More empirical research is needed to demonstrate how qualified HIM professionals contribute to patient safety., (© 2021 Health Libraries Group.)

Objective The study examined if, when and how select allied health professional standards currently articulate the Health LEADS Australia themes. Methods Eighteen allied health professional standards were searched to locate references to leadership. Data were extracted and analysed inductively, deductively and thematically as a meta-synthesis. Frequencies were counted, with subanalysis by professional area, classification level, competency type and level of cognition. Results There were 953 direct and indirect leadership statements. Only two leadership definitions were located, for pharmacists and dentists. The principal theme 'Leadership' only appeared in 18 (2%) statements from the total dataset that made direct references to leadership, which were mostly vague and unclear. The remaining indirect references to leadership are reported as four overarching themes: Self-leadership (n=289 statements; 30%); Leadership With and of Others (n=263; 28%); Improvement and Change Leadership (n=223; 23%); and Health Reform Leadership (n=139; 15%). Conclusion Health leadership was not easily recognisable in the allied health practice standards examined. With some refinement and alignment with a contemporary leadership framework, professional standards could play a critical role in preparing allied health graduates to support the ongoing health system reform required to improve health and well-being outcomes in the future. What is known about the topic? Leadership is essential at all health system levels, and leadership frameworks can usefully guide leadership development. However, little is known about allied health leadership compared with other clinical groups, and their contributions to directional changes in health system reform may be overlooked. What does this paper add? This paper presents results of an analysis of where and how 18 allied health disciplines align with the Australian Health LEADS framework, and where greater clarity or alignment is needed. What are implications for practitioners? Reinstatement of a national health leadership framework, such as the Australian Health LEADS framework, to articulate the need for and capabilities of leadership to enable innovation and support reform across all professional groups working in health care, including medical, nursing and allied health is required. A recognised national leadership framework could guide the revisions to allied health practice standards and coupled with a co-design process involving practitioners and professional associations, further development and incorporation of leadership competencies in a consistent manner would be enabled. Furthermore, alignment of allied health education and professional development with a national health leadership framework may strengthen allied health leadership graduate outcomes.

Digitization and automation across all industries has resulted in improvements in efficiencies and effectiveness to systems and process, and the higher education sector is not immune. Online learning, e-learning, electronic teaching tools, and digital assessments are not innovations. However, there has been limited implementation of online invigilated examinations in many countries. This paper provides a brief background on online examinations, followed by the results of a systematic review on the topic to explore the challenges and opportunities. We follow on with an explication of results from thirty-six papers, exploring nine key themes: student perceptions, student performance, anxiety, cheating, staff perceptions, authentication and security, interface design, and technology issues. While the literature on online examinations is growing, there is still a dearth of discussion at the pedagogical and governance levels., (© 2020 Elsevier Ltd. All rights reserved.)

Background: Education is essential to the integration of eHealth into primary care, but eHealth is not yet embedded in medical education., Objectives: In this opinion article, we aim to support organisers of Continuing Professional Development (CPD) and teachers delivering medical vocational training by providing recommendations for eHealth education. First, we describe what is required to help primary care professionals and trainees learn about eHealth. Second, we elaborate on how eHealth education might be provided., Discussion: We consider four essential topics. First, an understanding of existing evidence-based eHealth applications and conditions for successful development and implementation. Second, required digital competencies of providers and patients. Third, how eHealth changes patient-provider and provider-provider relationships and finally, understanding the handling of digital data. Educational activities to address these topics include eLearning, blended learning, courses, simulation exercises, real-life practice, supervision and reflection, role modelling and community of practice learning. More specifically, a CanMEDS framework aimed at defining curriculum learning goals can support eHealth education by describing roles and required competencies. Alternatively, Kern's conceptual model can be used to design eHealth training programmes that match the educational needs of the stakeholders using eHealth., Conclusion: Vocational and CPD training in General Practice needs to build on eHealth capabilities now. We strongly advise the incorporation of eHealth education into vocational training and CPD activities, rather than providing it as a separate single module. How learning goals and activities take shape and how competencies are evaluated clearly requires further practice, evaluation and study.

Electronic health and medical records are widely adopted in many healthcare settings worldwide to improve the quality of care. Users' perception is a significant factor influencing the successful implementation and use of e-health technologies. This systematic review aimed to identify factors influencing the perceptions of healthcare professionals towards the adoption and use of electronic health and medical record systems to improve the quality of healthcare services in the countries of the Gulf Cooperation Council. We identified primary studies evaluating healthcare professionals' perception towards electronic health records and/or electronic medical records in the Gulf region. Seven electronic databases, including Medline, CINAHL, Informit Health Collection, Science Direct, ProQuest, PubMed, and Scopus were used to search for the relevant articles published between January 2007 and December 2016. Thirteen articles met the inclusion criteria and were included in this systematic review. Both individual and system-related factors were found to positively or negatively influence healthcare providers' perceptions towards the systems. Understanding the impact of healthcare professionals' perception of health information technology is important for policymakers involved in the implementation programs to ensure their success. Future studies should evaluate other individual characteristics such as age, gender, and profession of the healthcare providers on their perceptions towards e-health technologies., (The OMJ is Published Bimonthly and Copyrighted 2020 by the OMSB.)

Background: Research is an important activity that informs knowledge and practice. The research culture within the Australian Health Information Management (HIM) profession has not been previously reported., Objective: This study explored the perceptions of HIM practitioners about research in their role to establish if there is a research culture in the Australian HIM profession., Method: An online survey was distributed to the HIM community using a snowball recruitment strategy., Results: Of the 149 respondents, more than half (54%) identified they possessed research skills from prior education, whilst 40% considered they had a strong knowledgebase in conducting research. However, only a quarter of respondents indicated that they should undertake research in their role. Barriers to undertaking research included recognition, organisational support and time., Discussion: The findings from this study reflected other studies within clinical workforces. The lack of recognition and support to incorporate research into practitioner roles has implications for the profession and its body of knowledge., Conclusion: Advocating for research to be incorporated into practitioner roles is required to inform knowledge and practice. Increased professional development opportunities may create a stronger research culture within the HIM profession in Australia and strengthen the position of the profession within health., (© 2019 Health Libraries Group.)

Introduction: Electronic health records (EHRs) can improve the quality and safety of care. However, the adoption and use of the EHR is influenced by several factors, including users' perception., Objectives: To undertake a systematic review of the literature to understand healthcare professionals' perceptions about the adoption and use of EHRs in Gulf Cooperation Council (GCC) countries in order to influence the implementation strategies, training programme and policy development in the GCC region., Method: A systematic literature search was undertaken on seven online databases to identify articles published between January 2006 and December 2017 examining healthcare professionals' perception towards the adoption and use of EHR in the Gulf context., Results: The fourteen articles included in this review identified both positive and negative perceptions of the role of EHR in healthcare. The positive perceptions included EHR benefits, such as improvements to work efficiency, quality of care, communication and access to patient data. Conversely, the negative perceptions were associated with challenges or risks of adopting an EHR, such as disruption of provider-patient communication, privacy and security concerns and high initial costs. The perceptions were influenced by personal factors (eg, age, occupation and computer literacy) and system factors (perceived usefulness and perceived ease of use)., Conclusion: Positive perceptions of EHRs by the healthcare professionals could facilitate the adoption of this technology in the Gulf region, particularly when barriers are addressed early. Negative perceptions may inform change management strategies during adoption and implementation. The perceptions should be further evaluated from a technology acceptance perspective., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The health information management (HIM) profession lacks clarity around leadership and leadership development. To date, little empirical research exists on this topic, and it is unclear if broader approaches for healthcare leadership are suitable. This paper aims to explore which the leadership styles are relevant to the HIM profession. The findings were also used to inform a discussion on how HIM professionals could develop these leadership styles., Design/methodology/approach: Through a systematic scoping literature review, deductive thematic analysis was undertaken to extrapolate common themes around this style of leadership based on transversal competency domains that reflect twenty-first century skills (i.e. critical thinking and innovation, interpersonal, intrapersonal and global citizenship) (Bernard, Watch and Ryan, 2016; UNESCO, 2015 ). This approach enabled the findings to be discussed from a leadership development perspective., Findings: Analysis of the literature revealed that a relational leadership style through a team-based approach is required. Literature studies on how to develop leadership competencies were not found., Research Limitations/implications: Future policy and research implications include the need for research on transversal competencies to determine if they can shape HIM leadership development., Practical Implications: This leadership style and competencies proposed are relevant across many occupations and may have broader applications for leadership research, education and development., Originality/value: This paper defines the style of leadership required in the HIM profession and identifies a succinct set of contemporary competencies to inform the development of this type of leadership.

Electronic Health Records (EHRs) constitute evidence of online health information management. Critical healthcare information technology (HIT) infrastructure facilitates health information exchange of 'modern' health systems. The growth and implementation of EHRs are progressing in many countries while the adoption rate is lagging and lacking momentum amidst privacy and security concerns. This paper uses an interrupted time series (ITS) analysis of OECD data related to EHRs from many countries to make predictions about EHR adoption. The ITS model can be used to explore the impact of various HIT on adoption. Assumptions about the impact of Information Accountability are entered into the model to generate projections if information accountability technologies are developed. In this way, the OECD data and ITS analysis can be used to perform simulations for improving EHR adoption.

The Australian Health Information Workforce is a critical discipline in the health sector as the investment in digital technologies increases. Yet historically there was no standardized reporting about the workforce and its six professional areas: clinical coding, costing analysts, data analysts, health informaticians, health information managers and health librarians. This paper presents the findings from the inaugural Australian Health Information Workforce Census. Analysis of 1,596 responses indicates this is an aging (56.1% ≥45 years) workforce with a large (78.1%) female population. Working in permanent (82%), public hospital (72%) roles, in professional or managerial roles (84%). The majority (93.2%) of respondents hold a tertiary qualification in health information, one-quarter of these at masters or doctoral level. Fewer than 30% of respondents hold a health information credential from a professional or industry association. The data from the ongoing national census will inform workforce planning and enable forecasting of the future workforce needs.

Improving communication among healthcare providers is one of the critical components of safe and quality patient care. The study objective is to examine how occupation and training of health professionals in Riyadh, Saudi Arabia influence professionals' perception of the role of electronic health records (EHRs) in improving communication between healthcare providers in primary healthcare centres. A survey-based study method employing a descriptive, cross-sectional design was used. Health professionals' occupation and training were found to influence their perception of the role of the EHR in improving interprofessional communication. Physicians and professionals with training on EHRs had the highest rating for the system's role in improving communication between healthcare professionals. All healthcare providers should embrace EHR systems in their practice to promote interprofessional communication and collaboration in the patient care process.

In a data driven environment, healthcare has seen ongoing digital transformation to meet both clinical and business needs. But, have the educational and functional requirements of the health informatics and information management (HIIM) workforce also adapted? This study examined the current employment opportunities in HIIM globally. Using 11 keywords generated from a literature review, postings on the job advertisement website Indeed™ for all available countries were analyzed. The results show that job postings tend to fall within 4 discrete categories: 1) health information technology; 2) health research; 3) health leadership and project management; and 4) health compliance. Data indicated a higher prevalence for certain areas by country. The findings from this study can inform HIIM educational providers about future skill requirements.

There has been no empirical evidence about the health informatics workforce in Australia produced in the last ten years. This study reports the findings from an analysis of a subset of the 2018 Australian Health Informatics Workforce Census data. Analysing 420 responses that were identified as the occupational group Health Informatics, the results indicate that whilst most of the workforce is classified as aged (>45 years), many respondents are still relatively early in their health informatics careers. Furthermore, most do not possess any formal education in health informatics and almost a quarter undertake their health informatics role alongside another health-related role. The broad range of position titles and functions demonstrates the breadth within this workforce. Ongoing monitoring of this occupational group is required to inform workforce reform and renewal.

In descriptions of digital health the role of human agency and the work of managing and governing health information and communication technology is often invisible. This paper reports preliminary results of a scoping review of the literature and a national workforce census, undertaken as part of a research program to shed light on the responsibilities and the contributions of the health information workforce. The global literature is not a good indicator of the actual proportion of health informaticians, health information managers, health librarians or other health professionals who are engaged in health information work in Australia. While the research interest in health information work of all descriptions is increasing, the practice of health information work is neither highly skilled nor easily identifiable in findings of an Australian census. Reforming this workforce may be a key to translating digital health rhetoric into measurable improvements in health system performance.