scholarly journals Development of a Natural Language Processing Algorithm to Identify and Evaluate Transgender Patients in Electronic Health Record System

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 441-450 ◽  
Author(s):  
Jesse M. Ehrenfeld ◽  
Keanan Gabriel Gottlieb ◽  
Lauren Brittany Beach ◽  
Shelby E. Monahan ◽  
Daniel Fabbri
Keyword(s):  
Health Care ◽  
Natural Language ◽  
Language Processing ◽  
Health Care Services ◽  
False Positive Rate ◽  
Health Condition ◽  
Record System ◽  
Care Services ◽  
Electronic Health ◽  
Hormone Use

Objective: To create a natural language pro­cessing (NLP) algorithm to identify transgen­der patients in electronic health records.Design: We developed an NLP algorithm to identify patients (keyword + billing codes). Patients were manually reviewed, and their health care services categorized by billing code.Setting: Vanderbilt University Medical CenterParticipants: 234 adult and pediatric trans­gender patientsMain Outcome Measures: Number of transgender patients correctly identified and categorization of health services utilized.Results: We identified 234 transgender pa­tients of whom 50% had a diagnosed men­tal health condition, 14% were living with HIV, and 7% had diabetes. Largely driven by hormone use, nearly half of patients attended the Endocrinology/Diabetes/Me­tabolism clinic. Many patients also attended the Psychiatry, HIV, and/or Obstetrics/Gyne­cology clinics. The false positive rate of our algorithm was 3%.Conclusions: Our novel algorithm correctly identified transgender patients and provided important insights into health care utiliza­tion among this marginalized population. Ethn Dis. 2019;29(Suppl 2): 441-450. doi:10.18865/ed.29.S2.441

Informatics and Health Services

2017 ◽  
pp. 215-241
Author(s):  
Nelson Ravka
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Services ◽  
Electronic Record ◽  
Inappropriate Drug ◽  
Health Records ◽  
Record Keeping ◽  
Care Services ◽  
Electronic Health

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

scholarly journals The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review

10.2196/20346 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e20346
Author(s):  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Ernest Lim ◽  
Melissa Harper Shehadeh ◽  
Nick de Pennington ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Health Care ◽  
Language Processing ◽  
Health Care Services ◽  
Interactive Voice Response ◽  
Future Research ◽  
Conversational Agents ◽  
Privacy And Security ◽  
Care Services

Background The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. Objective This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents. Methods PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another. Results A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback. Conclusions The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents. International Registered Report Identifier (IRRID) RR2-10.2196/16934

Informatics and Health Services

2017 ◽  
pp. 543-569
Author(s):  
Nelson Ravka
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Services ◽  
Electronic Record ◽  
Inappropriate Drug ◽  
Health Records ◽  
Record Keeping ◽  
Care Services ◽  
Electronic Health

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

scholarly journals The Effectiveness of Artificial Intelligence Conversational Agents in Health Care: Systematic Review (Preprint)

2020 ◽  
Author(s):  
Madison Milne-Ives ◽  
Caroline de Cock ◽  
Ernest Lim ◽  
Melissa Harper Shehadeh ◽  
Nick de Pennington ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Health Care ◽  
Language Processing ◽  
Health Care Services ◽  
Interactive Voice Response ◽  
Future Research ◽  
Conversational Agents ◽  
Privacy And Security ◽  
Care Services

BACKGROUND The high demand for health care services and the growing capability of artificial intelligence have led to the development of conversational agents designed to support a variety of health-related activities, including behavior change, treatment support, health monitoring, training, triage, and screening support. Automation of these tasks could free clinicians to focus on more complex work and increase the accessibility to health care services for the public. An overarching assessment of the acceptability, usability, and effectiveness of these agents in health care is needed to collate the evidence so that future development can target areas for improvement and potential for sustainable adoption. OBJECTIVE This systematic review aims to assess the effectiveness and usability of conversational agents in health care and identify the elements that users like and dislike to inform future research and development of these agents. METHODS PubMed, Medline (Ovid), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Association for Computing Machinery Digital Library were systematically searched for articles published since 2008 that evaluated unconstrained natural language processing conversational agents used in health care. EndNote (version X9, Clarivate Analytics) reference management software was used for initial screening, and full-text screening was conducted by 1 reviewer. Data were extracted, and the risk of bias was assessed by one reviewer and validated by another. RESULTS A total of 31 studies were selected and included a variety of conversational agents, including 14 chatbots (2 of which were voice chatbots), 6 embodied conversational agents (3 of which were interactive voice response calls, virtual patients, and speech recognition screening systems), 1 contextual question-answering agent, and 1 voice recognition triage system. Overall, the evidence reported was mostly positive or mixed. Usability and satisfaction performed well (27/30 and 26/31), and positive or mixed effectiveness was found in three-quarters of the studies (23/30). However, there were several limitations of the agents highlighted in specific qualitative feedback. CONCLUSIONS The studies generally reported positive or mixed evidence for the effectiveness, usability, and satisfactoriness of the conversational agents investigated, but qualitative user perceptions were more mixed. The quality of many of the studies was limited, and improved study design and reporting are necessary to more accurately evaluate the usefulness of the agents in health care and identify key areas for improvement. Further research should also analyze the cost-effectiveness, privacy, and security of the agents. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16934

scholarly journals A filosofia web 2.0 e os OPSAS: Reflexões iniciais sobre a cultura participativa em saúde

2019 ◽  
Author(s):  
Louise Amaral
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Web 2.0 ◽  
Health Care Services ◽  
Systematic Observation ◽  
Health Records ◽  
Care Services ◽  
Web Tools ◽  
Electronic Health ◽  
The Web

The proposal of this study, with an exploratory and descriptive approach, was to identify the use of Web Tools 2.0 of production, circulation, sharing, storage and access to electronic health records (RES) by the organisms producers of Health care Services (OPSAS) in Bahia. The immersion of OPSAS in cyberspace requires the competencies of health agents to produce, receive, accumulate, access, use and migrate electronic health records (RES) directed to digital repositories. The adoption of the Web 2.0 philosophy allows the expansion of the OPSAS relationship with health agents and stakeholders and extends to the participation of citizens. As a result of this research, from a questionnaire applied in 26 hospitals in the state of Bahia (linked to a network of innovation and learning in hospital management), it was found that OPSAS use the Web Tools 1.0 well more than the Web 2.0. We opted to conduct a direct and systematic observation on the websites of 38 bodies producing health care services, in order to verify the incorporation or not of the devices of the Web 2.0 and the possible advances and/or setbacks on the incorporation of the Web 2.0 Philosophy in the OPSAS.

scholarly journals ACTION-EHR: Patient-Centric Blockchain-Based Electronic Health Record Data Management for Cancer Care (Preprint)

2019 ◽  
Author(s):  
Alevtina Dubovitskaya ◽  
Furqan Baig ◽  
Zhigang Xu ◽  
Rohit Shukla ◽  
Pratik Sushil Zambani ◽  
...  
Keyword(s):  
Health Care ◽  
Data Management ◽  
Patient Care ◽  
Data Sharing ◽  
Cancer Care ◽  
Health Care Services ◽  
Health Records ◽  
Care Services ◽  
Electronic Health ◽  
Patient Centric

BACKGROUND With increased specialization of health care services and high levels of patient mobility, accessing health care services across multiple hospitals or clinics has become very common for diagnosis and treatment, particularly for patients with chronic diseases such as cancer. With informed knowledge of a patient’s history, physicians can make prompt clinical decisions for smarter, safer, and more efficient care. However, due to the privacy and high sensitivity of electronic health records (EHR), most EHR data sharing still happens through fax or mail due to the lack of systematic infrastructure support for secure, trustable health data sharing, which can also cause major delays in patient care. OBJECTIVE Our goal was to develop a system that will facilitate secure, trustable management, sharing, and aggregation of EHR data. Our patient-centric system allows patients to manage their own health records across multiple hospitals. The system will ensure patient privacy protection and guarantee security with respect to the requirements for health care data management, including the access control policy specified by the patient. METHODS We propose a permissioned blockchain-based system for EHR data sharing and integration. Each hospital will provide a blockchain node integrated with its own EHR system to form the blockchain network. A web-based interface will be used for patients and doctors to initiate EHR sharing transactions. We take a hybrid data management approach, where only management metadata will be stored on the chain. Actual EHR data, on the other hand, will be encrypted and stored off-chain in Health Insurance Portability and Accountability Act–compliant cloud-based storage. The system uses public key infrastructure–based asymmetric encryption and digital signatures to secure shared EHR data. RESULTS In collaboration with Stony Brook University Hospital, we developed ACTION-EHR, a system for patient-centric, blockchain-based EHR data sharing and management for patient care, in particular radiation treatment for cancer. The prototype was built on Hyperledger Fabric, an open-source, permissioned blockchain framework. Data sharing transactions were implemented using chaincode and exposed as representational state transfer application programming interfaces used for the web portal for patients and users. The HL7 Fast Healthcare Interoperability Resources standard was adopted to represent shared EHR data, making it easy to interface with hospital EHR systems and integrate a patient’s EHR data. We tested the system in a distributed environment at Stony Brook University using deidentified patient data. CONCLUSIONS We studied and developed the critical technology components to enable patient-centric, blockchain-based EHR sharing to support cancer care. The prototype demonstrated the feasibility of our approach as well as some of the major challenges. The next step will be a pilot study with health care providers in both the United States and Switzerland. Our work provides an exemplar testbed to build next-generation EHR sharing infrastructures.

scholarly journals Mediator – enabler for successful digital health care

2017 ◽  
Vol 9 (4) ◽  
pp. 284-298 ◽  
Author(s):  
Janne Lahtiranta
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Digital Health ◽  
Oecd Countries ◽  
Care Services ◽  
The Future ◽  
Electronic Health ◽  
Near Future

It is no news that as in any other field of industry, digitalization is changing health care. This change is ongoing and profound as it affects every aspect imaginable; from provisioning to funding, and from roles to responsibilities. The magnitude of this change is such that some label it as the ‘health care revolution’. Not all individuals are ready for this ‘revolution’. Some rebel against it while others are simply not able to cope with it. Regardless of the underlying reason, it can be estimated that in the near future, roughly 10 % of the population in the OECD countries will drift outside the reach of the modern electronic health care services. These individuals, the digital orphan, need to be brought back in order to prevent the future of health care from becoming more marginalized and discriminatory than it is today. Mediators, individuals in the crux of health care and technology, are one way to prevent this unwelcome eventuality from coming true. In the following, the focus of examination is on the mediators and mediation. The role of a mediator is critically examined from different perspectives, and a framework for mediation is presented.  

scholarly journals HELIANT HEALTH INFORMATION SYSTEM AS A SUPPORT TO ELECTRONIC BUSINESS OF HEALTHCARE ORGANIZATIONS IN SERBIA

2017 ◽  
pp. 265
Author(s):  
Žarko Rađenović ◽  
Slavoljub Milovanović ◽  
Goran Milovanović
Keyword(s):  
Health Care ◽  
Information System ◽  
Health Services ◽  
Health Information ◽  
Health Care Services ◽  
Health Information System ◽  
Electronic Business ◽  
Healthcare Organizations ◽  
Care Services ◽  
Electronic Health

Electronic business of healthcare organizations is specific technological innovation when it comes to providing adequate health care services. The process of providing health care services in this case is supported by electronic health record, which is an integral part of health information systems. Monitoring of the health services providing process using tools of electronic health (e-health) in this paper, will be based on the software for graphical modeling, which will target key activities, participants and the variables of the process, and make its mapping. This is because the analysis of the electronic business processes of healthcare organizations reveal activities that can be cost-optimized for more efficient delivery of health services and faster response on the patient's condition. In this work process analysis was conducted on the case of health information system Heliant Health, which is used in most public medical institutions of the Republic of Serbia.

scholarly journals Main characteristics of patients of primary health care services in Brazil

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Ione Aquemi Guibu ◽  
José Cássio De Moraes ◽  
Augusto Afonso Guerra Junior ◽  
Ediná Alves Costa ◽  
Francisco de Assis Acurcio ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Care Service ◽  
Health Care Service ◽  
Health Condition ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

OBJECTIVE: To characterize patients of primary health care services according to demographic and socioeconomic aspects, habits and lifestyle, health condition, and demand for health services and medicines. METHODS: This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services), a cross-sectional study carried out between 2014 and 2015. Interviews were conducted with patients over the age of 17 years, with a standardized questionnaire, in primary health care services of a representative sample of cities, stratified by regions of Brazil. The analysis was performed for complex samples and weighted according to the population size of each region. RESULTS: A total of 8,676 patients were interviewed, being 75.8% women, most of them aged from 18 to 39 years; 24.2% men, most of them aged from 40 to 59 years; 53.7% with elementary school; 50.5% reported to be of mixed race ethnicity, 39.7%, white, and 7.8%, black. Half of patients were classified as class C and 24.8% received the Bolsa Familia benefit. Only 9.8% had health insurance, with higher proportion in the South and lower in the North and Midwest. The proportion of men who consumed alcohol was higher than among women, as well as smokers. The self-assessment of health showed that 57% believed it to be very good or good, with lower proportion in the Northeast. The prevalence of chronic diseases/conditions, such as hypertension (38.6%), dyslipidemia (22.7%), arthritis/rheumatism (19.4%), depression (18.5%), diabetes (13.6%), and others are higher in these patients them among the general population. Medicines were predominantly sought in the health care service or in pharmacies of the Brazilian Unified Health System. CONCLUSIONS: It was possible to characterize the profile of patients of Primary Health Care, but the originality of the research and its national scope hinders the comparison of results with official data or other articles

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