Evaluating and Addressing Interoperability Constraints in Health Information Systems for Enhanced Healthcare Delivery in Zimbabwe

Interoperability constraints in health information systems pose significant challenges to the seamless exchange and utilization of health data, hindering effective healthcare delivery. This paper aims to evaluate and address these constraints to enhance healthcare delivery. The study examines the current state of interoperability in health information systems, identifies the key constraints, and explores their impact on healthcare outcomes. Various approaches and strategies for addressing interoperability constraints are discussed, including the adoption of standardized data formats, implementation of interoperability frameworks, and establishment of robust data governance mechanisms. Furthermore, the study highlights the importance of stakeholder collaboration, policy development, and technical advancements in achieving enhanced interoperability. The findings emphasize the need for a comprehensive evaluation of interoperability constraints and the implementation of targeted interventions to promote seamless data exchange, improve care coordination, and enhance patient outcomes in healthcare settings.

Application of VPN Technique in the Construction of Public Health Information System

Summary： Data communication and sharing of five level network of Public Health Information System, i.e. nation, province, district （city）, county, and town, as far as to the countryside level were described, and how to apply the three solutions, i.e. Access VPN, Intranet VPN, and Extranet VPN of VPN technique to achieve the appropriation of the public network was also presented.

The Impact of Computerized Health Information System on Medical &Administrative Decisions, Sana’a Hospitals, Yemen (2017-2020)

Background: Health information systems (HIS) play a major role in decision-making. The aim is to identify the components of computerized HIS and their relationship to administrative decisions at the main referral hospitals for Sana’a city. Method: This applied research is a descriptive, cross-sectional study in which the HIS of 7 hospitals affiliated with Sana’a city hospitals during “2017-2020”, was evaluated based on Self-administered questionnaires. Data were collected by using Self-administered questionnaires and analyzed in SPSS 16 by using descriptive statistics. Results: A total of 626 users (95.7%) had responded. 73%, 75%, 69%, 70%, 71% of users mentioned that resources were available, for physical, software, human, organizational, and decision computerized HIS, respectively. The study showed a strong relationship between computerized information systems with their physical, software, human and organizational components, and medical and administrative decisions. While the study showed the absence of a relationship between demographic factors and computerized information systems with their hardware, software, human and organizational components, medical and administrative decisions, except for gender with organizational components, age, qualification with hardware and software components, and years of experience with all study variables. Conclusion: The application of HIS at hospitals in decision-making has several challenges, including the lack of updating of hardware and software components Furthermore, the absence of specific, focusing on developing their technical staffs, and mobilizing financial resources to achieve implementation properly. Therefore, establishing the technical management with clear roles and tasks with multi-disciplinary, and increasing the support of the administrative leadership in the process of implementing HIS are recommended.

Community workers contribution for data quality improvement in routine health information system: Live births number estimation by capture recapture method

The lack of reliable vital statistics raises questions about the role of the health information system in acquiring such data, which are essential for planning health services and for the general management of the population’s needs. This study analyzed completeness of the vital data registration system and assessed the potential contribution of a community worker net-work to this system in rural Benin. The capture-recapture method was used in this interventional study to estimate the number of live births from three sources: the Routine Health Information System, the municipality, and community workers in two groups of villages. Log linear modelling was carried out with a Bayesian Information Criterion-weighted estimate of the number of live births. The exhaustiveness of the Routine Health Information System was improved by the contribution of the community workers from 29.3% to 42.5% in the first group, and from 61.7% to 77.5% in the second group. Estimating live births by the capture method in rural settings based on the contribution of community workers could be a more efficient alternative to censuses in acquiring reliable vital statistics.

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .

Evaluation of the Usability of a Telehealth System for COVID-19 According to the Perception of the User Professional

With the advent of the pandemic, the Brazilian Ministry of Health structured in record time the Telehealth Service of the Unified Health System called TeleSUS, an ecosystem based on the intensive use of information technology involving automated mechanisms and a personalized health care center at distance. In addition to constant evaluations carried out in the service as a public health strategy, at clinical and epidemiological levels, the team involved in the project was also concerned with evaluating the system developed to enable the operation of remote care, from the conception of the organization of health actions to the technological development of the digital health tool. The objective of this study was to carry out an evaluation of a telehealth system, measuring the degree of satisfaction of users of health professionals regarding its usability and identifying factors that positively and/or negatively influence the evaluation.

Assessing intersectional gender analysis in Nepal’s health management information system:a case study on tuberculosis for inclusive health systems

Background Tuberculosis(TB)remains a major public health problem in Nepal,high in settings marked by prevalent gender and social inequities.Various social stratifiers intersect,either privileging or oppressing individuals based on their characteristics and contexts,thereby increasing risks,vulnerabilities and marganilisation associated with TB.This study aimed to assess the inclusiveness of gender and other social stratifiers in key health related national policies and the Health Management Information System(HMIS)of National Tuberculosis Programme(NTP)by conducting an intersectional analysis of TB cases recorded via HMIS.Methods A desk review of key policies and the NTP’s HMIS was conducted.Retrospective intersectional analysis utilized two secondary data sources:annual NTP report(2017-2021)and records of 628 TB cases via HMIS 6.5 from two TB centres(2017/18-2018/19).Chi-square test and multi-variate analysis was used to assess the association between social stratifers and types of TB,registration category and treatment outcome.Results Gender,social inclusion and concept of intersectionality are incorporated into various health policies and strategies but lack effective implementation.NTP has initiated the collection of age,sex,ethnicity and location data since 2014/15 through the HMIS.However,only age and sex disaggregated data are routinely reported,leaving recorded social stratifiers of TB patients static without analysis and dissemination.Furthermore,findings from the intersectional analysis using TB secondary data,showed that male more than 25 years exhibited higher odds[adjusted odds ratio(a OR)=4.95,95%confidence interval(CI):1.60-19.06,P=0.01]of successful outcome compared to male TB patients less than 25 years.Similarly,sex was significantly associated with types of TB(P<0.05)whereas both age(P<0.05)and sex(P<0.05)were significantly associated with patient registration category(old/new cases).Conclusions The results highlight inadequacy in the availability of social stratifiers in the routine HMIS.This limitation hampers the NTP’s ability to conduct intersectional analyses,crucial for unveiling the roles of other social determinants of TB.Such limitation underscores the need for more disaggregated data in routine NTP to better inform policies and plans contributing to the development of a more responsive and equitable TB programme and effectively addressing disparities.

Seeking Health Information Online:The Moderating Effects of Problematic Situations on User Intention

Purpose： This study investigates how online user intention in searching health information is affected by problematic situations.Design/methodology/approach： Based on the Theory of Reasoned Action, the Technology Acceptance Model, and Sense-making theory, we propose two dimensions of problematic situations： urgency and severity of health issues being searched online. Data were collected through a questionnaire survey among 214 Wuhan University students and analyzed using hierarchical regression analysis.Findings： Perceived usefulness, perceived ease of use, and subjective norm can influence user intention to seek health information online. The urgency of problematic situations has a negative moderating effect on the relationship between perceived ease of use and user intention and the relationship between subjective norm and user intention. The severity of problematic situations has a negative moderating effect on the relationship between subjective norm and user intention.Research limitations： The respondents of the survey are limited to students in one Chinese university, so whether this study＇s results can be applied to another population or not remains to be verified. In addition, only two dimensions of problematic situations are considered in this study. Practical implications： The paper puts forward the moderating effect of problematic situations and verifies it, which is the compensation for online health information-seeking behavior research. Besides, our analyses have implications for professional design of health care systems and related consumer information searches, and improve their performance. Originality/value： Previous work has reported the effects of problematic situation on user intention to seek health information online, ignoring its influence on other factors. This empirical study extends that work to identify the influence of problematic situation when seeking intention-behavior data in two dimensions, urgency and severity.

Linking the health data system in the U.S.:Challenges to the benefits

In order to improve patient care in the United States there,the government made a mandate called HIE(Health Information Exchange).This order was created from the belief that sharing digital health in-formation between,across,and within health communities will improve one's healthcare experience across their lifespan.Patient health information,i.e.the personal health record,should be shareable between healthcare providers;such as private practice physicians,home health agencies,hospitals and nursing care facilities.Most of the U.S.hospitals now have electronic health records,however,with a lack of standards for structuring health information and unified communication protocols to share health information across providers,only a small percentage of U.S.hospitals engage in computerized HIE.In order to understand barriers and facilitators in the U.S.of HIE adoption,we reviewed the published research literature between 2010 and 2015.Our search yielded 664 articles from Medline,PsychInfo,Global health,InSpec,Scopus and Business Source Complete databases.Thirty-nine articles met our inclusion criteria.This article presents the compiled organizational and end user barriers and facilitators along with suggested methods to achieve continuity of care through HIE.

Research on the Model of Consumer Health Information Seeking Behavior via Social Media

Purpose: We aim to create a model of consumer health information seeking behavior via social media, then to have a better understand of it. After that further efforts should be made to provide targeted recommendations for media managers to promote health communication via social media. Methods: Our custom model was derived from literature review, empirical research was tested by the use of questionnaire investigation, and then the collected data were analyzed by structural equation model tool SmartPLS. Finally, the custom model was modified according to the experimental results of SmartPLS. Results: A total of 239 (66.39%) of the respondents were female and 121 (33.61%) were male. The maximum of two stages of age were 18 - 29 (70.56%), 30 - 39 (13.89%). Wechat (60.28%), QQ Zone (55.22%), Micro-blog (48.89%) were the most commonly used social media to obtain health information. About 44.72% of respondents used social media to obtain health information multiple times a day. The whole numerical values of AVE, cronbach’s alpha, CR and square roots of AVE were above the benchmarks of themselves and showed great reliability and validity. All the 11 hypotheses had obvious statistical significance, the P-value of eight path coefficients exhibited <0.001, one path coefficient exhibited <0.01 and two path coefficients exhibited <0.05. Conclusions: A suitable model of consumer health information seeking behavior via social media was created and some inner relationships were found. Namely, gratification of health information and its platform had a positive effect on attitudes toward health information seeking behavior. Health information literacy and health status were proved to have a significant influence on attitudes toward health information seeking behavior, subject norms and perceived behavioral control respectively. In addition, attitudes toward the health information seeking behavior, subject norms and perceived behavioral control were proved to positively associate with health information seeking behavior intention.

Enriching online access to health information for the public: Efforts from a medical library in China

Purpose: Disseminating medical and health information is a mission of a public medical library. This paper describes a practice of a medical library in providing online access to health information for the general public.Design/methodology/approach: A four-step workflow is developed to integrate and disseminate heterogeneous health information from medical associations. First, a raw data repository is developed to manage the original submissions from information providers.Second, each document in the raw data repository is represented in a standardized XML schema. Third, the medical terms are identified and manually annotated, enriching the semantics of health information. Lastly, all the semantically enriched XML documents are converted to HTMLs for online dissemination.Findings: A health information website, CHealth, was developed for Chinese speakers. It provides free online access for all without any login or IP constrains. CHealth is available at www.chealth.org.cn.Research limitations: The current workflow is time-consuming and labor-intensive due to the lack of information submission/exchange standard and commonly agreed-on consumer health terminology in Chinese.Originality/value: In this work, the target audience of the medical library has been extended from traditional academic/professional to the general public. Methodologies in library sciences have been combined with those in consumer health informatics in CHealth development.

The Elder Health Information Technology Framework for Geriatric Care in Rural India: A Policy Initiative

Healthcare monitoring and analysis of healthcare parameters is a reality to reduce costs and increase access to specialist and experts that holds the future for geriatric care in India. This paper proposes distinct methods towards the implementation of rural elder health information technologies (IT), which includes electronic medical records, clinical decision support, mobile medical applications, and software driven medical devices used in the diagnosis or treatment of disease for the older adult population in the villages of India. The purpose is online patient satisfaction at the microlevel (village panchayat) through methods accessible and affordable by establishing a common standard of operations at the village primary care units giving way to early disease detection and routine screening among the aged population avoiding institutionalization. The rural elder health IT framework is of great interest for all stakeholders in the field, as it benefits the investors and the consumers, adding to the technological infrastructure, thereby opening new avenues of research in health informatics, telemedicine and enhancing the scope of geriatric research, which in turn enhances the health-related quality of life for the rural older adults in the remote villages of the nation.

Survey and Research on Health Information Assistance Needs of Junior Middle School Students in Different Regions of Guangdong Province

Objective:To study the health information assistance needs of junior high school students in 8 different regions of Guangdong Province in a cluster,to understand the current situation of junior high school students'health information assistance needs,and to collect feasibility data for hospitals and schools to jointly promote the healthy development of students.Methods:In June 2019,a group of junior high school students from 8 different regions in Guangdong Province[678 students(in 2 towns),352 students(in 2 counties and prefecture-level cities),and 1098 students(in 4 provincial-level cities)]were selected in a group.A questionnaire survey was conducted by 2128 people,the results of the questionnaire survey were collected,and statistical analysis was performed.Results:Of the 2128 junior high school students in 8 different regions,only 52.07% had confidence in their health,and there were no regional differences.Health information for students seeking professional medical assistance includes:1578 person-times(74.15%)of nutritional diets,1084 person-times(50.94%)to eliminate tiredness,1190 person-times(55.92%)to improve sleep quality,1002 person-times(47.09%)to reduce anxiety,making him happier and stronger 1164 person-times(54.70%).Students in different regions asked for help on how to make their hearts happier and stronger.The results suggest that provincial and county-level students have greater needs than urban students.Conclusion:The results of this research show that junior high school students in different regions of Guangdong Province have insufficient awareness of health,and there is a large demand for various health help information,and the focus is on prevention.It is of practical significance to strengthen and meet the health information needs of junior high school students.

Analysis on the Risks of Health Information Platform under the Environment of Big Data

Big Data applications in the health service field have gradually been paid more close attention. Based on big data technology, more and more health information platforms are beginning to take effects, such as disease prevention, precision medicine, reducing expenditures for medical care and public health, improving medicine research and development. Meanwhile, the platforms have to face a lot of risks, such as health data disclosure, dispute of health data ownership, implicit contradiction explicit, unsustainable platform operation and so on. With the solutions of these risks, the construction of the public platform can provide better service for the citizens, hospital, pharmaceutical company, R＆D institutions or and other parties.

The portrayal of hearing loss information in online Mandarin videos

Background/purpose:With increasing accessibility to the Internet,patients frequently use the Internet for hearing healthcare information.No study has examined the information about hearing loss available in the Mandarin language on online video-sharing platforms.The study’s primary purpose is to investigate the content,source,understandability,and actionability of hearing loss information in the Mandarin language’s one hundred most popular online videos.Method:In this project,publicly accessible online videos were analyzed.One hundred of the most popular Mandarin-language videos about hearing loss were identified(51 videos on YouTube and 49 on the Bilibili video-sharing platform).They were manually coded for different popularity metrics,sources,and content.Each video was also rated using the Patient Education Materials Assessment Tool for Audiovisual Materials(PEMAT-AV)to measure the understandability and actionability scores.Results:The video sources were classified as either media(n=36),professional(n=39),or consumer(n=25).The videos covered various topics,including symptoms,consequences,and treatment of hearing loss.Overall,videos attained adequate understandability scores(mean=73.6%)but low(mean=43.4%)actionability scores.Conclusions:While existing online content related to hearing loss is quite diverse and largely understandable,those videos provide limited actionable information.Hearing healthcare professionals,media,and content creators can help patients better understand their conditions and make educated hearing healthcare decisions by focusing on the actionability information in their online videos.

Construction of HMI Network System for Individualized Maternity Intervention Service against Birth Defects in Community

The paper expounds the community maternity service system against birth defects, from the viewpoint of individualized service in family planning. We have utilized modern information technology to develop health management information （HMI） network with individualized maternity, and to establish the community service system for intervention of birth dejects. The service system applied the concept of modern health management information to implementing informational management for screening, treatment, following up, outcome monitoring, so as to provide a base for promotion of health, diagnosis, treatment as well as scientific research, with the prenatal screening of Down＇s syndrome as a model. The introduction to informational network during the processes of service has been carried out with regards to its composition, function and application, while introducing the effects of computerized case record individualized in prevention, management and research of Down＇s syndrome.

Online Vaccine Information in a Knowledge Exchange Social Website (KESW)

Background: The potential for misinformation on usercontrolled Knowledge Exchange Social Websites (KESWs) is concerning since it can actively influence Internet users’ knowledge, attitudes, and behaviors related to childhood vaccinations. Objective: The present study examines the accuracy and predictors of health information posted to a Knowledge Exchange Social Website (KESW). Methods: A sample of 480 answers to childhood vaccination questions were retrieved and rated for accuracy. Multiple logistic regression modeling was used to examine whether answer characteristics (best answer, professional background, statistical information, source disclosure, online link, word count, vaccine stance, and tone) predict accuracy. Results: Overall, only 56.2% of the posted answers were rated as “accurate.” Accuracy varied by topics with between 52.8% - 64.3% being rated as accurate. When Yahoo Answers’ “best answers” were examined, only 49.2% rated as accurate compared to 57.7% of all other answers, a finding attributed to widespread nominations of vaccine misinformation as “best answers” for questions addressing the side effects of vaccines. For all other types of questions, “best answers” were more likely to be accurate. Regression modeling revealed that discussions of personal choices regarding childhood vaccinations predicted the accuracy of posted answers, with those who mentioned vaccinating their own children proving more likely to communicate accurate vaccine information, and those expressing vaccine hesitancy proving more likely to share factually inaccurate statements about vaccines. Conclusion: The high prevalence of misinformation on KESWs suggests that these websites may serve as a vector for spreading vaccine misperceptions. Further research is needed to assess the impact of various KESWs and to develop effective, coordinated responses by public health agencies.

Bridging Healthcare and Health IT

Health IT （Information Technology） is new to the healthcare industry, even though the term surfaced in 2008 the true meaning of what it is and how data aggregation, evaluation, and validation of patient data and information drives a successful quality healthcare organization. Understanding of key factors, what quality is and how it is measured, helps bridge together healthcare and technology for an organization to be successful in reporting quality measures for the best patient care.

Psychometric evaluation of a Swedish version of Krantz Health Opinion Survey

The purpose of this study was to evaluate the psychometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A convenience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was examined for face and content validity, internal consistency and test-retest reliability. The findings showed that the Swedish version of KHOS is acceptable in terms of face and content validity, internal consistency and test-retest reliability over time among 79 individuals >65 years of age and with a cardiac disease. In conclusion, wider evaluations of the psychometric use of KHOS for other populations and settings are recommended.

基于用户阅读行为数据的住院患者信息化健康教育现状分析--以HEALS系统为例

目的通过对用户的阅读行为进行数据挖掘,分析住院患者使用信息化健康教育系统的现状。方法选取2021年9月-2022年8月于我院住院患者使用健康教育精准连接系统(HEALS系统)的数据,以科室为标签,共纳入10673例住院患者使用HEALS系统的用户阅读行为数据进行分析。结果10673例患者用户中,有阅读行为的患者6465例,文章阅读量为37611篇,平均阅读时长为(10.69±3.87)min,患者平均有效阅读率53.27%,文章平均有效阅读率56.58%。不同科室住院患者平均阅读时长无差异,老年病科患者阅读率最高,但文章平均有效阅读率最低;妇儿科室的平均有效阅读率最高,差异有统计学意义(P<0.001)。患者阅读率与患者平均阅读时长呈正相关(r=0.312,P<0.05),与文章平均有效阅读率呈负相关(r=-0.434,P<0.001)。结论住院患者对信息化健康教育的需求趋势上升,医护人员开展信息化健康教育时,应根据科室和人群特点,采用多样化健康教育形式,优化健康教育内容,适应不同患者群体需求特点的健康教育,提高健康教育效果。