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Healthcare organizations must de-identify patient records before sharing data. Many organizations rely on the Safe Harbor Standard of the HIPAA Privacy Rule, which enumerates 18 identifiers that must be suppressed (eg, ages over 89). An alternative model in the Privacy Rule, known as the Statistical Standard, can facilitate the sharing of more detailed data, but is rarely applied because of a lack of published methodologies. The authors propose an intuitive [...]

Over the last four decades, the UK has made large investments in healthcare information technology. The authors conducted interviews and reviewed published and unpublished documents to describe national-scale clinical information exchange in England, how it was achieved, and the problems experienced that the USA might avoid. Clinical information exchange in the UK was accomplished by establishing a foundation of policy, infrastructure, and systems of care, by creating and acquiring clinical [...]

With the advent of personal health records and other patient-focused health technologies, there is a growing need to better understand factors that contribute to acceptance and use of such innovations. In this study, we employed the Unified Theory of Acceptance and Use of Technology as the basis for determining what predicts patients' acceptance (measured by behavioral intention) and perceived effective use of a web-based, interactive self-management innovation among home care [...]

This case report describes a qualitative investigation into how a Hands-free Communication Device (HCD) system impacted communication among anesthesia staff in a pediatric surgical suite. The authors recruited a purposive sample that included anesthesiologists, certified registered nurse anesthetists, circulating nurses, a charge nurse, and a postanesthesia care unit nurse. Data were collected using semistructured interviews and observations, then analyzed using a constant comparison approach. The results corroborate and enrich themes [...]

This case report describes how two complementary standards, CONTsys (European Standard EN 13940-1 for continuity of care) and the reference model of openEHR, were applied in modeling a shared care plan for shared homecare based on requirements from the OLD@HOME project. Our study shows that these requirements are matched by CONTsys on a general level. However, certain attributes are not explicit in CONTsys, for example agents responsible for performing planned [...]

Implementing health information technology (IT) at the community level is a national priority to help improve healthcare quality, safety, and efficiency. However, community-based organizations implementing health IT may not have expertise in evaluation. This study describes lessons learned from experience as a multi-institutional academic collaborative established to provide independent evaluation of community-based health IT initiatives. The authors' experience derived from adapting the principles of community-based participatory research to the field [...]

This paper describes natural-language-processing techniques for two tasks: identification of medical concepts in clinical text, and classification of assertions, which indicate the existence, absence, or uncertainty of a medical problem. Because so many resources are available for processing clinical texts, there is interest in developing a framework in which features derived from these resources can be optimally selected for the two tasks of interest.

The aim of this study was to measure the effect of an electronic heparin-induced thrombocytopenia (HIT) alert on provider ordering behaviors and on patient outcomes.

Despite at least 40 years of promising empirical performance, very few clinical natural language processing (NLP) or information extraction systems currently contribute to medical science or care. The authors address this gap by reducing the need for custom software and rules development with a graphical user interface-driven, highly generalizable approach to concept-level retrieval.