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Can structured EHR data support clinical coding? A data mining approach. 结构化的电子病历数据能支持临床编码吗?一种数据挖掘方法。
IF 1.8
Health Systems Pub Date : 2020-03-01 DOI: 10.1080/20476965.2020.1729666
José Carlos Ferrão, Mónica Duarte Oliveira, Filipe Janela, Henrique M G Martins, Daniel Gartner
{"title":"Can structured EHR data support clinical coding? A data mining approach.","authors":"José Carlos Ferrão, Mónica Duarte Oliveira, Filipe Janela, Henrique M G Martins, Daniel Gartner","doi":"10.1080/20476965.2020.1729666","DOIUrl":"10.1080/20476965.2020.1729666","url":null,"abstract":"<p><p>Structured data formats are gaining momentum in electronic health records and can be leveraged for decision support and research. Nevertheless, such structured data formats have not been explored for clinical coding, which is an essential process requiring significant manual workload in health organisations. This article explores the extent to which fully structured clinical data can support assignment of clinical codes to inpatient episodes, through a methodology that tackles high dimensionality issues, addresses the multi-label nature of coding and optimises model parameters. The methodology encompasses transformation of raw data to define a feature set, build a data matrix representation, and testing combinations of feature selection methods with machine learning models to predict code assignment. The methodology was tested with a real hospital dataset and showed varying predictive power across codes, while demonstrating the potential of leveraging structuring data to reduce workload and increase efficiency in clinical coding.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1729666","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Improving chemotherapy infusion operations through the simulation of scheduling heuristics: a case study. 通过模拟调度启发式方法改进化疗输液操作：案例研究。
IF 1.8
Health Systems Pub Date : 2020-02-02 eCollection Date: 2021-01-01 DOI: 10.1080/20476965.2019.1709908
Ryan F Slocum, Herbert L Jones, Matthew T Fletcher, Brandon M McConnell, Thom J Hodgson, Javad Taheri, James R Wilson
{"title":"Improving chemotherapy infusion operations through the simulation of scheduling heuristics: a case study.","authors":"Ryan F Slocum, Herbert L Jones, Matthew T Fletcher, Brandon M McConnell, Thom J Hodgson, Javad Taheri, James R Wilson","doi":"10.1080/20476965.2019.1709908","DOIUrl":"10.1080/20476965.2019.1709908","url":null,"abstract":"<p><p>Over the last decade, chemotherapy treatments have dramatically shifted to outpatient services such that nearly 90% of all infusions are now administered outpatient. This shift has challenged oncology clinics to make chemotherapy treatment as widely available as possible while attempting to treat all patients within a fixed period of time. Historical data from a Veterans Affairs chemotherapy clinic in the United States and staff input informed a discrete event simulation model of the clinic. The case study examines the impact of altering the current schedule, where all patients arrive at 8:00 AM, to a schedule that assigns patients to two or three different appointment times based on the expected length of their chemotherapy infusion. The results identify multiple scheduling policies that could be easily implemented with the best solutions reducing both average patient waiting time and average nurse overtime requirements.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330715/pdf/THSS_10_1709908.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39299090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Monitoring behaviours with model divergence: emailing studies of users with cognitive impairments. 模型发散监测行为:认知障碍用户的电子邮件研究。
IF 1.8
Health Systems Pub Date : 2020-01-21 eCollection Date: 2021-01-01 DOI: 10.1080/20476965.2019.1710582
William N Robinson, Tianjie Deng, Andrea Aria
{"title":"Monitoring behaviours with model divergence: emailing studies of users with cognitive impairments.","authors":"William N Robinson,&nbsp;Tianjie Deng,&nbsp;Andrea Aria","doi":"10.1080/20476965.2019.1710582","DOIUrl":"https://doi.org/10.1080/20476965.2019.1710582","url":null,"abstract":"<p><p>Users with cognitive impairments use an assistive technology email system, CogLink, for socialisation and help in their activities of daily living. As users interact with the AT email client, the logged stream of events is monitored and analysed to aid decision-making. When caregivers receive monitor notifications, they know that the user has had a significant change in her emailing behaviour. Consequently, caregivers select adaptations to the email client that can challenge the user to gain still more emailing skills. The monitor in this emailing system analyzes user data to recognise when significant changes in user behaviour warrants caregiver attention. Moreover, the monitor can distinguish newly learned skills from new, but transient behaviours. This article summarises the CogLink assistive technology monitoring techniques, introduces the learning likelihood algorithm, which distinguishes transient from learned behaviour, and provides lessons learnt from a decade of monitoring CogLink users.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1710582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39299551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Health informatics, healthcare quality and safety, and healthcare simulation: continuing the discussion to advance healthcare operations 健康信息学、医疗质量和安全以及医疗模拟：继续讨论以推进医疗运营
IF 1.8
Health Systems Pub Date : 2020-01-02 DOI: 10.1080/20476965.2020.1732013
Sue S. Feldman
{"title":"Health informatics, healthcare quality and safety, and healthcare simulation: continuing the discussion to advance healthcare operations","authors":"Sue S. Feldman","doi":"10.1080/20476965.2020.1732013","DOIUrl":"https://doi.org/10.1080/20476965.2020.1732013","url":null,"abstract":"ABSTRACT This issue is the second in the series to explore the intersection of health informatics, healthcare quality and safety, and healthcare simulation. The uses of all three domains to advance healthcare operations has been diverse and intentional across a variety of domestic and international organisations. This issue focuses primarily on studies that use throughput modelling and system modelling. Findings from this special collection of papers demonstrate the value of modelling techniques and their role in predicting and enhancing healthcare operations.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2020.1732013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49090745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Minimax c th percentile of makespan in surgical scheduling. 极小最大值c手术调度中最大作业时间的百分位数。
IF 1.8
Health Systems Pub Date : 2019-12-14 DOI: 10.1080/20476965.2019.1700763
Vikas Agrawal, Aber Elsaleiby, Yue Zhang, P S Sundararaghavan, Andrew Casabianca
{"title":"Minimax <i>c</i> <sup>th</sup> percentile of makespan in surgical scheduling.","authors":"Vikas Agrawal,&nbsp;Aber Elsaleiby,&nbsp;Yue Zhang,&nbsp;P S Sundararaghavan,&nbsp;Andrew Casabianca","doi":"10.1080/20476965.2019.1700763","DOIUrl":"https://doi.org/10.1080/20476965.2019.1700763","url":null,"abstract":"<p><p>In this paper, we address the problem of finding an assignment of <i>n</i> surgeries to be performed in one of <i>m</i> parallel identical operating rooms (ORs), given each surgery has a stochastic duration with a known mean and standard deviation. The objective is to minimise the maximum of the <i>c<sup>th</sup></i> percentile of makespan of any OR. We formulate this problem as a nonlinear integer program, and small-sized instances are solved using the GAMS BONMIN solver. We develop a greedy heuristic and a genetic algorithm procedure for solving large-sized instances. Using real data from a major U.S. teaching hospital and benchmarking datasets from the literature, we report on the performance of the heuristics as compared to the GAMS BONMIN solver.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1700763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39076456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Unravelling the dynamics of referral-to-treatment in the NHS. 揭示在NHS转诊治疗的动态。
IF 1.8
Health Systems Pub Date : 2019-12-11 DOI: 10.1080/20476965.2019.1700764
Richard M Wood
{"title":"Unravelling the dynamics of referral-to-treatment in the NHS.","authors":"Richard M Wood","doi":"10.1080/20476965.2019.1700764","DOIUrl":"https://doi.org/10.1080/20476965.2019.1700764","url":null,"abstract":"<p><p>Despite being the principal measure of elective performance in Great Britain's National Health Service, there is little on-the-ground awareness of the dynamics at play behind the referral-to-treatment (RTT) standard. Through a simple worked analogy, it is shown how this performance measure - calculated as the proportion of unresolved RTT pathways within 18 weeks from referral - is dependent on the interplay between elective demand and capacity. Bringing in activity (cost) and waiting list size, the presented theory unifies the five key components of the pathway dynamics for the first time within the published literature. A computer simulation model based on these principles is thereafter constructed as part of a more quantitative analysis using publicly available national data for 2017-2018. In this, referral rates and capacity are varied in line with a range of \"what if\" scenarios known to be of interest to service planners, with the effect on performance and cost objectively assessed.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1700764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39092501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Introduction to "health informatics, healthcare quality and safety, and healthcare simulation: the new triad to advance healthcare operations". 介绍“卫生信息学，卫生保健质量和安全，和卫生保健模拟:新的三位一体，以推进医疗保健业务”。
IF 1.8
Health Systems Pub Date : 2019-12-02 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1687264
Sue S Feldman, Ferhat D Zengul, Bunyamin Ozaydin, Victoria Brazil, Leslie Hayes, Benjamin Schooley
{"title":"Introduction to \"health informatics, healthcare quality and safety, and healthcare simulation: the new triad to advance healthcare operations\".","authors":"Sue S Feldman,&nbsp;Ferhat D Zengul,&nbsp;Bunyamin Ozaydin,&nbsp;Victoria Brazil,&nbsp;Leslie Hayes,&nbsp;Benjamin Schooley","doi":"10.1080/20476965.2019.1687264","DOIUrl":"https://doi.org/10.1080/20476965.2019.1687264","url":null,"abstract":"<p><p>This special themed international issue explores the multiple facets of health informatics, healthcare quality and safety, and healthcare simulation from different parts of the world. The papers in this issue fall into two broad themes. The first theme uses the intersection to address better management of care including physical design layout. The second theme examines innovative uses of the triad to prevent critical and non-critical safety events. The collection of papers culminates with a position paper reporting on the interdependence that is emerging as an important triad for research and practice within medical education, system development and testing, and teamwork and communication and concludes with reducing imprecision and factual errors in handoffs. Findings from the special collection of papers can inform managers and leaders on advancing operations in healthcare settings.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1687264","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37460006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The emerging literature for the triad of health informatics, healthcare quality and safety, and healthcare simulation. 新兴文献的健康信息学，卫生保健质量和安全，和卫生保健模拟。
IF 1.8
Health Systems Pub Date : 2019-11-11 eCollection Date: 2019-01-01 DOI: 10.1080/20476965.2019.1687263
Shikha Modi, Bunyamin Ozaydin, Ferhat Zengul, Sue S Feldman
{"title":"The emerging literature for the triad of health informatics, healthcare quality and safety, and healthcare simulation.","authors":"Shikha Modi,&nbsp;Bunyamin Ozaydin,&nbsp;Ferhat Zengul,&nbsp;Sue S Feldman","doi":"10.1080/20476965.2019.1687263","DOIUrl":"https://doi.org/10.1080/20476965.2019.1687263","url":null,"abstract":"<p><p>The areas of health informatics, healthcare quality and safety, and healthcare simulation are often thought of as separate domains. The purpose of this position paper is to report on the interdependence that is emerging as an important triad across the healthcare/health system continuum. A qualitative review of 24 studies suggests the interdependence of health informatics, healthcare quality and safety, and healthcare simulation reaches much broader than traditional utilisation of simulation. We suggest ways that organisations can take advantage of the interdependence of this triad across a broader variety of healthcare environments, including teamwork, communication, and complex system relationships. In conclusion, the reviewed 24 studies suggest that the research in the triad focuses on simulation education and computerised simulation, and when coupled with health informatics, bears greater strength on quality improvement or patient safety.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1687263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37459954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Improving emergency department resource planning: a multiple case study. 改进急诊科资源规划:一个多案例研究。
IF 1.8
Health Systems Pub Date : 2019-11-03 eCollection Date: 2020-01-01 DOI: 10.1080/20476965.2019.1680260
Daniel Bouzon Nagem Assad, Thaís Spiegel
{"title":"Improving emergency department resource planning: a multiple case study.","authors":"Daniel Bouzon Nagem Assad,&nbsp;Thaís Spiegel","doi":"10.1080/20476965.2019.1680260","DOIUrl":"https://doi.org/10.1080/20476965.2019.1680260","url":null,"abstract":"<p><p>Sizing and allocating health-care professionals are a critical problem in the management of emergency departments (EDs) managed by a public company in Rio de Janeiro (Brazil). An efficient ED configuration that is cost and time effective must be developed by this company for hospital managers. In this paper, the problem of health-care professional configurations in EDs is modelled to minimise the total labour cost while satisfying patient queues and waiting times as defined by the actual ED capacity and current clinical protocols. To solve this issue, mixed integer linear programming (MILP) that allocates health-care professionals and specifies the amount of professionals who must be hired is proposed. To consider the uncertainties in this environment and evaluate their impacts, a discrete-event simulation model is developed to reflect patient flow. An optimisation and simulation approach is used to search for efficiency leads for different ED configurations. These configurations change depending on the shift and the day of the week.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1680260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37828837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Identification of barriers and enablers to rapid diagnosis along the paediatric stroke chain of recovery using Value-Focused Process Engineering. 使用以价值为中心的过程工程识别障碍和使能器，以便沿着儿科中风恢复链快速诊断。
IF 1.8
Health Systems Pub Date : 2019-09-24 DOI: 10.1080/20476965.2019.1664941
Mark T Mackay, Leonid Churilov, Anna Moon, Ian McKenzie, Geoffrey A Donnan, Paul Monagle, Qi Li, Franz E Babl
{"title":"Identification of barriers and enablers to rapid diagnosis along the paediatric stroke chain of recovery using Value-Focused Process Engineering.","authors":"Mark T Mackay,&nbsp;Leonid Churilov,&nbsp;Anna Moon,&nbsp;Ian McKenzie,&nbsp;Geoffrey A Donnan,&nbsp;Paul Monagle,&nbsp;Qi Li,&nbsp;Franz E Babl","doi":"10.1080/20476965.2019.1664941","DOIUrl":"https://doi.org/10.1080/20476965.2019.1664941","url":null,"abstract":"<p><p>Coordinated systems of care are required to improve access to reperfusion therapies in paediatric stroke. A conceptual model was developed to map the process-of-care from symptom onset to confirmation of diagnosis. Value-Focused Process Engineering with event-driven process modelling was used to identify barriers and enablers to timely and accurate paediatric stroke diagnosis. Stakeholder interviews were conducted to inform model design, development, demonstration and validation. Barriers included: (i) ambulance dispatcher failure to allocate high-priority response, (ii) childrens' exclusion from paramedic clinical practice guidelines, (ii) non-allocation of high triage category on hospital arrival, (iii) absence of emergency department guidelines for focal neurological deficits, and (iv) computed tomography as the first imaging investigation. Enablers included: (i) public awareness programs, (ii) childrens' inclusion in prehospital emergency stroke algorithms, (iii) re-organisation of health services, with primary paediatric stroke centres, (iv) implementation of triage and neuroimaging decision support tools, and (iv) rapid stroke MRI imaging protocols.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20476965.2019.1664941","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25510464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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