Health Information Management Journal最新文献

{"title":"The Concept of ‘Intent’ within Australian Coronial Data: Factors Affecting the National Coronial Information System's Classification of Mortality Attributable to Intentional Self-Harm","authors":"Leonie Dodds, Kerin Robinson, Leanne Daking, Lindsay Paul","doi":"10.1177/183335831404300302","DOIUrl":"https://doi.org/10.1177/183335831404300302","url":null,"abstract":"within Australia all unexpected deaths are investigated by the Coroners Court; specifically, the coroner investigates the identity of the deceased and the cause and circumstances of death. This ‘unexpected death’ category inevitably includes cases of self-harm and suicide. Concerns regarding the accurate reporting of national suicide statistics resulted in a review of the coding process undertaken by the Australian Bureau of Statistics (ABS), which produces the national statistics, and a formal Commonwealth Government Senate Inquiry in 2009. This article reflects data and opinions collected prior to the Senate Inquiry or the adjustment of the ABS coding processes, and explores the role of the Coroner in determining the intent of the deceased person and the role the National Coronial Information System (NCIS) 1 database plays in the provision of this information. At the Case Notification and Case Closure stages of the coronial process, administrative coders abstract from the coronial file the ‘intent’ of the deceased and enter the data into relevant administrative systems (which upload to the NCIS). The relevant intent code in the NCIS is ‘Intentional Self-Harm’, which incorporates deliberate actions of self-harm and suicide. A mixed-method study was employed to investigate anecdotal reports of a problematic coronial coding process surrounding this category of cases. A sample of Australian coroners (n=16), and of the national population of NCIS coders (n=36), were surveyed using separate instruments, and an unobtrusive case review of sampled NCIS cases (n= 127) reflecting nine key mechanisms-of-death, was undertaken. Each Australian state and territory has its own Coroners Act, none of which provides legislative direction regarding the determination of intent by the coroner. Neither the coroner-respondents nor the coders favoured a standard proforma to record ‘intent’. In order to inform their classificatory decision-making regarding the deceased's ‘intent’, the coders need to abstract extensively from the entire case file, scrutinising documentary materials from different investigators. They rely primarily on the police report at Case Notification and the coroner's finding at Case Completion. Coders do not generally perceive the classification of ‘intent’ to be problematic; however, despite NCIS-provided coder (technical) support materials, there exist inconsistent coder work practices and, sometimes, absent documentary evidence reflecting lack of information for ascertainment and interpretation by the coroner, investigators, and forensic experts on the ‘intent’ of the deceased. The gap between what a coroner is legally required to document regarding ‘intent’ and what society needs to know for statistical and preventive purposes, seems problematic to bridge.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831404300302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Documentation Errors on Accuracy of Cause of Death Coding in an Educational Hospital in Southern Iran","authors":"Mohammad Hossein Hayavi Haghighi, M. Dehghani, Saeid Hoseini Teshizi, H. Mahmoodi","doi":"10.1177/183335831404300205","DOIUrl":"https://doi.org/10.1177/183335831404300205","url":null,"abstract":"Accurate cause of death coding leads to organised and usable death information but there are some factors that influence documentation on death certificates and therefore affect the coding. We reviewed the role of documentation errors on the accuracy of death coding at Shahid Mohammadi Hospital (SMH), Bandar Abbas, Iran. We studied the death certificates of all deceased patients in SMH from October 2010 to March 2011. Researchers determined and coded the underlying cause of death on the death certificates according to the guidelines issued by the World Health Organization in Volume 2 of the International Statistical Classification of Diseases and Health Related Problems-10th revision (ICD-10). Necessary ICD coding rules (such as the General Principle, Rules 1–3, the modification rules and other instructions about death coding) were applied to select the underlying cause of death on each certificate. Demographic details and documentation errors were then extracted. Data were analysed with descriptive statistics and chi square tests. The accuracy rate of causes of death coding was 51.7%, demonstrating a statistically significant relationship (p=.001) with major errors but not such a relationship with minor errors. Factors that result in poor quality of Cause of Death coding in SMH are lack of coder training, documentation errors and the undesirable structure of death certificates.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831404300205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Process Mining-Based Investigation of Adverse Events in Care Processes","authors":"Filip Caron, J. Vanthienen, K. Vanhaecht, E. van Limbergen, Jochen Deweerdt, B. Baesens","doi":"10.1177/183335831404300103","DOIUrl":"https://doi.org/10.1177/183335831404300103","url":null,"abstract":"This paper proposes the Clinical Pathway Analysis Method (CPAM) approach that enables the extraction of valuable organisational and medical information on past clinical pathway executions from the event logs of healthcare information systems. The method deals with the complexity of real-World clinical pathways by introducing a perspective-based segmentation of the date-stamped event log. CPAM enables the clinical pathway analyst to effectively and efficiently acquire a profound insight into the clinical pathways. By comparing the specific medical conditions of patients with the factors used for characterising the different clinical pathway variants, the medical expert can identify the best therapeutic option. Process mining-based analytics enables the acquisition of valuable insights into clinical pathways, based on the complete audit traces of previous clinical pathway instances. Additionally, the methodology is suited to assess guideline compliance and analyse adverse events. Finally, the methodology provides support for eliciting tacit knowledge and providing treatment selection assistance.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831404300103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Quality of Medical Record Documentation and External Cause of Fall Injury Coding in a Tertiary Teaching Hospital","authors":"J. Cunningham, D. Williamson, Kerin Robinson, Rhonda Carroll, Ross Buchanan, Lindsay Paul","doi":"10.1177/183335831404300102","DOIUrl":"https://doi.org/10.1177/183335831404300102","url":null,"abstract":"This paper reviews the documentation and coding of External causes of admitted fall cases in a major hospital. Intensive analysis of a random selection of 100 medical records included blind re-coding in the International Statistical Classification of Diseases and Related Health Problems, Tenth revision, Australian Modification (ICD-10-AM), Fifth Edition for External causes to ascertain whether: (i) the medical records contained sufficient information for assignment of specific External cause codes; and (ii) the most appropriate External cause codes were assigned per available documentation. Comparison of the hospital data with the state-wide Victorian Admitted Episodes Database (VAED) data on frequency of use of External cause codes revealed that the index hospital, a major trauma centre, treated comparatively more falls involving steps, stairs and ladders. The hospital sample reflected lower usage, than state-wide, of unspecified External cause codes and Other specified activity codes; otherwise, there was similarity in External cause coding. A comparison of researcher and hospital codes for the falls study sample revealed differences. The ambulance report was identified as the best source of External cause information; only 50% of hospital medical records contained sufficient information for specific code assignation for all three External cause codes, mechanism of injury, place of occurrence and activity at time of injury. Whilst all medical records contained mechanism of falls injury information, 16% contained insufficient details, indicating a deficiency in medical record documentation to underpin external cause coding. This was compounded by flaws in the ICD- 10-AM classification.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831404300102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Generic Quality Assurance Model (GQAM) for Successful E-Health Implementation in Rural Hospitals in South Africa","authors":"N. Ruxwana, M. Herselman, D. Pottas","doi":"10.1177/183335831404300104","DOIUrl":"https://doi.org/10.1177/183335831404300104","url":null,"abstract":"Although e-health can potentially facilitate the management of scarce resources and improve the quality of healthcare services, implementation of e-health programs continues to fail or not fulfil expectations. A key contributor to the failure of e-health implementation in rural hospitals is poor quality management of projects. Based on a survey 35 participants from five rural hospitals in the Eastern Cape Province of South Africa, and using a qualitative case study research methodology, this article attempted to answer the question: does the adoption of quality assurance (QA) models add value and help to ensure success of information technology projects, especially in rural health settings? The study identified several weaknesses in the application of QA in these hospitals; however, findings also showed that the QA methods used, in spite of not being formally applied in a standardised manner, did nonetheless contribute to the success of some projects. The authors outline a generic quality assurance model (GQAM), developed to enhance the potential for successful acquisition of e-health solutions in rural hospitals, in order to improve the quality of care and service delivery in these hospitals.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831404300104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clustering in Northern Territory Perinatal Data for 2003–2005: Implications for Analysis and Interpretation","authors":"M. Steenkamp","doi":"10.1177/183335831404300105","DOIUrl":"https://doi.org/10.1177/183335831404300105","url":null,"abstract":"Clustering in perinatal data can violate assumptions of independence, an important consideration for data analysis. Few published studies report on the extent of repeat births in routinely collected Australian perinatal data and the implications thereof for analysis and interpretation. This paper reports on a case study that examined the extent and implications of clustering in the Northern Territory Midwives Collection (NTMC) for the period 2003–2005. Data were obtained on 7,741 individual mothers giving birth to 8,707 babies in public hospitals during 2003–2005. Clusters of multiple pregnancies and repeat births were identified and the design effects for birth weight of Aboriginal and non-Aboriginal newborns were calculated. Of the mothers, 46.1% were Aboriginal. Of these, 13.2% had repeat singleton births; 0.4% had multiple pregnancies, and 0.3% had both. Of non-Aboriginal mothers, 8.7% had repeat singleton births; 1.2% had multiple pregnancies; and 0.3% had both. The design effect was 1.07 for Aboriginal newborns and 1.04 for non-Aboriginal newborns. The design effects indicate that the correct variance accounting for clustering is 4–7% larger than the incorrect variance ignoring clustering when three consecutive years of NT data are considered and an intracluster correlation coefficient of 0.48 is assumed for birth weight between twin and non-twin siblings. Depending on the outcome of interest, the impact of clustering should be considered in multivariate analysis of perinatal data, especially when such analyses involve more than one year's data, include large proportions of Aboriginal mothers and newborns, and groups with different rates of repeat births.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831404300105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the PCEHR Mean a New Paradigm for Information Security? Implications for Health Information Management","authors":"Patricia A. H. Williams","doi":"10.1177/183335831304200205","DOIUrl":"https://doi.org/10.1177/183335831304200205","url":null,"abstract":"Australia is stepping up to the new e-health environment. With this comes new legislation and new demands on information security. The expanded functionality of e-health and the increased legislative requirements, coupled with new uses of technology, means that enhancement of existing security practice will be necessary. This paper analyses the new operating environment for Australian healthcare and the legislation governing it, and highlights the changes that are required to meet this new context. Individuals are now more responsible for security and organisations should be prompted to review their security measures in light of the new demands of legislative compliance.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831304200205","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65606060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Health Law in Australia","authors":"Andrew Took","doi":"10.1177/183335831104000306","DOIUrl":"https://doi.org/10.1177/183335831104000306","url":null,"abstract":"Review(s) of: Health law in Australia, by Edited by Ben White Fiona McDonald and Lindy Willmott, Publisher: Thomson Reuters Australia, July 2010. Price: $115.","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831104000306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65605182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: Health Care and the Law (5th Ed.)","authors":"J. Mair","doi":"10.1177/183335831104000108","DOIUrl":"https://doi.org/10.1177/183335831104000108","url":null,"abstract":"Review(s) of: Health Care and the Law (5th Ed.), by Janine McIlwraith and Bill Madden, Thomson Reuters (Professional), 2010 ISBN 9780455 227030, 735 pp. Price $98.00 (softbound).","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2011-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831104000108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65603896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Review: The Globalization of Managerial Innovation in Health Care","authors":"D. O'Bryan","doi":"10.1177/183335831003900115","DOIUrl":"https://doi.org/10.1177/183335831003900115","url":null,"abstract":"","PeriodicalId":55068,"journal":{"name":"Health Information Management Journal","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2010-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/183335831003900115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65604267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}