Discover health systems最新文献

{"title":"A mixed methods exploration of mental health pathways and treatment as usual for young people experiencing depression in the United Kingdom.","authors":"Siobhan B Mitchell, Vashti Berry, Juliette Westbrook, Emma Grace Carey, Alice Wickersham, Alice Garrood, Rachel Hayes, Julieta Galante, Husna Hassan Basri, Kristin Liabo, Tamsin Ford","doi":"10.1007/s44250-026-00412-0","DOIUrl":"10.1007/s44250-026-00412-0","url":null,"abstract":"<p><p>Epidemiological data indicate that the prevalence of depression among young people (YP) is increasing. Although evidence-based interventions are effective for many, 20 to 40% fail, and relapse is common. This study focused on second-line treatments. Modifying psychological processes that predispose individuals to treatment failure or relapse necessitates the development of interventions, but their evaluation depends on a clear understanding of current practice to enable meaningful comparison and assessment of effectiveness. We explored treatment as usual (TAU) for YP receiving support for depression in a two-site pilot, feasibility trial comparing Mindfulness for Adolescents and Carers (MAC) and TAU against TAU in UK Child & Adolescent Mental Health Services (CAMHS). Qualitative data were collected via interviews with senior managers and case-managing clinicians. Quantitative data were gathered through Treatment Recording Sheets completed by clinicians and a clinical service audit. Data were synthesised across sites to provide a comprehensive description of TAU, informing the design of a future definitive trial of MAC. Despite site-level variation in service delivery, key components and processes of CAMHS TAU were identified. Typical pathways included referral and intake; waiting/supportive provision; first- and second-line treatment/s; discharge and re-referral; and crisis support. Care coordination emerged as the most common second-line provision and was provided to YP in both trial arms. Participants received varied combinations of support; those allocated to MAC received less CAMHS input than those allocated to TAU. There is substantial variability in service provision for YP experiencing depression. Future studies should compare treatment plus care coordination with TAU.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44250-026-00412-0.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"5 1","pages":"75"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842150","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}

{"title":"Health professional perspectives on integrating substance use services into pediatric hospitals for adolescents with chronic medical conditions.","authors":"Faith Summersett Williams, Sarah Welch, Nidhi Gopagani, Isabella Zylka, Kennedy Curtis, Patricia Franklin, Sara Becker","doi":"10.1007/s44250-026-00357-4","DOIUrl":"10.1007/s44250-026-00357-4","url":null,"abstract":"<p><p>Adolescents with chronic medical conditions (A-CMCs) are at elevated risk for alcohol and substance use (SU) and its adverse health consequences, yet screening and intervention remain limited in pediatric hospitals. This study identified barriers and facilitators to SBIRT implementation within an urban pediatric hospital, using the Learning Health System (LHS) framework and the Consolidated Framework for Implementation Research (CFIR) to embed SU prevention into routine clinical care. Guided by CFIR, we conducted semi-structured interviews with 26 multidisciplinary hospital staff. Interviews were analyzed deductively using CFIR domains to elucidate determinants influencing SBIRT implementation, with attention to LHS principles of continuous learning and data-driven improvement. Facilitators included provider perception of SBIRT effectiveness, alignment with existing hospital workflows, electronic health record integration with decision support tools, and engagement of behavioral health staff, which are all consistent with LHS mechanisms of routine data use and continuous learning. Barriers included high patient acuity in the pediatric emergency department and inpatient settings, insufficient SU screening protocols, competing workload priorities, unclear role responsibilities, billing challenges, and concerns regarding SU stigma among patients and families. Participants emphasized that implementing SBIRT in pediatric inpatient settings requires multi-level strategies that leverage LHS strengths such as embedded data capture, real-time decision support, and continuous quality improvement cycles to overcome barriers. Addressing identified barriers via workflow piloting, standardized screening tools, leadership alignment, and training may enhance system capacity. Future research should evaluate LHS-enabled implementation models for SBIRT to scale equitable SU interventions within pediatric hospital settings.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44250-026-00357-4.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"5 1","pages":"17"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328447","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}

{"title":"A systemic longitudinal case study of the eMed GP at hand digital first primary care model.","authors":"Iqra Shahzad, Melanie King","doi":"10.1007/s44250-026-00344-9","DOIUrl":"10.1007/s44250-026-00344-9","url":null,"abstract":"<p><p>The shift toward digital-first healthcare models presents both opportunities and challenges for health systems worldwide. This case study critically examines the evolution of eMed GP at Hand (formerly Babylon GP at Hand) within the NHS, tracing its journey from an innovative digital provider to the largest GP practice in England, and ultimately, its downsizing. By bringing together an analysis of reviews, media coverage, and existing research, the study evaluates the model's impact on accessibility, continuity of care, and health inequalities. Findings reveal that while the digital-first approach improved access for younger, healthier populations, it inadequately served vulnerable groups, such as the elderly and those with complex conditions. The study also highlights systemic challenges, such as limitations in Babylon's business model, regulatory gaps in digital health oversight, and the complexities of integrating private sector innovation within public healthcare systems. These insights emphasise the necessity for robust regulation, tailored digital solutions, and a complementary relationship between digital and traditional care models to ensure sustainable and equitable healthcare delivery.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"5 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12876483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144835","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}

{"title":"The association of medical mistrust, clinical trial knowledge, and perceived clinical trial risk with willingness to participate in health research among historically marginalized individuals living in New York City.","authors":"Isabel Inez Curro, Laura Wyatt, Victoria Foster, Yousra Yusuf, Sonia Sifuentes, Perla Chebli, Julie A Kranick, Simona C Kwon, Chau Trinh-Shevrin, Madison N LeCroy","doi":"10.1007/s44250-025-00336-1","DOIUrl":"10.1007/s44250-025-00336-1","url":null,"abstract":"<p><p>Medical mistrust, clinical trial knowledge, and clinical trial risk impact research participation, yet are rarely studied among racial and ethnic groups. Data were from a cross-sectional survey (<i>n</i> = 1,794). Multinomial logistic regression models examined associations of medical mistrust, clinical trial knowledge, and clinical trial risk with willingness to participate in health research (Yes, No, Unsure) among Chinese, Korean, South Asian, Haitian, North American Latiné, South American Latiné, and Southwest Asian and North African (SWANA) NYC residents with one model per group. Overall, 46.0% of participants reported willingness to participate, ranging from 35.8% (Chinese participants) to 58.7% (South Asian participants). Increased mistrust was associated with less willingness among Chinese (OR: 1.06, 95%CI: 1.00, 1.12) and South American Latiné (OR: 1.15, 95%CI: 1.02, 1.30) participants; more willingness among Haitian participants (OR: 0.87, 95%CI: 0.81, 0.94); more uncertainty among Korean (OR: 1.13, 95%CI: 1.05, 1.22), South Asian (OR: 1.06 95%CI: 1.01, 1.12), and North American Latiné (OR: 1.18, 95%CI: 1.10, 1.28) participants; and less uncertainty among Haitian (OR: 0.91, 95%CI: 0.84, 0.99) and SWANA (OR: 0.91, 95%CI:0.86, 0.97) participants. Knowledge was associated with more willingness for Haitian participants (OR: 2.77, 95%CI: 1.15, 6.65), less willingness for Chinese participants (OR: 0.55, 95%CI: 0.34, 0.88), and more uncertainty among South Asian (OR: 2.09, 95%CI: 1.07, 4.07) and SWANA (OR: 2.71, 95%CI: 1.21, 6.03) participants. Some risk and more willingness were linked for South American Latiné participants (OR: 0.13, 95%CI: 0.02, 0.82). Associations varied by group. Studying multiple racial and ethnic groups advances equitable research representation.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"5 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954051","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}

{"title":"A rapid qualitative analysis of health care worker and community focus groups on determinants and implementation strategies for long-acting PrEP in antenatal and postpartum settings in Kenya.","authors":"Tessa Concepcion, Marin Strong, John Kinuthia, Felix A Otieno, Eunita Akim, Helen Aketch, Laurén Gómez, Grace John-Stewart, Bih Moki Suh, Nancy Ngumbau, Emmaculate M Nzove, Jerusha N Mogaka, Sarah Obatsa, Ben O Odhiambo, Caroline Omom, Anjuli D Wagner, Salphine Watoyi, Jillian Pintye","doi":"10.1007/s44250-026-00415-x","DOIUrl":"10.1007/s44250-026-00415-x","url":null,"abstract":"<p><strong>Background: </strong>New long-acting (LA-) PrEP modalities have demonstrated efficacy in HIV prevention and growing evidence of safety during pregnancy and lactation. There are unique considerations for LA-PrEP implementation in reproductive health settings, yet scarce implementation data are available. We identified potential barriers and facilitators and strategies for LA-PrEP implementation for pregnant and postpartum women.</p><p><strong>Methods: </strong>We conducted a qualitative study using focus group discussions (FGDs) with healthcare workers (HCW) at five clinics and community advisory board (CAB) members related to PrEP delivery for pregnant and postpartum women. Interview guides were informed by the EPIS and CFIR frameworks. HCW FGDs included an activity to prioritize information, training, or support strategies for LA-PrEP provision. We used a rapid qualitative analysis to identify facilitators and barriers to integrating LA-PrEP into reproductive health settings and matched potential implementation strategies.</p><p><strong>Results: </strong>A total of 9 FGDs were conducted with 45 individuals between August and October 2023 (5 FGDs among HCWs and 4 among CAB members). They identified interconnected determinants including training, funding, personnel, and community sensitization. Some strategies clearly addressed barriers (e.g. ongoing training to target access to knowledge). However, some barriers had no clear solution, such as LA-PrEP drug availability and access to funds to conduct training and community sensitization. The prioritization activity revealed common resources needed for LA-PrEP implementation (e.g., national guidelines, training, and personnel), but importance varied by location. A wide range of implementation strategies were identified, such as financial incentives for transportation, using community health providers to conduct community sensitization, and integrating LA-PrEP into family planning clinics.</p><p><strong>Conclusions: </strong>HCW and CAB members were optimistic about the promise of new LA-PrEP options and identified important barriers and strategies for consideration. Future research should consider prioritizing implementation strategies and evaluating the impact of strategies on implementation barriers. This study emphasizes the importance and potential impact of offering LA-PrEP options to pregnant and postpartum women.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44250-026-00415-x.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"5 1","pages":"74"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842116","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}

{"title":"Understanding context: leveraging the pragmatic robust implementation sustainability model to inform the implementation of a community-based southeastern preconception counseling intervention to improve maternal health equity.","authors":"N D Hernandez-Green, K Berry, M D Haiman, A McDonald, O T O Farinu, E Harris, A Suarez, L Rollins, C Franklin, T Williams, L S Clarke, M P Fort, A G Huebschmann","doi":"10.1007/s44250-025-00257-z","DOIUrl":"10.1007/s44250-025-00257-z","url":null,"abstract":"<p><strong>Background: </strong>One major preconception risk driving poor childbirth outcomes in Black/African American women is cardiovascular health. Preconception counseling (PC) can reduce maternal health inequities, prevent fatal cardiovascular conditions, and improve the overall health of mothers before, during, and after pregnancy. This article examines contextual factors influencing the implementation of a community-based and culturally tailored PC intervention, ensuring equitable access amongst underserved populations.</p><p><strong>Methods: </strong>We used the Practical Robust Implementation Science Model (PRISM) to guide a mixed-methods assessment among community partner sites to inform the implementation of a PC intervention for Black adults in the Southeastern U.S. We developed a regional accountability board (RAB) of community stakeholders and conducted a partner site survey (n = 10) to identify organizational characteristics and group interviews with site staff and community members that receive services at our partner sites.</p><p><strong>Results: </strong>There was strong community and organizational buy-in for the PC intervention. Partner sites indicated moderate capability to implement PC; however, there was a need for enhanced infrastructure and organizational support for implementation, given limited experience providing PC and organizational funding, staff turnover, and lack of on-site medical services. Existing community trust and robust referral networks were major strengths among all sites.</p><p><strong>Conclusion: </strong>Collaborative community partnerships engaged throughout this process surfaced key community priorities, strengths, and needs for PC implementation. Using multiple methods to gather community data and feedback informed iterative revisions to the implementation plans that have positioned partner sites to deliver culturally congruent PC to at-risk communities.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"4 1","pages":"71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303780","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}

{"title":"Sociodemographic patterns of provider-to-home telehealth use within the veterans health administration between 2015 and 2023.","authors":"Navid Dardashti, Jacqueline M Ferguson, Andrew Nicholson, Leonie Heyworth, Timothy P Hogan, Nicholas McMahon, Cindie Slightam, Donna M Zulman, Scott E Sherman","doi":"10.1007/s44250-025-00256-0","DOIUrl":"10.1007/s44250-025-00256-0","url":null,"abstract":"<p><strong>Background: </strong>The VHA is the largest healthcare system in the US and an early adopter of telehealth. Barriers to adoption may exist among subpopulations of VHA patients.</p><p><strong>Objective: </strong>To identify patterns in use of telehealth by modality, race, rurality, age and priority group before and during the COVID-19 pandemic.</p><p><strong>Design: </strong>We used data from the VHA Pyramid Analytics database to determine quarterly telehealth utilization rates from October 2015 to March 2023 using a pre-post analysis. Main measures were stratified by race, rurality, age group, and VA priority groups.</p><p><strong>Participants: </strong>Unique patients who used any VHA care within each Fiscal Year of the study period.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main measures: </strong>Quarterly encounters by modality and number of users with one or more Provider to Home (PTH) encounters per 1000 unique patients.</p><p><strong>Key results: </strong>There were 36,315,299 telehealth encounters completed by 4,597,055 users during the analytic period. From October 2015-March 2020, PTH video encounters grew from 3.2% of VHA telehealth encounters to 38%. From April 2020-March 2023, PTH video encounters accounted for 90.7% of VHA telehealth encounters. Uptake of PTH during the pandemic differed significantly between demographic groups. Quarterly users per 1000 unique patients (increase relative to reference group; p-values < 0.01) increased significantly more for urban-residing patients (44.9 relative to rural); Black, Asian, or Multi-Racial patients (Black: 52.1; Asian: 48.2; multi-racial: 57.5 relative to White), younger Veterans (age < 45: 113.0; age 45-64: 80.3 relative to age ≥ 65); and Veterans with major disabilities (127.3 relative to Veterans without special considerations).</p><p><strong>Conclusions: </strong>With the expansion of PTH telehealth during the pandemic, there was a shift in sociodemographic patterns among patients receiving at-home video-based care. Moving forward, VA may choose to test implementation strategies that target different demographic groups to support equitable access to PTH care.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s44250-025-00256-0.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"4 1","pages":"80"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627881","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}

{"title":"Principles of the Africa health workforce investment charter to stimulate sustainable health workforce investments.","authors":"James Avoka Asamani, Kasonde Mwinga, Sunny C Okoroafor, Ogochukwu Chukwujekwu, Paul Marsden, Christmal Dela Christmals, Maritza Titus, San Boris Kouadjo Bediakon, Adam Ahmat, Juliet Nabyonga-Orem, Regina Titi-Ofei, Karen Zamboni, Maren Hopfe, Nertila Tavanxhi, Yoswa Dambisya, Simphiwe Mabhele, Tana Wuliji, Laurence Codjia, Pascal Zurn, Francis Omaswa, Joseph Cabore, Matshidiso Rebecca Moeti","doi":"10.1007/s44250-025-00297-5","DOIUrl":"10.1007/s44250-025-00297-5","url":null,"abstract":"<p><p>Despite improvements in health workforce density, the World Health Organization (WHO) African Region Member States an additional 6.1 million additional health workers by 2030 to achieve universal health coverage (UHC) and health sustainable development goals (SDGs) targets and ensure health security. Additional investments are needed for their education, employment, and retention. However, most countries cannot meet this and require support to secure increased sustainable long-term domestic and external investments in the health workforce to strengthen health systems as part of broader health and national development efforts to improve health, economic, and social outcomes. The Africa Health Workforce Investment Charter, launched by the WHO Africa Regional Office in May 2024, outlines a set of key principles that countries can adapt to stimulate and secure the multisectoral domestic and external investments needed to reduce Africa's health workforce shortages by 2030. This would ultimately increase access and availability of health care workers and primary healthcare services, especially in rural and underserved communities. The Investment Charter sets out the following key principles for coordinating and sustaining investments in education, employment, retention, and public health functions: (1) Enabling government leadership and stewardship; (2) Applying evidence-informed prioritisation investment; (3) Aligning multisectoral investments through partnership and collaboration; (4) Stimulating more and better investments; and (5) Securing sustainable health workforce investments.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"4 1","pages":"108"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042335","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}

{"title":"Addressing skilled birth attendants' needs of primary healthcare facilities in Nigeria using the human resources for health solutions model.","authors":"Hilda Ebinim, Oluwadamilare Olatunji, Olugbemisola Samuel, Toluwani Oluwatola, Laura Hoemeke, Charity Chenge, Emediong Otu, Terver Orbunde, Miriamtherese Omanukwue, Sidney Sampson","doi":"10.1007/s44250-025-00239-1","DOIUrl":"10.1007/s44250-025-00239-1","url":null,"abstract":"<p><p>This study addresses the needs of skilled birth attendants (SBAs) of primary healthcare centers (PHCs) in Nigeria using the human resources for health (HRH) solutions model. A model analysis approach was adopted to understand existing frameworks in the global HRH landscape. An initial framework identification and contextualization were conducted to guide the analysis of the models identified in the literature. Relevant frameworks were identified, reviewed, and consolidated using the WHO HRH Action Framework (HAF). A total of 109 articles were included in the study after thorough screening out of which only nine (9) models of improving HRH planning and implementation in global health were reviewed. These were the Task Shifting/Sharing Model, Community Midwifery Model (CMM), Performance-Based Financing Model (PBF), Needs-Based Planning Model, Facilities-Based HRH Planning Model, Utilization-Based HRH Planning Model, Workforce Indicator Staffing Needs Model, USAID-Financing Innovations for Nutrition (FINFI) Model, and Micro-Learning Model. The proposed HRH solution model was adapted based on the gaps identified in all analyzed models. This study showed that there are different HRH models which address specific elements of the HRH value chain. However, these models are not comprehensive, therefore, tackling the challenges of SBA shortage in Nigeria would either require the integration of multiple models or the deployment of models in a phased approach which is what informed the proposed HRH solution model in addressing SBAs' needs of PHCs in Nigeria. We therefore recommend the implementation of the model.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"4 1","pages":"59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182980","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}

{"title":"Augmenting maternal clinical cohort data with administrative laboratory dataset linkages: a validation study.","authors":"Laura Rossouw, Nkosinathi Ngcobo, Kate Clouse, Cornelius Nattey, Karl-Günter Technau, Mhairi Maskew","doi":"10.1007/s44250-025-00298-4","DOIUrl":"10.1007/s44250-025-00298-4","url":null,"abstract":"<p><strong>Background: </strong>The use of big data and large language models in healthcare can play a key role in improving patient treatment and healthcare management, especially when applied to large-scale administrative data. A major challenge to achieving this is ensuring that patient confidentiality and personal information is protected. One way to overcome this is by augmenting clinical data with administrative laboratory dataset linkages in order to avoid the use of demographic information.</p><p><strong>Methods: </strong>We explored an alternative method to examine patient files from a large administrative dataset in South Africa (the National Health Laboratory Services, or NHLS), by linking external data to the NHLS database using specimen barcodes associated with laboratory tests. This provides a deterministic way of performing data linkages without accessing demographic information. In this paper, we quantify the performance metrics of this approach.</p><p><strong>Results: </strong>The linkage of the large NHLS data to external hospital data using specimen barcodes achieved a 95% success. Out of the 1200 records in the validation sample, 87% were exact matches and 9% were matches with typographic correction. The remaining 5% were either complete mismatches or were due to duplicates in the administrative data.</p><p><strong>Conclusions: </strong>The high success rate indicates the reliability of using barcodes for linking data without demographic identifiers. Specimen barcodes are an effective deterministic linkage tool that enable creation of large linked datasets without compromising confidentiality.</p>","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"4 1","pages":"115"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082558","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}