Sample records for facilitate information exchange

  1. Barriers and facilitators to exchanging health information: a systematic review.

    PubMed

    Eden, Karen B; Totten, Annette M; Kassakian, Steven Z; Gorman, Paul N; McDonagh, Marian S; Devine, Beth; Pappas, Miranda; Daeges, Monica; Woods, Susan; Hersh, William R

    2016-04-01

    We conducted a systematic review of studies assessing facilitators and barriers to use of health information exchange (HIE). We searched MEDLINE, PsycINFO, CINAHL, and the Cochrane Library databases between January 1990 and February 2015 using terms related to HIE. English-language studies that identified barriers and facilitators of actual HIE were included. Data on study design, risk of bias, setting, geographic location, characteristics of the HIE, perceived barriers and facilitators to use were extracted and confirmed. Ten cross-sectional, seven multiple-site case studies, and two before-after studies that included data from several sources (surveys, interviews, focus groups, and observations of users) evaluated perceived barriers and facilitators to HIE use. The most commonly cited barriers to HIE use were incomplete information, inefficient workflow, and reports that the exchanged information that did not meet the needs of users. The review identified several facilitators to use. Incomplete patient information was consistently mentioned in the studies conducted in the US but not mentioned in the few studies conducted outside of the US that take a collective approach toward healthcare. Individual patients and practices in the US may exercise the right to participate (or not) in HIE which effects the completeness of patient information available to be exchanged. Workflow structure and user roles are key but understudied. We identified several facilitators in the studies that showed promise in promoting electronic health data exchange: obtaining more complete patient information; thoughtful workflow that folds in HIE; and inclusion of users early in implementation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Facilitators on networks reveal optimal interplay between information exchange and reciprocity.

    PubMed

    Szolnoki, Attila; Perc, Matjaž; Mobilia, Mauro

    2014-04-01

    Reciprocity is firmly established as an important mechanism that promotes cooperation. An efficient information exchange is likewise important, especially on structured populations, where interactions between players are limited. Motivated by these two facts, we explore the role of facilitators in social dilemmas on networks. Facilitators are here mirrors to their neighbors-they cooperate with cooperators and defect with defectors-but they do not participate in the exchange of strategies. As such, in addition to introducing direct reciprocity, they also obstruct information exchange. In well-mixed populations, facilitators favor the replacement and invasion of defection by cooperation as long as their number exceeds a critical value. In structured populations, on the other hand, there exists a delicate balance between the benefits of reciprocity and the deterioration of information exchange. Extensive Monte Carlo simulations of social dilemmas on various interaction networks reveal that there exists an optimal interplay between reciprocity and information exchange, which sets in only when a small number of facilitators occupy the main hubs of the scale-free network. The drawbacks of missing cooperative hubs are more than compensated for by reciprocity and, at the same time, the compromised information exchange is routed via the auxiliary hubs with only marginal losses in effectivity. These results indicate that it is not always optimal for the main hubs to become leaders of the masses, but rather to exploit their highly connected state to promote tit-for-tat-like behavior.

  3. Facilitators on networks reveal optimal interplay between information exchange and reciprocity

    NASA Astrophysics Data System (ADS)

    Szolnoki, Attila; Perc, Matjaž; Mobilia, Mauro

    2014-04-01

    Reciprocity is firmly established as an important mechanism that promotes cooperation. An efficient information exchange is likewise important, especially on structured populations, where interactions between players are limited. Motivated by these two facts, we explore the role of facilitators in social dilemmas on networks. Facilitators are here mirrors to their neighbors—they cooperate with cooperators and defect with defectors—but they do not participate in the exchange of strategies. As such, in addition to introducing direct reciprocity, they also obstruct information exchange. In well-mixed populations, facilitators favor the replacement and invasion of defection by cooperation as long as their number exceeds a critical value. In structured populations, on the other hand, there exists a delicate balance between the benefits of reciprocity and the deterioration of information exchange. Extensive Monte Carlo simulations of social dilemmas on various interaction networks reveal that there exists an optimal interplay between reciprocity and information exchange, which sets in only when a small number of facilitators occupy the main hubs of the scale-free network. The drawbacks of missing cooperative hubs are more than compensated for by reciprocity and, at the same time, the compromised information exchange is routed via the auxiliary hubs with only marginal losses in effectivity. These results indicate that it is not always optimal for the main hubs to become leaders of the masses, but rather to exploit their highly connected state to promote tit-for-tat-like behavior.

  4. Barriers and facilitators to health information exchange in low- and middle-income country settings: a systematic review.

    PubMed

    Akhlaq, Ather; McKinstry, Brian; Muhammad, Khalid Bin; Sheikh, Aziz

    2016-11-01

    The exchange and use of health information can help healthcare professionals and policymakers make informed decisions on ways of improving patient and population health. Many low- and middle-income countries (LMICs) have however failed to embrace the approaches and technologies to facilitate health information exchange (HIE). We sought to understand the barriers and facilitators to the implementation and adoption of HIE in LMICs. Two reviewers independently searched 11 academic databases for published and on-going qualitative, quantitative and mixed-method studies and searched for unpublished work through the Google search engine. The searches covered the period from January 1990 to July 2014 and were not restricted by language. Eligible studies were independently, critically appraised and then thematically analysed. The searches yielded 5461 citations after de-duplication of results. Of these, 56 articles, three conference abstracts and four technical reports met the inclusion criteria. The lack of importance given to data in decision making, corruption and insecurity, lack of training and poor infrastructure were considered to be major challenges to implementing HIE, but strong leadership and clear policy direction coupled with the financial support to acquire essential technology, improve the communication network, and provide training for staff all helped to promote implementation. The body of work also highlighted how implementers of HIE needed to take into account local needs to ensure that stakeholders saw HIE as relevant and advantageous. HIE interventions implemented through leapfrog technologies such as telehealth/telemedicine and mHealth in Brazil, Kenya, and South Africa, provided successful examples of exchanging health information in LMICs despite limited resources and capability. It is important that implementation of HIE is aligned with national priorities and local needs. © The Author 2016. Published by Oxford University Press in association with

  5. Facilitating the Information Exchange Using a Modular Electronic Discharge Summary.

    PubMed

    Denecke, Kerstin; Dittli, Pascal A; Kanagarasa, Niveadha; Nüssli, Stephan

    2018-01-01

    Discharge summaries are a standard communication tool delivering important clinical information from inpatient to ambulatory care. To ensure a high quality, correctness and completeness, the generation process is time consuming. It requires also contributions of multiple persons. This is problematic since the primary care provider needs the information from the discharge summary for continuing the intended treatment. To address this challenge, we developed a concept for exchanging a modular electronic discharge summary. Through a literature review and interviews with multiple stakeholders, we analysed existing processes and derived requirements for an improved communication of the discharge summary. In this paper, we suggest a concept of a modular electronic discharge summary that is exchanged through the electronic patient dossier in CDA CH level 2 documents. Until 2020, all Swiss hospitals are obliged to connect to the electronic patient dossier. Our concept allows to access already completed modules of the discharge summary from the primary care side, before the entire report is entirely finalised. The data is automatically merged with the local patient record on the physician side and prepared for data integration into the practice information system. Our concept offers the opportunity not only to improve the information exchange between hospital and primary care, but it also provides a potential use case and demonstrates a benefit of the electronic patient dossier for primary care providers who are so far not obliged to connect to the patient dossier in Switzerland.

  6. Health information exchange: persistent challenges and new strategies

    PubMed Central

    Gamm, Larry D

    2010-01-01

    Recent federal policies and actions support the adoption of health information exchange (HIE) in order to improve healthcare by addressing fragmented personal health information. However, concerted efforts at facilitating HIE have existed for over two decades in this country. The lessons of these experiences include a recurrence of barriers and challenges beyond those associated with technology. Without new strategies, the current support and methods of facilitating HIE may not address these barriers. PMID:20442146

  7. Exchanging Medical Information with Eastern Europe through the Internet.

    ERIC Educational Resources Information Center

    Daniels, Julie K.; Cronje, Ruth J.; Sokolowski, Beth C.

    1998-01-01

    Interviews foreign Information Coordinators who facilitate exchange of medical information over the Internet between healthcare providers in America and eastern Europe to learn how Internet technologies are being introduced, disseminated, and adopted in their institutions. Applies diffusion of innovations theory for interpretation. Shows technical…

  8. Differing Strategies to Meet Information-Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems' Enterprise Health Information Exchanges.

    PubMed

    Vest, Joshua R; Kash, Bita A

    2016-03-01

    Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations. Noninteroperable electronic health records and vendors' expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges. Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Enterprise HIEs support health systems' strategic goals through the control of an information technology network consisting of desired trading

  9. Information Control in the Virtual Office: Preparing Intermediaries To Facilitate Information Exchange in the Home Work Environment.

    ERIC Educational Resources Information Center

    Fulton, Crystal

    2002-01-01

    Discusses work done by information professionals and the increase in teleworking, using telecommunications technology; considers teleworkers' information needs; examines ways in which library and information science professionals can facilitate teleworkers' information access; and investigates information environments of 20 teleworkers and 20…

  10. Barriers and Facilitators for Information Exchange during Over-The-Counter Consultations in Community Pharmacy: A Focus Group Study

    PubMed Central

    Seubert, Liza J; Boeni, Fabienne; Hattingh, Laetitia; Clifford, Rhonda M

    2017-01-01

    Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so. PMID:29211054

  11. CALINX (California Information Exchange): a multi-stakeholder statewide initiative to improve healthcare information flows.

    PubMed

    Hopkins, D S; Oswald, N; McCaffrey, K; Bressler, S; Davidson, N; Vela, L

    2000-01-01

    Given the diffusion of responsibilities for gathering and reporting healthcare information in a managed care environment, California stakeholders are taking concrete steps to break the deadlock on data and information flows that has characterized the industry for some time. The California Information Exchange (CALINX) was established to facilitate the implementation of the Health Insurance Portability and Accountability Act (HIPAA) standards in California and to create trust for data exchange between trading partners, without which data exchange still will not occur. Strategic directions are set by the chief executives of key associations and organizations representing purchasers, plans, providers, and consumers. Multi-stakeholder workgroups have produced detailed data guidelines for the HIPAA standards along with rules for exchange of key data sets between trading partners. These rules address frequency, timeliness, and accuracy of data submission. Both the data guidelines and the rules have been tested in live demonstration projects, and the results of these projects have been reported to substantiate the business case for implementation. Further incentives are being built into contracts between purchasers and plans, and between plans and providers. CALINX is currently promoting widespread adoption of the data guidelines and rules for exchange with all members of the industry.

  12. From the Office of the National Coordinator: the strategy for advancing the exchange of health information.

    PubMed

    Williams, Claudia; Mostashari, Farzad; Mertz, Kory; Hogin, Emily; Atwal, Parmeeth

    2012-03-01

    Electronic health information exchange addresses a critical need in the US health care system to have information follow patients to support patient care. Today little information is shared electronically, leaving doctors without the information they need to provide the best care. With payment reforms providing a strong business driver, the demand for health information exchange is poised to grow. The Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, has led the process of establishing the essential building blocks that will support health information exchange. Over the coming year, this office will develop additional policies and standards that will make information exchange easier and cheaper and facilitate its use on a broader scale.

  13. Differing Strategies to Meet Information‐Sharing Needs: Publicly Supported Community Health Information Exchanges Versus Health Systems’ Enterprise Health Information Exchanges

    PubMed Central

    KASH, BITA A.

    2016-01-01

    Policy Points: Community health information exchanges have the characteristics of a public good, and they support population health initiatives at the state and national levels. However, current policy equally incentivizes health systems to create their own information exchanges covering more narrowly defined populations.Noninteroperable electronic health records and vendors’ expensive custom interfaces are hindering health information exchanges. Moreover, vendors are imposing the costs of interoperability on health systems and community health information exchanges.Health systems are creating networks of targeted physicians and facilities by funding connections to their own enterprise health information exchanges. These private networks may change referral patterns and foster more integration with outpatient providers. Context The United States has invested billions of dollars to encourage the adoption of and implement the information technologies necessary for health information exchange (HIE), enabling providers to efficiently and effectively share patient information with other providers. Health care providers now have multiple options for obtaining and sharing patient information. Community HIEs facilitate information sharing for a broad group of providers within a region. Enterprise HIEs are operated by health systems and share information among affiliated hospitals and providers. We sought to identify why hospitals and health systems choose either to participate in community HIEs or to establish enterprise HIEs. Methods We conducted semistructured interviews with 40 policymakers, community and enterprise HIE leaders, and health care executives from 19 different organizations. Our qualitative analysis used a general inductive and comparative approach to identify factors influencing participation in, and the success of, each approach to HIE. Findings Enterprise HIEs support health systems' strategic goals through the control of an information technology

  14. Health Information Exchange: The Determinants of Usage and the Impact on Utilization

    ERIC Educational Resources Information Center

    Vest, Joshua Ryan

    2010-01-01

    Health information exchange (HIE) is the process of electronically sharing patient-level information among different organizations with the objectives of quality and cost improvements. The adoption of HIE in the United States is not widespread, but numerous efforts at facilitating HIE exist and the incentives for electronic health record system…

  15. Impact of Health Disclosure Laws on Health Information Exchanges

    PubMed Central

    Adjerid, Idris; Padman, Rema

    2011-01-01

    Health information exchanges (HIEs) are expected to facilitate data sharing between healthcare entities, thereby improving the efficiency and quality of care. Privacy concerns have been consistently cited as one of the primary challenges to HIE formation and success. Currently, it is unclear how privacy laws – in particular, legislation restricting the disclosure of health records – have shaped the development of HIEs. This preliminary study explores the landscape of state-level health privacy legislation and examines the impact of variations in such privacy and confidentiality laws on the progress of HIEs. We found that states with stronger privacy laws, limiting the disclosure of health information, had significantly more HIEs exchanging data and had fewer failed HIEs. We suggest that this counterintuitive finding may be explained by the more subtle benefits of such laws, such as increased confidence and trust of participants in an exchange. Other key contributors to this work are Alessandro Acquisti, Rahul Telang, and Julia Adler-Milstein PMID:22195054

  16. Indiana Health Information Exchange

    Cancer.gov

    The Indiana Health Information Exchange is comprised of various Indiana health care institutions, established to help improve patient safety and is recognized as a best practice for health information exchange.

  17. 45 CFR 156.330 - Changes of ownership of issuers of Qualified Health Plans in Federally-facilitated Exchanges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health Plans in Federally-facilitated Exchanges. 156.330 Section 156.330 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Federally-Facilitated Exchange...

  18. Enabling Health Reform through Regional Health Information Exchange: A Model Study from China

    PubMed Central

    Wen, Dong; Meng, Qun

    2017-01-01

    Objective. To investigate and share the major challenges and experiences of building a regional health information exchange system in China in the context of health reform. Methods. This study used interviews, focus groups, a field study, and a literature review to collect insights and analyze data. The study examined Xinjin's approach to developing and implementing a health information exchange project, using exchange usage data for analysis. Results. Within three years and after spending approximately $2.4 million (15 million RMB), Xinjin County was able to build a complete, unified, and shared information system and many electronic health record components to integrate and manage health resources for 198 health institutions in its jurisdiction, thus becoming a model of regional health information exchange for facilitating health reform. Discussion. Costs, benefits, experiences, and lessons were discussed, and the unique characteristics of the Xinjin case and a comparison with US cases were analyzed. Conclusion. The Xinjin regional health information exchange system is different from most of the others due to its government-led, government-financed approach. Centralized and coordinated efforts played an important role in its operation. Regional health information exchange systems have been proven critical for meeting the global challenges of health reform. PMID:29065565

  19. 26 CFR 1.7872-16 - Loans to an exchange facilitator under § 1.468B-6.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES General Actuarial Valuations § 1.7872-16 Loans to... of approximate method permitted. The taxpayer and exchange facilitator may use the approximate method to determine the amount of forgone interest on any exchange facilitator loan. (f) Exemption for...

  20. Multiprocessor shared-memory information exchange

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Santoline, L.L.; Bowers, M.D.; Crew, A.W.

    1989-02-01

    In distributed microprocessor-based instrumentation and control systems, the inter-and intra-subsystem communication requirements ultimately form the basis for the overall system architecture. This paper describes a software protocol which addresses the intra-subsystem communications problem. Specifically the protocol allows for multiple processors to exchange information via a shared-memory interface. The authors primary goal is to provide a reliable means for information to be exchanged between central application processor boards (masters) and dedicated function processor boards (slaves) in a single computer chassis. The resultant Multiprocessor Shared-Memory Information Exchange (MSMIE) protocol, a standard master-slave shared-memory interface suitable for use in nuclear safety systems, ismore » designed to pass unidirectional buffers of information between the processors while providing a minimum, deterministic cycle time for this data exchange.« less

  1. 47 CFR 90.555 - Information exchange.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Information exchange. 90.555 Section 90.555...-805 MHz Bands § 90.555 Information exchange. (a) Prior notification. Public safety licensees... Safety Information Exchange. (1) Upon request by a 746-757, 758-763, 776-787, or 788-793 MHz band...

  2. Health information exchange: 'lex parsimoniae'.

    PubMed

    Overhage, J Marc

    2007-01-01

    The country has identified health information exchange (HIE) as an essential strategy to address our crisis of cost, quality, and safety in health care. The Nationwide Health Information Network (NHIN) will consist of a "network of networks"--interconnected local or regional HIEs. We must create policy and technical interfaces that allow these local exchanges to share data with each other. More importantly, we must create nationwide exchanges that are consistent across the country. The should be parsimonious--not overly constraining how the exchanges operate and maintaining separation between the applications that provide functionality and the network that supports HIE.

  3. 77 FR 72813 - Information Collection; Land Exchanges

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-06

    ... Information Collection; Land Exchanges AGENCY: Forest Service, USDA. ACTION: Notice; request for comment... approved information collection, OMB 0596-0105, Land Exchanges. DATES: Comments must be received in writing...: Extension with revision of a currently approved information collection. Abstract: Land exchanges are...

  4. 47 CFR 22.880 - Information exchange.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Information exchange. 22.880 Section 22.880...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a...-ground system licensee must provide the following information to the public safety/CII licensee at least...

  5. 47 CFR 22.880 - Information exchange.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Information exchange. 22.880 Section 22.880...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a...-ground system licensee must provide the following information to the public safety/CII licensee at least...

  6. 47 CFR 27.70 - Information exchange.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Information exchange. 27.70 Section 27.70... COMMUNICATIONS SERVICES Technical Standards § 27.70 Information exchange. (a) Prior notification. Public safety... 776-787 MHz band licensee must provide the following information to the public safety licensee at...

  7. 47 CFR 22.880 - Information exchange.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Information exchange. 22.880 Section 22.880...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a...-ground system licensee must provide the following information to the public safety/CII licensee at least...

  8. 47 CFR 22.880 - Information exchange.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Information exchange. 22.880 Section 22.880...-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a...-ground system licensee must provide the following information to the public safety/CII licensee at least...

  9. 47 CFR 27.70 - Information exchange.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Information exchange. 27.70 Section 27.70... COMMUNICATIONS SERVICES Technical Standards § 27.70 Information exchange. (a) Prior notification. Public safety... information to the public safety licensee at least 10 business days before a new base or fixed station is...

  10. 47 CFR 22.973 - Information exchange.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Information exchange. 22.973 Section 22.973... Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII... information to the public safety/CII licensee at least 10 business days before a new cell site is activated or...

  11. 47 CFR 22.973 - Information exchange.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Information exchange. 22.973 Section 22.973... Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII... information to the public safety/CII licensee at least 10 business days before a new cell site is activated or...

  12. 47 CFR 22.973 - Information exchange.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Information exchange. 22.973 Section 22.973... Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII... information to the public safety/CII licensee at least 10 business days before a new cell site is activated or...

  13. 47 CFR 22.973 - Information exchange.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Information exchange. 22.973 Section 22.973... Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII... information to the public safety/CII licensee at least 10 business days before a new cell site is activated or...

  14. 47 CFR 27.70 - Information exchange.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Information exchange. 27.70 Section 27.70... COMMUNICATIONS SERVICES Technical Standards § 27.70 Information exchange. (a) Prior notification. Public safety... information to the public safety licensee at least 10 business days before a new base or fixed station is...

  15. 47 CFR 27.70 - Information exchange.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Information exchange. 27.70 Section 27.70... COMMUNICATIONS SERVICES Technical Standards § 27.70 Information exchange. (a) Prior notification. Public safety... information to the public safety licensee at least 10 business days before a new base or fixed station is...

  16. Improving newborn screening laboratory test ordering and result reporting using health information exchange

    PubMed Central

    van Dyck, Peter C; Rinaldo, Piero; McDonald, Clement; Howell, R Rodrey; Zuckerman, Alan; Downing, Gregory

    2010-01-01

    Capture, coding and communication of newborn screening (NBS) information represent a challenge for public health laboratories, health departments, hospitals, and ambulatory care practices. An increasing number of conditions targeted for screening and the complexity of interpretation contribute to a growing need for integrated information-management strategies. This makes NBS an important test of tools and architecture for electronic health information exchange (HIE) in this convergence of individual patient care and population health activities. For this reason, the American Health Information Community undertook three tasks described in this paper. First, a newborn screening use case was established to facilitate standards harmonization for common terminology and interoperability specifications guiding HIE. Second, newborn screening coding and terminology were developed for integration into electronic HIE activities. Finally, clarification of privacy, security, and clinical laboratory regulatory requirements governing information exchange was provided, serving as a framework to establish pathways for improving screening program timeliness, effectiveness, and efficiency of quality patient care services. PMID:20064796

  17. Consumer-mediated health information exchanges: the 2012 ACMI debate.

    PubMed

    Cimino, James J; Frisse, Mark E; Halamka, John; Sweeney, Latanya; Yasnoff, William

    2014-04-01

    The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: "Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure." Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately each discussant recognizes that there are many sides to this complex issue, each followed the debater's tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. Published by Elsevier Inc.

  18. Consumer-Mediated Health Information Exchanges: The 2012 ACMI Debate

    PubMed Central

    Cimino, James J.; Frisse, Mark; Halamka, John; Sweeney, Latanya; Yasnoff, William

    2017-01-01

    The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: “Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure.” Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately, each discussant recognizes that there are many sides to this complex issue, each followed the debater’s tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader. PMID:24561078

  19. 47 CFR 22.973 - Information exchange.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Information exchange. 22.973 Section 22.973 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.973 Information exchange. (a) Prior notification. Public safety/CII...

  20. 40 CFR 22.52 - Information exchange and discovery.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Procedure Act § 22.52 Information exchange and discovery. Respondent's information exchange pursuant to § 22.19(a) shall include information on any economic benefit resulting from any activity or failure to act... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Information exchange and discovery. 22...

  1. 45 CFR 156.298 - Meaningful difference standard for Qualified Health Plans in the Federally-facilitated Exchanges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health Plans in the Federally-facilitated Exchanges. 156.298 Section 156.298 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Qualified Health Plan Minimum...

  2. Health Information Exchange: What do patients want?

    PubMed

    Medford-Davis, Laura N; Chang, Lawrence; Rhodes, Karin V

    2017-12-01

    To determine whether emergency department patients want to share their medical records across health systems through Health Information Exchange and if so, whether they prefer to sign consent or share their records automatically, 982 adult patients presenting to an emergency department participated in a questionnaire-based interview. The majority (N = 906; 92.3%) were willing to share their data in a Health Information Exchange. Half (N = 490; 49.9%) reported routinely getting healthcare outside the system and 78.6 percent reported having records in other systems. Of those who were willing to share their data in a Health Information Exchange, 54.3 percent wanted to sign consent but 90 percent of those would waive consent in the case of an emergency. Privacy and security were primary concerns of patients not willing to participate in Health Information Exchange and preferring to sign consent. Improved privacy and security protections could increase participation, and findings support consideration of "break-the-glass" provider access to Health Information Exchange records in an emergent situation.

  3. Greater Patient Health Information Control to Improve the Sustainability of Health Information Exchanges.

    PubMed

    Abdelhamid, Mohamed

    2018-06-09

    Health information exchanges (HIEs) are multisided platforms that facilitate the sharing of patient health information (PHI) between providers and payers across organizations within a region, community or hospital system. The benefits of HIEs to payers and providers include lower cost, faster services, and better health outcome. However, most HIEs have configured the patient healthcare consent process to give all providers who sign up with the exchange access to PHI for all consenting patients, leaving no control to patients in customized what information to share and with who. This research investigates the impact of granting greater control to patients in sharing their personal health information on consent rates and making them active participants in the HIEs system. This research utilizes a randomized experimental survey design study. The study uses responses from 388 participants and structural equation modeling (SEM) to test the conceptual model. The main findings of this research include that patients consent rate increases significantly when greater control in sharing PHI is offered to the patient. In addition, greater control reduces the negative impact of privacy concern on the intention to consent. Similarly, trust in healthcare professionals leads to higher consent when greater control is offered to the patient. Thus, greater control empowers the role of trust in engaging patients and sustaining HIEs. The paper makes a theoretical contribution to research by extending the unified theory of acceptance and use of technology (UTAUT) model. The findings impact practice by providing insights that will help sustain HIEs. Copyright © 2018. Published by Elsevier Inc.

  4. Investing in International Information Exchange Activities to Improve the Safety, Cost Effectiveness and Schedule of Cleanup - 13281

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Seed, Ian; James, Paula; Mathieson, John

    2013-07-01

    With decreasing budgets and increasing pressure on completing cleanup missions as quickly, safely and cost-effectively as possible, there is significant benefit to be gained from collaboration and joint efforts between organizations facing similar issues. With this in mind, the US Department of Energy (DOE) and the UK Nuclear Decommissioning Authority (NDA) have formally agreed to share information on lessons learned on the development and application of new technologies and approaches to improve the safety, cost effectiveness and schedule of the cleanup legacy wastes. To facilitate information exchange a range of tools and methodologies were established. These included tacit knowledge exchangemore » through facilitated meetings, conference calls and Site visits as well as explicit knowledge exchange through document sharing and newsletters. A DOE web-based portal has been established to capture these exchanges and add to them via discussion boards. The information exchange is operating at the Government-to-Government strategic level as well as at the Site Contractor level to address both technical and managerial topic areas. This effort has resulted in opening a dialogue and building working relationships. In some areas joint programs of work have been initiated thus saving resource and enabling the parties to leverage off one another activities. The potential benefits of high quality information exchange are significant, ranging from cost avoidance through identification of an approach to a problem that has been proven elsewhere to cost sharing and joint development of a new technology to address a common problem. The benefits in outcomes significantly outweigh the costs of the process. The applicability of the tools and methods along with the lessons learned regarding some key issues is of use to any organization that wants to improve value for money. In the waste management marketplace, there are a multitude of challenges being addressed by multiple

  5. Operation of the power information center: Performance of secretariat functions and information exchange activities in the advanced power field of the interagency advanced power group

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Highlights of activities conducted during the reporting period to facilitate the exchange of technical information among scientists and engineers both within the federal government and within industry are cited. Interagency Advanced Power Group meetings and special efforts, project briefs, and organization development are considered.

  6. 48 CFR 5.405 - Exchange of acquisition information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Exchange of acquisition... ACQUISITION PLANNING PUBLICIZING CONTRACT ACTIONS Release of Information 5.405 Exchange of acquisition... than one contracting activity within an agency, the exchange and coordination of pertinent information...

  7. Learning from Health Information Exchange Technical Architecture and Implementation in Seven Beacon Communities

    PubMed Central

    McCarthy, Douglas B.; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A.; Rein, Alison L.

    2014-01-01

    As health care providers adopt and make “meaningful use” of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions. PMID:25848591

  8. Learning from health information exchange technical architecture and implementation in seven beacon communities.

    PubMed

    McCarthy, Douglas B; Propp, Karen; Cohen, Alexander; Sabharwal, Raj; Schachter, Abigail A; Rein, Alison L

    2014-01-01

    As health care providers adopt and make "meaningful use" of health information technology (health IT), communities and delivery systems must set up the infrastructure to facilitate health information exchange (HIE) between providers and numerous other stakeholders who have a role in supporting health and care. By facilitating better communication and coordination between providers, HIE has the potential to improve clinical decision-making and continuity of care, while reducing unnecessary use of services. When implemented as part of a broader strategy for health care delivery system and payment reform, HIE capability also can enable the use of analytic tools needed for population health management, patient engagement in care, and continuous learning and improvement. The diverse experiences of seven communities that participated in the three-year federal Beacon Community Program offer practical insight into factors influencing the technical architecture of exchange infrastructure and its role in supporting improved care, reduced cost, and a healthier population. The case studies also document challenges faced by the communities, such as significant time and resources required to harmonize variations in the interpretation of data standards. Findings indicate that their progress developing community-based HIE strategies, while driven by local needs and objectives, is also influenced by broader legal, policy, and market conditions.

  9. 29 CFR 1640.3 - Exchange of information.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 4 2012-07-01 2012-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

  10. 29 CFR 1640.3 - Exchange of information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 4 2013-07-01 2013-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

  11. 29 CFR 1640.3 - Exchange of information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

  12. 29 CFR 1640.3 - Exchange of information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

  13. 29 CFR 1640.3 - Exchange of information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Exchange of information. 1640.3 Section 1640.3 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COORDINATING... Exchange of information. The EEOC, section 504 agencies, and designated agencies shall share any...

  14. Sociotechnical Analysis of Health Information Exchange Consent Processes in an HIV Clinic.

    PubMed

    Ramos, S Raquel; Gordon, Peter; Bakken, Suzanne; Schnall, Rebecca

    Federal regulations have encouraged the electronic sharing of protected health information (PHI). As an opt-in state, New York abides by an affirmative consent model where PHI is electronically shared only after written consent is obtained. The purpose of our study was to describe sociotechnical factors that influence health information exchange (HIE) consent for persons living with HIV (PLWH) at one clinic in New York City. We employed mixed methods to gather perceptions of facilitators and barriers to HIE consent. Study participants included PLWH, staff, and clinicians. The mixed-methods approach revealed multiple interruptions in clinical workflow, staff and providers' time constraints, and lack of dedicated personnel focused on HIE consent as the major barriers to HIE consent. Although there is no one strategy to resolve barriers to HIE consent, having a dedicated person was identified as the most salient factor for facilitating HIE consent. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  15. Health information exchange policy and evaluation.

    PubMed

    Marchibroda, Janet M

    2007-12-01

    Concerns about the quality, safety, and cost of healthcare have driven the nation to increase its focus on this issue. A number of states are moving forward-in parallel with federal efforts-to develop and adopt policies for improving health and healthcare through health information technology and electronic health information exchange. Based on the eHealth Initiative's experience providing technical assistance to more than 20 states, and its work related to its coalition of more than 250 state, regional and community-based health information exchange initiatives and organizations, the most difficult challenges facing these initiatives and organizations today is that related to assessing the value of services that emerge from the health information exchange to various stakeholders groups such as providers, payers, and employers, and converting those value assessments to business plans that promote and assure sustainability for these initiatives. The combination of increased federal and state focus and funding and the pace at which regional and community-based health information networks are developing, along with the identification of value and sustainability as some of the most difficult challenges experienced by these efforts, all point to the significant need for evaluation. The most critical evaluation questions focus on the impact of health information technology and health information exchange on quality, safety, efficiency, the value of such efforts for various stakeholders, and assessment of how grant programs can be designed to support positive impact, value, and a sustainable business model, so that efforts continue when the grant funds are fully expended.

  16. SUPERFUND GROUNDWATER ISSUE - FACILITATED TRANSPORT

    EPA Science Inventory

    The Regional Superfund Ground Water Forum is a group of ground-water scientists representing EPA's Regional Superfund Offices, organized to exchange up to date information related to ground-water remediation at Superfund sites. Facilitated transport is an issue identified by the ...

  17. Health information exchange reduces repeated diagnostic imaging for back pain.

    PubMed

    Bailey, James E; Pope, Rebecca A; Elliott, Elizabeth C; Wan, Jim Y; Waters, Teresa M; Frisse, Mark E

    2013-07-01

    This study seeks to determine whether health information exchange reduces repeated diagnostic imaging and related costs in emergency back pain evaluation. This was a longitudinal data analysis of health information exchange patient-visit data. All repeated emergency department (ED) patient visits for back pain with previous ED diagnostic imaging to a Memphis metropolitan area ED between August 1, 2007, and July 31, 2009, were included. Use of a regional health information exchange by ED personnel to access the patient's record during the emergency visit was the primary independent variable. Main outcomes included repeated lumbar or thoracic diagnostic imaging (radiograph, computed tomography [CT], or magnetic resonance imaging [MRI]) and total patient-visit estimated cost. One hundred seventy-nine (22.4%) of the 800 qualifying repeated back pain visits resulted in repeated diagnostic imaging (radiograph 84.9%, CT 6.1%, and MRI 9.5%). Health information exchange use in the study population was low, at 12.5%, and health care providers as opposed to administrative/nursing staff accounted for 80% of the total health information exchange use. Health information exchange use by any ED personnel was associated with reduced repeated diagnostic imaging (odds ratio 0.36; 95% confidence interval 0.18 to 0.71), as was physician or nurse practitioner health information exchange use (odds ratio 0.47; 95% confidence interval 0.23 to 0.96). No cost savings were associated with health information exchange use because of increased CT imaging when health care providers used health information exchange. Health information exchange use is associated with 64% lower odds of repeated diagnostic imaging in the emergency evaluation of back pain. Health information exchange effect on estimated costs was negligible. More studies are needed to evaluate specific strategies to increase health information exchange use and further decrease potentially unnecessary diagnostic imaging and associated

  18. Is Cancer Information Exchanged on Social Media Scientifically Accurate?

    PubMed

    Gage-Bouchard, Elizabeth A; LaValley, Susan; Warunek, Molli; Beaupin, Lynda Kwon; Mollica, Michelle

    2017-07-19

    Cancer patients and their caregivers are increasingly using social media as a platform to share cancer experiences, connect with support, and exchange cancer-related information. Yet, little is known about the nature and scientific accuracy of cancer-related information exchanged on social media. We conducted a content analysis of 12 months of data from 18 publically available Facebook Pages hosted by parents of children with acute lymphoblastic leukemia (N = 15,852 posts) and extracted all exchanges of medically-oriented cancer information. We systematically coded for themes in the nature of cancer-related information exchanged on personal Facebook Pages and two oncology experts independently evaluated the scientific accuracy of each post. Of the 15,852 total posts, 171 posts contained medically-oriented cancer information. The most frequent type of cancer information exchanged was information related to treatment protocols and health services use (35%) followed by information related to side effects and late effects (26%), medication (16%), medical caregiving strategies (13%), alternative and complementary therapies (8%), and other (2%). Overall, 67% of all cancer information exchanged was deemed medically/scientifically accurate, 19% was not medically/scientifically accurate, and 14% described unproven treatment modalities. These findings highlight the potential utility of social media as a cancer-related resource, but also indicate that providers should focus on recommending reliable, evidence-based sources to patients and caregivers.

  19. The Joint Fire Science Program Fire Exchange Network: Facilitating Knowledge Exchange About Wildland Fire Science Across the U.S.

    NASA Astrophysics Data System (ADS)

    York, A.; Blocksome, C.; Cheng, T.; Creighton, J.; Edwards, G.; Frederick, S.; Giardina, C. P.; Goebel, P. C.; Gucker, C.; Kobziar, L.; Lane, E.; Leis, S.; Long, A.; Maier, C.; Marschall, J.; McGowan-Stinski, J.; Mohr, H.; MontBlanc, E.; Pellant, M.; Pickett, E.; Seesholtz, D.; Skowronski, N.; Stambaugh, M. C.; Stephens, S.; Thode, A.; Trainor, S. F.; Waldrop, T.; Wolfson, B.; Wright, V.; Zedler, P.

    2014-12-01

    The Joint Fire Science Program's (JFSP) Fire Exchange Network is actively working to accelerate the awareness, understanding, and adoption of wildland fire science information by federal, tribal, state, local, and private stakeholders within ecologically similar regions. Our network of 15 regional exchanges provides timely, accurate, and regionally relevant science-based information to assist with fire management challenges. Regional activities, through which we engage fire and resource managers, scientists, and private landowners, include online newsletters and announcements, social media, regionally focused web-based clearinghouses of relevant science, field trips and demonstration sites, workshops and conferences, webinars and online training, and syntheses and fact sheets. Exchanges also help investigators design research that is relevant to regional management needs and assist with technology transfer to management audiences. This poster provides an introduction to and map of the regional exchanges.

  20. Health information exchange: national and international approaches.

    PubMed

    Vest, Joshua R

    2012-01-01

    Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

  1. Shortcomings in Information Sharing Facilitates Transnational Organized Crime

    DTIC Science & Technology

    2017-06-09

    SHORTCOMINGS IN INFORMATION SHARING FACILITATES TRANSNATIONAL ORGANIZED CRIME A thesis presented to the Faculty of the U.S...JUN 2017 4. TITLE AND SUBTITLE Shortcomings in Information Sharing Facilitates Transnational Organized Crime 5a. CONTRACT NUMBER 5b...NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Army Command and General Staff College ATTN: ATZL-SWD-GD Fort Leavenworth, KS 66027

  2. 41 CFR 60-742.2 - Exchange of information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Exchange of information. 60-742.2 Section 60-742.2 Public Contracts and Property Management Other Provisions Relating to... AGAINST EMPLOYERS HOLDING GOVERNMENT CONTRACTS OR SUBCONTRACTS § 60-742.2 Exchange of information. (a...

  3. Applications of health information exchange information to public health practice.

    PubMed

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-01-01

    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US' investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health.

  4. Applications of Health Information Exchange Information to Public Health Practice

    PubMed Central

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-01-01

    Increased information availability, timeliness, and comprehensiveness through health information exchange (HIE) can support public health practice. The potential benefits to disease monitoring, disaster response, and other public health activities served as an important justification for the US’ investments in HIE. After several years of HIE implementation and funding, we sought to determine if any of the anticipated benefits of exchange participation were accruing to state and local public health practitioners participating in five different exchanges. Using qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. HIE supported public health activities consistent with expectations in the literature. However, no single department realized all the potential benefits of HIE identified. These findings suggest ways to improve HIE usage in public health. PMID:25954386

  5. Physician capability to electronically exchange clinical information, 2011.

    PubMed

    Patel, Vaishali; Swain, Matthew J; King, Jennifer; Furukawa, Michael F

    2013-10-01

    To provide national estimates of physician capability to electronically share clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors using the 2011 National Ambulatory Medical Care Survey Electronic Medical Record Supplement. Survey of a nationally representative sample of nonfederal office-based physicians who provide direct patient care. The survey was administered by mail with telephone follow-up and had a 61% weighted response rate. The overall sample consisted of 4326 respondents. We calculated estimates of electronic exchange capability at the national and state levels, and applied multivariate analyses to examine the association between the capability to exchange different types of clinical information and physician and practice characteristics. In 2011, 55% of physicians had computerized capability to send prescriptions electronically; 67% had the capability to view lab results electronically; 42% were able to incorporate lab results into their EHR; 35% were able to send lab orders electronically; and, 31% exchanged patient clinical summaries with other providers. The strongest predictor of exchange capability is adoption of an EHR. However, substantial variation exists across geography and EHR vendors in exchange capability, especially electronic exchange of clinical summaries. In 2011, a majority of office-based physicians could exchange lab and medication data, and approximately one-third could exchange clinical summaries with patients or other providers. EHRs serve as a key mechanism by which physicians can exchange clinical data, though physicians' capability to exchange varies by vendor and by state.

  6. 29 CFR 1691.2 - Exchange of information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 4 2013-07-01 2013-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF EMPLOYMENT DISCRIMINATION FILED AGAINST RECIPIENTS OF FEDERAL FINANCIAL ASSISTANCE § 1691.2 Exchange of...

  7. How can knowledge exchange portals assist in knowledge management for evidence-informed decision making in public health?

    PubMed Central

    2014-01-01

    Background Knowledge exchange portals are emerging as web tools that can help facilitate knowledge management in public health. We conducted a review to better understand the nature of these portals and their contribution to knowledge management in public health, with the aim of informing future development of portals in this field. Methods A systematic literature search was conducted of the peer-reviewed and grey literature to identify articles that described the design, development or evaluation of Knowledge Exchange Portals KEPs in the public health field. The content of the articles was analysed, interpreted and synthesised in light of the objectives of the review. Results The systematic search yielded 2223 articles, of which fifteen were deemed eligible for review, including eight case studies, six evaluation studies and one commentary article. Knowledge exchange portals mainly included design features to support knowledge access and creation, but formative evaluation studies examining user needs suggested collaborative features supporting knowledge exchange would also be useful. Overall web usage statistics revealed increasing use of some of these portals over time; however difficulties remain in retaining users. There is some evidence to suggest that the use of a knowledge exchange portal in combination with tailored and targeted messaging can increase the use of evidence in policy and program decision making at the organisational level. Conclusions Knowledge exchange portals can be a platform for providing integrated access to relevant content and resources in one location, for sharing and distributing information and for bringing people together for knowledge exchange. However more performance evaluation studies are needed to determine how they can best support evidence-informed decision making in public health. PMID:24884530

  8. How can knowledge exchange portals assist in knowledge management for evidence-informed decision making in public health?

    PubMed

    Quinn, Emma; Huckel-Schneider, Carmen; Campbell, Danielle; Seale, Holly; Milat, Andrew J

    2014-05-12

    Knowledge exchange portals are emerging as web tools that can help facilitate knowledge management in public health. We conducted a review to better understand the nature of these portals and their contribution to knowledge management in public health, with the aim of informing future development of portals in this field. A systematic literature search was conducted of the peer-reviewed and grey literature to identify articles that described the design, development or evaluation of Knowledge Exchange Portals KEPs in the public health field. The content of the articles was analysed, interpreted and synthesised in light of the objectives of the review. The systematic search yielded 2223 articles, of which fifteen were deemed eligible for review, including eight case studies, six evaluation studies and one commentary article. Knowledge exchange portals mainly included design features to support knowledge access and creation, but formative evaluation studies examining user needs suggested collaborative features supporting knowledge exchange would also be useful. Overall web usage statistics revealed increasing use of some of these portals over time; however difficulties remain in retaining users. There is some evidence to suggest that the use of a knowledge exchange portal in combination with tailored and targeted messaging can increase the use of evidence in policy and program decision making at the organisational level. Knowledge exchange portals can be a platform for providing integrated access to relevant content and resources in one location, for sharing and distributing information and for bringing people together for knowledge exchange. However more performance evaluation studies are needed to determine how they can best support evidence-informed decision making in public health.

  9. Health information exchange policies of 11 diverse health systems and the associated impact on volume of exchange.

    PubMed

    Downing, N Lance; Adler-Milstein, Julia; Palma, Jonathan P; Lane, Steven; Eisenberg, Matthew; Sharp, Christopher; Longhurst, Christopher A

    2017-01-01

    Provider organizations increasingly have the ability to exchange patient health information electronically. Organizational health information exchange (HIE) policy decisions can impact the extent to which external information is readily available to providers, but this relationship has not been well studied. Our objective was to examine the relationship between electronic exchange of patient health information across organizations and organizational HIE policy decisions. We focused on 2 key decisions: whether to automatically search for information from other organizations and whether to require HIE-specific patient consent. We conducted a retrospective time series analysis of the effect of automatic querying and the patient consent requirement on the monthly volume of clinical summaries exchanged. We could not assess degree of use or usefulness of summaries, organizational decision-making processes, or generalizability to other vendors. Between 2013 and 2015, clinical summary exchange volume increased by 1349% across 11 organizations. Nine of the 11 systems were set up to enable auto-querying, and auto-querying was associated with a significant increase in the monthly rate of exchange (P = .006 for change in trend). Seven of the 11 organizations did not require patient consent specifically for HIE, and these organizations experienced a greater increase in volume of exchange over time compared to organizations that required consent. Automatic querying and limited consent requirements are organizational HIE policy decisions that impact the volume of exchange, and ultimately the information available to providers to support optimal care. Future efforts to ensure effective HIE may need to explicitly address these factors. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  10. Control of the Ability of Profilin to Bind and Facilitate Nucleotide Exchange from G-actin*

    PubMed Central

    Wen, Kuo-Kuang; McKane, Melissa; Houtman, Jon C. D.; Rubenstein, Peter A.

    2008-01-01

    A major factor in profilin regulation of actin cytoskeletal dynamics is its facilitation of G-actin nucleotide exchange. However, the mechanism of this facilitation is unknown. We studied the interaction of yeast (YPF) and human profilin 1 (HPF1) with yeast and mammalian skeletal muscle actins. Homologous pairs (YPF and yeast actin, HPF1 and muscle actin) bound more tightly to one another than heterologous pairs. However, with saturating profilin, HPF1 caused a faster etheno-ATP exchange with both yeast and muscle actins than did YPF. Based on the -fold change in ATP exchange rate/Kd, however, the homologous pairs are more efficient than the heterologous pairs. Thus, strength of binding of profilin to actin and nucleotide exchange rate are not tightly coupled. Actin/HPF interactions were entropically driven, whereas YPF interactions were enthalpically driven. Hybrid yeast actins containing subdomain 1 (sub1) or subdomain 1 and 2 (sub12) muscle actin residues bound more weakly to YPF than did yeast actin (Kd = 2 μm versus 0.6 μm). These hybrids bound even more weakly to HPF than did yeast actin (Kd = 5 μm versus 3.2 μm). sub1/YPF interactions were entropically driven, whereas the sub12/YPF binding was enthalpically driven. Compared with WT yeast actin, YPF binding to sub1 occurred with a 5 times faster koff and a 2 times faster kon. sub12 bound with a 3 times faster koff and a 1.5 times slower kon. Profilin controls the energetics of its interaction with nonhybrid actin, but interactions between actin subdomains 1 and 2 affect the topography of the profilin binding site. PMID:18223293

  11. 29 CFR 1691.2 - Exchange of information.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 4 2012-07-01 2012-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

  12. 29 CFR 1691.2 - Exchange of information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

  13. 29 CFR 1691.2 - Exchange of information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

  14. 29 CFR 1691.2 - Exchange of information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Exchange of information. 1691.2 Section 1691.2 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS OF... information. EEOC and agencies shall share any information relating to the employment policies and practices...

  15. The Veteran-Initiated Electronic Care Coordination: A Multisite Initiative to Promote and Evaluate Consumer-Mediated Health Information Exchange.

    PubMed

    Klein, Dawn M; Pham, Kassi; Samy, Leila; Bluth, Adam; Nazi, Kim M; Witry, Matthew; Klutts, J Stacey; Grant, Kathleen M; Gundlapalli, Adi V; Kochersberger, Gary; Pfeiffer, Laurie; Romero, Sergio; Vetter, Brian; Turvey, Carolyn L

    2017-04-01

    Information continuity is critical to person-centered care when patients receive care from multiple healthcare systems. Patients can access their electronic health record data through patient portals to facilitate information exchange. This pilot was developed to improve care continuity for rural Veterans by (1) promoting the use of the Department of Veterans Affairs (VA) patient portal to share health information with non-VA providers, and (2) evaluating the impact of health information sharing at a community appointment. Veterans from nine VA healthcare systems were trained to access and share their VA Continuity of Care Document (CCD) with their non-VA providers. Patients and non-VA providers completed surveys on their experiences. Participants (n = 620) were primarily older, white, and Vietnam era Veterans. After training, 78% reported the CCD would help them be more involved in their healthcare and 86% planned to share it regularly with non-VA providers. Veterans (n = 256) then attended 277 community appointments. Provider responses from these appointments (n = 133) indicated they were confident in the accuracy of the information (97%) and wanted to continue to receive the CCD (96%). Ninety percent of providers reported the CCD improved their ability to have an accurate medication list and helped them make medication treatment decisions. Fifty percent reported they did not order a laboratory test or another procedure because of information available in the CCD. This pilot demonstrates feasibility and value of patient access to a CCD to facilitate information sharing between VA and non-VA providers. Outreach and targeted education are needed to promote consumer-mediated health information exchange.

  16. The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina.

    PubMed

    Messer, Lynne C; Parnell, Heather; Huffaker, Renee; Wooldredge, Rich; Wilkin, Aimee

    2012-10-01

    The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties. Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention. We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close. Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Implementation of Medical Information Exchange System Based on EHR Standard

    PubMed Central

    Han, Soon Hwa; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

    2010-01-01

    Objectives To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. Methods To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. Results The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. Conclusions This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information. PMID:21818447

  18. Implementation of Medical Information Exchange System Based on EHR Standard.

    PubMed

    Han, Soon Hwa; Lee, Min Ho; Kim, Sang Guk; Jeong, Jun Yong; Lee, Bi Na; Choi, Myeong Seon; Kim, Il Kon; Park, Woo Sung; Ha, Kyooseob; Cho, Eunyoung; Kim, Yoon; Bae, Jae Bong

    2010-12-01

    To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.

  19. An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States.

    PubMed

    Garcia, Macarena C; Garrett, Nedra Y; Singletary, Vivian; Brown, Sheereen; Hennessy-Burt, Tamara; Haney, Gillian; Link, Kimberly; Tripp, Jennifer; Mac Kenzie, William R; Yoon, Paula

    2017-12-07

    State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public-s health through various surveillance systems and data exchange practices. The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information. Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems. All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency. Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

  20. Investigating the Challenges and Opportunities in Home Care to Facilitate Effective Information Technology Adoption.

    PubMed

    Koru, Güneş; Alhuwail, Dari; Topaz, Maxim; Norcio, Anthony F; Mills, Mary Etta

    2016-01-01

    As home care utilization increases, information technology (IT) becomes a critical tool for providing quality home care. However, most home health agencies (HHAs) in the United States are in a position to adopt and leverage IT solutions in budget-constrained settings, where it is crucial to address important and pressing challenges and opportunities for achieving effectiveness in IT adoption. (1) Explore HHAs' challenges and opportunities related to delivering home care as well as performing administrative functions and conducting business, (2) learn about current IT implementation levels and activities in home care, and (3) make recommendations to facilitate efforts and initiatives designed for adopting IT in home care effectively. Semistructured interviews were conducted to elicit rich contextual information from the participants recruited from 13 local HHAs in one of the states in the United States. Established systems analysis techniques were used to ask questions during the interviews. Framework, a qualitative research method, was used to analyze the qualitative data obtained from the interviews. Coordinating clinical and administrative workflows was an important challenge. Inadequate access to patients' medical history and difficulties with medication reconciliation detracted from the quality of care. Hiring, training, scheduling, and retaining qualified personnel constituted another important challenge. Training and educating patients, caregivers, and families hold important opportunities for improving the quality of care. All except one HHA adopted electronic health records (EHR) but many continued to struggle considerably in their day-to-day functions. Health information exchange (HIE) seems to be the most needed technology. Telehealth solutions were perceived to be promising but their added value and financial viability in the long run were questioned. The recommendations for effective IT adoption include keeping a quality improvement focus, keeping a

  1. The ARAC-RODOS-WSPEEDI Information Exchange Project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sullivan, T J

    1999-09-01

    Under the auspices of a US DOE-JAPAN Memorandum of Understanding JAERI and LLNL agreed to develop and evaluate a prototype information exchange protocol for nuclear accident emergency situations. This project received some interest from the US DOS and FEMA as it fits nicely under the umbrella of the G-7's GEMINI (Global Emergency Management Information Network Initiative) project. Because of LLNL/ARAC and JAERV WSPEEDI interest in nuclear accident consequence assessment and hazard prediction on all scales, to include global, we were happy to participate. Subsequent to the Spring 1997 RODOS-ARAC Workshop a Memorandum of Agreement was developed to enhance mutual collaborationmore » on matters of emergency systems development. In the summer of 1998 the project leaders of RODOS, WSPEEDI and ARAC met at FZK and agreed to join in a triangular collaboration on the development and demonstration of an emergency information exchange protocol. JAERI and FZK are engaged in developing a formal cooperation agreement. The purpose of this project is to evaluate the prototype information protocol application for technical feasibility and mutual benefit through simulated (real) event; quick exchange of atmospheric modeling products and environmental data during emergencies, distribution of predicted results to other countries having no prediction capabilities, and utilization of the link for collaborative studies.« less

  2. 43 CFR 2203.2 - Submission of information concerning proposed exchange.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

  3. 43 CFR 2203.2 - Submission of information concerning proposed exchange.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

  4. 43 CFR 2203.2 - Submission of information concerning proposed exchange.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

  5. 43 CFR 2203.2 - Submission of information concerning proposed exchange.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: GENERAL PROCEDURES Exchanges Involving Fee Federal Coal Deposits § 2203.2 Submission of information concerning proposed exchange. (a) Any person submitting a proposal for a fee exchange of Federal coal... proposed exchange. 2203.2 Section 2203.2 Public Lands: Interior Regulations Relating to Public Lands...

  6. INFOTERRA: Gateway to International Environmental Information.

    ERIC Educational Resources Information Center

    McNamar, Emma J.

    1993-01-01

    Describes the components, collaborators, and services of INFOTERRA, an environmental information exchange network designed to facilitate the exchange of information among countries and to promote knowledge with countries of the international environmental situation. (MDH)

  7. Sociotechnical challenges to developing technologies for patient access to health information exchange data

    PubMed Central

    Ancker, Jessica S; Miller, Melissa C; Patel, Vaishali; Kaushal, Rainu

    2014-01-01

    Background Providing patients with access to their medical data is widely expected to help educate and empower them to manage their own health. Health information exchange (HIE) infrastructures could potentially help patients access records across multiple healthcare providers. We studied three HIE organizations as they developed portals to give consumers access to HIE data previously exchanged only among healthcare organizations. Objective To follow the development of new consumer portal technologies, and to identify barriers and facilitators to patient access to HIE data. Methods Semistructured interviews of 15 key informants over a 2-year period spanning the development and early implementation of three new projects, coded according to a sociotechnical framework. Results As the organizations tried to develop functionality that fully served the needs of both providers and patients, plans were altered by technical barriers (primarily related to data standardization) and cultural and legal issues surrounding data access. Organizational changes also played an important role in altering project plans. In all three cases, patient access to data was significantly scaled back from initial plans. Conclusions This prospective study revealed how sociotechnical factors previously identified as important in health information technology success and failure helped to shape the evolution of three novel consumer informatics projects. Barriers to providing patients with seamless access to their HIE data were multifactorial. Remedies will have to address technical, organizational, cultural, and other factors. PMID:24064443

  8. [No exchange of information without technology : modern infrastructure in radiology].

    PubMed

    Hupperts, H; Hermann, K-G A

    2014-01-01

    Modern radiology cannot accomplish the daily numbers of examinations without supportive technology. Even though technology seems to be becoming increasingly more indispensable, business continuity should be ensured at any time and if necessary even with a limited technical infrastructure by business continuity management. An efficient information security management system forms the basis. The early radiology information systems were islands of information processing. A modern radiology department must be able to be modularly integrated into an informational network of a bigger organization. The secondary use of stored data for clinical decision-making support poses new challenges for the integrity of the data or systems because medical knowledge is displayed and provided in a context of treatment. In terms of imaging the creation and distribution radiology services work in a fully digital manner which is often different for radiology reports. Legally secure electronic diagnostic reports require a complex technical infrastructure; therefore, diagnostic findings still need to be filed as a paper document. The internal exchange and an improved dose management can be simplified by systems which continuously and automatically record the doses and thus provide the possibility of permanent analysis and reporting. Communication between patient and radiologist will gain ongoing importance. Intelligent use of technology will convey this to the radiologist and it will facilitate the understanding of the information by the patient.

  9. U.S.-U.S.S.R. Rail Inspection Information Exchange

    DOT National Transportation Integrated Search

    1977-06-01

    This trip report describes the results and conclusions of the U.S. delegation resulting from the U.S.-U.S.S.R. Rail Inspection Information exchange tour of the Soviet Union, August 24 through September 1, 1975. This information exchange was conducted...

  10. Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.

    PubMed

    Zulman, Donna M; Piette, John D; Jenchura, Emily C; Asch, Steven M; Rosland, Ann-Marie

    2013-07-10

    Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care. We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving. We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving. Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving. Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest

  11. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges.

    PubMed

    Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S; Mattke, Soeren

    2016-05-09

    Overhauling the individual health insurance market-including through the creation of health insurance exchanges-was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges-privately facilitated exchanges-which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment.

  12. Speeding decisions. Social security's information exchange program.

    PubMed

    Winter, Kitt; Hastings, Bob

    2011-05-01

    The Social Security Administration has plenty of reasons to streamline its records request process-more than 15 million reasons each year, in fact. That's why it has been pioneering information exchange projects with the private sector, including use of the Nationwide Health Information Network.

  13. 47 CFR 22.880 - Information exchange.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Air-Ground Radiotelephone Service Commercial Aviation Air-Ground Systems § 22.880 Information exchange. (a) Prior notification. Public safety/CII licensees may notify a commercial aviation air-ground system...

  14. 29 CFR 1641.2 - Exchange of information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

  15. 29 CFR 1641.2 - Exchange of information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

  16. 29 CFR 1641.2 - Exchange of information.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

  17. 29 CFR 1641.2 - Exchange of information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

  18. 29 CFR 1641.2 - Exchange of information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES FOR COMPLAINTS... CONTRACTS OR SUBCONTRACTS § 1641.2 Exchange of information. (a) EEOC and OFCCP shall share any information... not applicable to requests for data in EEOC files made by any State or local agency designated as a...

  19. Bridging Organizational Divides in Health Care: An Ecological View of Health Information Exchange

    PubMed Central

    Johnson, Kevin B; Gadd, Cynthia S; Lorenzi, Nancy M

    2013-01-01

    Background The fragmented nature of health care delivery in the United States leads to fragmented health information and impedes patient care continuity and safety. Technologies to support interorganizational health information exchange (HIE) are becoming more available. Understanding how HIE technology changes health care delivery and affects people and organizations is crucial to long-term successful implementation. Objective Our study investigated the impacts of HIE technology on organizations, health care providers, and patients through a new, context-aware perspective, the Regional Health Information Ecology. Methods We conducted more than 180 hours of direct observation, informal interviews during observation, and 9 formal semi-structured interviews. Data collection focused on workflow and information flow among health care team members and patients and on health care provider use of HIE technology. Results We structured the data analysis around five primary information ecology components: system, locality, diversity, keystone species, and coevolution. Our study identified three main roles, or keystone species, involved in HIE: information consumers, information exchange facilitators, and information repositories. The HIE technology impacted patient care by allowing providers direct access to health information, reducing time to obtain health information, and increasing provider awareness of patient interactions with the health care system. Developing the infrastructure needed to support HIE technology also improved connections among information technology support groups at different health care organizations. Despite the potential of this type of technology to improve continuity of patient care, HIE technology adoption by health care providers was limited. Conclusions To successfully build a HIE network, organizations had to shift perspectives from an ownership view of health data to a continuity of care perspective. To successfully integrate external health

  20. Legal Barriers to the Growth of Health Information Exchange-Boulders or Pebbles?

    PubMed

    Mello, Michelle M; Adler-Milstein, Julia; Ding, Karen L; Savage, Lucia

    2018-03-01

    Policy Points: Historically, in addition to economic and technical hurdles, state and federal health information privacy laws have been cited as a significant obstacle to expanding electronic health information exchange (HIE) in the United States. Our review finds that over the past decade, several helpful developments have ameliorated the legal barriers to HIE, although variation in states' patient consent requirements remains a challenge. Today, health care providers' complaints about legal obstacles to HIE may be better understood as reflecting concerns about the economic and competitive risks of information sharing. Although the clinical benefits of exchanging patients' health information electronically across providers have long been recognized, participation in health information exchange (HIE) has lagged behind adoption of electronic health records. Barriers erected by federal and state health information privacy law have been cited as a leading reason for the slow progress. A comprehensive assessment of these issues has not been undertaken for nearly a decade, despite a number of salient legal developments. Analysis of federal and state health information privacy statutes and regulations and secondary materials. Although some legal barriers to HIE persist, many have been ameliorated-in some cases, simply through improved understanding of what the law actually requires. It is now clear that the Health Insurance Portability and Accountability Act presents no obstacles to electronically sharing protected health information for treatment purposes and does not hold providers who properly disclose information liable for privacy breaches by recipients. The failure of federal efforts to establish a unique patient identifier number does slow HIE by inhibiting optimal matching of patient records, but other action to facilitate matching will be taken under the 21st Century Cures Act. The Cures Act also creates the legal architecture to begin to combat "information

  1. Health information exchange implementation: lessons learned and critical success factors from a case study.

    PubMed

    Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

    2014-08-15

    Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

  2. Health Information Exchange Implementation: Lessons Learned and Critical Success Factors From a Case Study

    PubMed Central

    2014-01-01

    Background Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. Objective The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. Methods We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders’ perspectives across technical, organizational, and governance dimensions. Results Several challenges, successes, and lessons learned during the

  3. Raising the Curtain. A Report with Recommendations on Academic Exchanges with East Central Europe and the USSR. East Central Europe Information Exchange Report 1.

    ERIC Educational Resources Information Center

    Burn, Barbara B.

    This report provides an overview of the changes in the development of academic exchange activity between the United States, the Soviet Union, and East Central Europe in the context of far-reaching reforms throughout the region. It also explores the factors which may facilitate or inhibit further growth in academic exchanges. The report begins with…

  4. Part-Set Cuing Facilitation for Spatial Information

    ERIC Educational Resources Information Center

    Cole, Sydni M.; Reysen, Matthew B.; Kelley, Matthew R.

    2013-01-01

    Part-set cuing "inhibition" refers to the counterintuitive finding that hints--specifically, part of the set of to-be-remembered information--often impair memory performance in free recall tasks. Although inhibition is the most commonly reported result, part-set cuing "facilitation" has been shown with serial order tasks. The…

  5. Quantum secret information equal exchange protocol based on dense coding

    NASA Astrophysics Data System (ADS)

    Jiang, Ying-Hua; Zhang, Shi-Bin; Dai, Jin-Qiao; Shi, Zhi-Ping

    2018-04-01

    In this paper, we design a novel quantum secret information equal exchange protocol, which implements the equal exchange of secret information between the two parties with the help of semi-trusted third party (TP). In the protocol, EPR pairs prepared by the TP are, respectively, distributed to both the communication parties. Then, the two parties perform Pauli operation on each particle and return the new particles to TP, respectively. TP measures each new pair with Bell basis and announces the measurement results. Both parties deduce the secret information of each other according to the result of announcement by TP. Finally, the security analysis shows that this protocol solves the problem about equal exchange of secret information between two parties and verifies the security of semi-trusted TPs. It proves that the protocol can effectively resist glitch attacks, intercept retransmission attacks and entanglement attack.

  6. Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges

    PubMed Central

    Gresenz, Carole Roan; Hoch, Emily; Eibner, Christine; Rudin, Robert S.; Mattke, Soeren

    2016-01-01

    Abstract Overhauling the individual health insurance market—including through the creation of health insurance exchanges—was a key component of the Patient Protection and Affordable Care Act's multidimensional approach to addressing the long-standing problem of the uninsured in the United States. Despite succeeding in enrolling millions of Americans, the exchanges still face several challenges, including poor consumer experience, high operational and development costs, and incomplete market penetration. In light of these challenges, analysts considered a different model for the exchanges—privately facilitated exchanges—which could address these challenges and deepen the Affordable Care Act's impact. In this model, the government retains control over sovereign exchange functions but allows the private sector to assume responsibility for more-peripheral exchange functions, such as developing and sustaining exchange websites. Although private-sector entities have already undertaken exchange-related functions on a limited basis, privately facilitated exchanges could conceivably relieve the government of its responsibility for front-end website operations and consumer decision-support functions entirely. A shift to privately facilitated exchanges could improve the consumer experience, increase enrollment, and lower costs for state and federal governments. A move to such a model requires, nonetheless, managing its risks, such as reduced consumer protection, increased consumer confusion, and the possible lack of a viable revenue base for privately facilitated exchanges, especially in less populous states. On net, the benefits are large enough and the risks sufficiently manageable to seriously consider such a shift. This paper provides background information and more detail on the analysts' assessment. PMID:28083414

  7. Observability and Estimation of Distributed Space Systems via Local Information-Exchange Networks

    NASA Technical Reports Server (NTRS)

    Fathpour, Nanaz; Hadaegh, Fred Y.; Mesbahi, Mehran; Rahmani, Amirreza

    2011-01-01

    Spacecraft formation flying involves the coordination of states among multiple spacecraft through relative sensing, inter-spacecraft communication, and control. Most existing formation-flying estimation algorithms can only be supported via highly centralized, all-to-all, static relative sensing. New algorithms are proposed that are scalable, modular, and robust to variations in the topology and link characteristics of the formation exchange network. These distributed algorithms rely on a local information exchange network, relaxing the assumptions on existing algorithms. Distributed space systems rely on a signal transmission network among multiple spacecraft for their operation. Control and coordination among multiple spacecraft in a formation is facilitated via a network of relative sensing and interspacecraft communications. Guidance, navigation, and control rely on the sensing network. This network becomes more complex the more spacecraft are added, or as mission requirements become more complex. The observability of a formation state was observed by a set of local observations from a particular node in the formation. Formation observability can be parameterized in terms of the matrices appearing in the formation dynamics and observation matrices. An agreement protocol was used as a mechanism for observing formation states from local measurements. An agreement protocol is essentially an unforced dynamic system whose trajectory is governed by the interconnection geometry and initial condition of each node, with a goal of reaching a common value of interest. The observability of the interconnected system depends on the geometry of the network, as well as the position of the observer relative to the topology. For the first time, critical GN&C (guidance, navigation, and control estimation) subsystems are synthesized by bringing the contribution of the spacecraft information-exchange network to the forefront of algorithmic analysis and design. The result is a

  8. Model Development for EHR Interdisciplinary Information Exchange of ICU Common Goals

    PubMed Central

    Collins, Sarah A.; Bakken, Suzanne; Vawdrey, David K.; Coiera, Enrico; Currie, Leanne

    2010-01-01

    Purpose Effective interdisciplinary exchange of patient information is an essential component of safe, efficient, and patient–centered care in the intensive care unit (ICU). Frequent handoffs of patient care, high acuity of patient illness, and the increasing amount of available data complicate information exchange. Verbal communication can be affected by interruptions and time limitations. To supplement verbal communication, many ICUs rely on documentation in electronic health records (EHRs) to reduce errors of omission and information loss. The purpose of this study was to develop a model of EHR interdisciplinary information exchange of ICU common goals. Methods The theoretical frameworks of distributed cognition and the clinical communication space were integrated and a previously published categorization of verbal information exchange was used. 59.5 hours of interdisciplinary rounds in a Neurovascular ICU were observed and five interviews and one focus group with ICU nurses and physicians were conducted. Results Current documentation tools in the ICU were not sufficient to capture the nurses' and physicians' collaborative decision-making and verbal communication of goal-directed actions and interactions. Clinicians perceived the EHR to be inefficient for information retrieval, leading to a further reliance on verbal information exchange. Conclusion The model suggests that EHRs should support: 1) Information tools for the explicit documentation of goals, interventions, and assessments with synthesized and summarized information outputs of events and updates; and 2) Messaging tools that support collaborative decision-making and patient safety double checks that currently occur between nurses and physicians in the absence of EHR support. PMID:20974549

  9. Keeping up appearances: Strategic information exchange by disidentified group members

    PubMed Central

    Matschke, Christina

    2017-01-01

    Information exchange is a crucial process in groups, but to date, no one has systematically examined how a group member’s relationship with a group can undermine this process. The current research examined whether disidentified group members (i.e., members who have a negative relationship with their group) strategically undermine the group outcome in information exchange. Disidentification has been found to predict negative group-directed behaviour, but at the same time disidentified members run the risk of being punished or excluded from the group when displaying destructive behaviour. In three studies we expected and found that disidentified group members subtly act against the interest of the group by withholding important private information, while at the same time they keep up appearances by sharing important information that is already known by the other group members. These findings stress the importance of taking a group member’s relationship with a group into account when considering the process of information exchange. PMID:28384322

  10. 40 CFR 22.19 - Prehearing information exchange; prehearing conference; other discovery.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... method of discovery sought, provide the proposed discovery instruments, and describe in detail the nature... finding that: (i) The information sought cannot reasonably be obtained by alternative methods of discovery... promptly supplement or correct the exchange when the party learns that the information exchanged or...

  11. Facilitating consumer access to health information.

    PubMed

    Snowdon, Anne; Schnarr, Karin; Alessi, Charles

    2014-01-01

    The lead paper from Zelmer and Hagens details the substantive evolution occurring in health information technologies that has the potential to transform the relationship between consumers, health practitioners and health systems. In this commentary, the authors suggest that Canada is experiencing a shift in consumer behaviour toward a desire to actively manage one's health and wellness that is being facilitated through the advent of health applications on mobile and online technologies platforms. The result is that Canadians are now able to create personalized health solutions based on their individual health values and goals. However, before Canadians are able to derive a personal health benefit from these rapid changes in information technology, they require and are increasingly demanding greater real-time access to their own health information to better inform decision-making, as well as interoperability between their personal health tracking systems and those of their health practitioner team.

  12. 47 CFR 90.675 - Information exchange.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... business days before a new cell site is activated or an existing cell site is modified: (1) Location; (2... believes a proposed cell will generate unacceptable interference; (2) Permit ESMR or part 22 Cellular... cell is activated. (c) Public safety information exchange. (1) Upon request by an ESMR or part 22...

  13. An exchange format for use-cases of hospital information systems.

    PubMed

    Masuda, G; Sakamoto, N; Sakai, R; Yamamoto, R

    2001-01-01

    Object-oriented software development is a powerful methodology for development of large hospital information systems. We think use-case driven approach is particularly useful for the development. In the use-cases driven approach, use-cases are documented at the first stage in the software development process and they are used through the whole steps in a variety of ways. Therefore, it is important to exchange and share the use-cases and make effective use of them through the overall lifecycle of a development process. In this paper, we propose a method of sharing and exchanging use-case models between applications, developers, and projects. We design an XML based exchange format for use-cases. We then discuss an application of the exchange format to support several software development activities. We preliminarily implemented a support system for object-oriented analysis based on the exchange format. The result shows that using the structural and semantic information in the exchange format enables the support system to assist the object-oriented analysis successfully.

  14. Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey.

    PubMed

    Serrano, Katrina J; Yu, Mandi; Riley, William T; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A

    2016-01-01

    The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients' willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68-7.81), general health tips (OR = 2.03; 95% CI, 1.74-2.38), medication reminders (OR = 2.73; 95% CI, 2.35-3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62-1.92), vital signs (OR = 1.63; 95% CI, 1.48-1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24-1.58), and symptoms (OR = 1.62; 95% CI, 1.46-1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. © 2016 Annals of Family Medicine, Inc.

  15. Willingness to Exchange Health Information via Mobile Devices: Findings From a Population-Based Survey

    PubMed Central

    Serrano, Katrina J.; Yu, Mandi; Riley, William T.; Patel, Vaishali; Hughes, Penelope; Marchesini, Kathryn; Atienza, Audie A.

    2016-01-01

    PURPOSE The rapid proliferation of mobile devices offers unprecedented opportunities for patients and health care professionals to exchange health information electronically, but little is known about patients’ willingness to exchange various types of health information using these devices. We examined willingness to exchange different types of health information via mobile devices, and assessed whether sociodemographic characteristics and trust in clinicians were associated with willingness in a nationally representative sample. METHODS We analyzed data for 3,165 patients captured in the 2013 Health Information National Trends Survey. Multinomial logistic regression analysis was conducted to test differences in willingness. Ordinal logistic regression analysis assessed correlates of willingness to exchange 9 types of information separately. RESULTS Participants were very willing to exchange appointment reminders (odds ratio [OR] = 6.66; 95% CI, 5.68–7.81), general health tips (OR = 2.03; 95% CI, 1.74–2.38), medication reminders (OR = 2.73; 95% CI, 2.35–3.19), laboratory/test results (OR = 1.76; 95% CI, 1.62–1.92), vital signs (OR = 1.63; 95% CI, 1.48–1.80), lifestyle behaviors (OR = 1.40; 95% CI, 1.24–1.58), and symptoms (OR = 1.62; 95% CI, 1.46–1.79) as compared with diagnostic information. Older adults had lower odds of being more willing to exchange any type of information. Education, income, and trust in health care professional information correlated with willingness to exchange certain types of information. CONCLUSIONS Respondents were less willing to exchange via mobile devices information that may be considered sensitive or complex. Age, socioeconomic factors, and trust in professional information were associated with willingness to engage in mobile health information exchange. Both information type and demographic group should be considered when developing and tailoring mobile technologies for patient-clinician communication. PMID:26755781

  16. Exchanging environmental information and decision making: developing the local Pilot Environmental Virtual Observatory with stakeholder communities

    NASA Astrophysics Data System (ADS)

    Mackay, E.; Beven, K.; Brewer, P.; M, Haygarth, P.; Macklin, M.; Marshall, K.; Quinn, P.; Stutter, M.; Thomas, N.; Wilkinson, M.

    2012-04-01

    Public participation in the development of flood risk management and river basin management plans are explicit components of both the Water Framework and Floods Directives. At the local level, involving communities in land and water management has been found to (i) aid better environmental decision making, (ii) enhance social, economic and environmental benefits, and (iii) increase a sense of ownership. Facilitating the access and exchange of information on the local environment is an important part of this new approach to the land and water management process, which also includes local community stakeholders in decisions about the design and content of the information provided. As part of the Natural Environment Research Council's pilot Environment Virtual Observatory (EVO), the Local Level group are engaging with local community stakeholders in three different catchments in the UK (the rivers Eden, Tarland and Dyfi) to start the process of developing prototype visualisation tools to address the specific land and water management issues identified in each area. Through this local collaboration, we will provide novel visualisation tools through which to communicate complex catchment science outcomes and bring together different sources of environmental data in ways that better meet end-user needs as well as facilitate a far broader participatory approach in environmental decision making. The Local Landscape Visualisation Tools are being evolved iteratively during the project to reflect the needs, interests and capabilities of a wide range of stakeholders. The tools will use the latest concepts and technologies to communicate with and provide opportunities for the provision and exchange of information between the public, government agencies and scientists. This local toolkit will reside within a wider EVO platform that will include national datasets, models and state of the art cloud computer systems. As such, local stakeholder groups are assisting the EVO

  17. Exploring the Affordances of WeChat for Facilitating Teaching, Social and Cognitive Presence in Semi-Synchronous Language Exchange

    ERIC Educational Resources Information Center

    Wang, Yuping; Fang, Wei-Chieh; Han, Julia; Chen, Nian-Shing

    2016-01-01

    This research is an exploratory study that evaluates the affordances of WeChat for the development of a community of inquiry (CoI) in semi-synchronous language exchange supported by WeChat. WeChat is an instant messenger that facilitates a multimodal environment in which interaction can happen synchronously, semi-synchronously and asynchronously…

  18. GrabBlur--a framework to facilitate the secure exchange of whole-exome and -genome SNV data using VCF files.

    PubMed

    Stade, Björn; Seelow, Dominik; Thomsen, Ingo; Krawczak, Michael; Franke, Andre

    2014-01-01

    Next Generation Sequencing (NGS) of whole exomes or genomes is increasingly being used in human genetic research and diagnostics. Sharing NGS data with third parties can help physicians and researchers to identify causative or predisposing mutations for a specific sample of interest more efficiently. In many cases, however, the exchange of such data may collide with data privacy regulations. GrabBlur is a newly developed tool to aggregate and share NGS-derived single nucleotide variant (SNV) data in a public database, keeping individual samples unidentifiable. In contrast to other currently existing SNV databases, GrabBlur includes phenotypic information and contact details of the submitter of a given database entry. By means of GrabBlur human geneticists can securely and easily share SNV data from resequencing projects. GrabBlur can ease the interpretation of SNV data by offering basic annotations, genotype frequencies and in particular phenotypic information - given that this information was shared - for the SNV of interest. GrabBlur facilitates the combination of phenotypic and NGS data (VCF files) via a local interface or command line operations. Data submissions may include HPO (Human Phenotype Ontology) terms, other trait descriptions, NGS technology information and the identity of the submitter. Most of this information is optional and its provision at the discretion of the submitter. Upon initial intake, GrabBlur merges and aggregates all sample-specific data. If a certain SNV is rare, the sample-specific information is replaced with the submitter identity. Generally, all data in GrabBlur are highly aggregated so that they can be shared with others while ensuring maximum privacy. Thus, it is impossible to reconstruct complete exomes or genomes from the database or to re-identify single individuals. After the individual information has been sufficiently "blurred", the data can be uploaded into a publicly accessible domain where aggregated genotypes are

  19. Physicians' opinions of a health information exchange

    PubMed Central

    Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

    2010-01-01

    Background Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). Objective To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. Measurements A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. Results A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of “doctor shopping”; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Conclusion Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available. PMID:21106994

  20. Physicians' opinions of a health information exchange.

    PubMed

    Hincapie, Ana Lucia; Warholak, Terri L; Murcko, Anita C; Slack, Marion; Malone, Daniel C

    2011-01-01

    Arizona Medicaid developed a Health Information Exchange (HIE) system called the Arizona Medical Information Exchange (AMIE). To evaluate physicians' perceptions regarding AMIE's impact on health outcomes and healthcare costs. A focus-group guide was developed and included five domains: perceived impact of AMIE on (1) quality of care; (2) workflow and efficiency; (3) healthcare costs; (4) system usability; and (5) AMIE data content. Qualitative data were analyzed using analytical coding. A total of 29 clinicians participated in the study. The attendance rate was 66% (N=19) for the first and last month of focus-group meetings and 52% (N=15) for the focus group meetings conducted during the second month. The benefits most frequently mentioned during the focus groups included: (1) identification of "doctor shopping"; (2) averting duplicative testing; and (3) increased efficiency of clinical information gathering. The most frequent disadvantage mentioned was the limited availability of data in the AMIE system. Respondents reported that AMIE had the potential to improve care, but they felt that AMIE impact was limited due to the data available.

  1. 28 CFR 42.602 - Exchange of information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Exchange of information. 42.602 Section 42.602 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of...

  2. Ontological modeling of electronic health information exchange.

    PubMed

    McMurray, J; Zhu, L; McKillop, I; Chen, H

    2015-08-01

    Investments of resources to purposively improve the movement of information between health system providers are currently made with imperfect information. No inventories of system-level electronic health information flows currently exist, nor do measures of inter-organizational electronic information exchange. Using Protégé 4, an open-source OWL Web ontology language editor and knowledge-based framework, we formalized a model that decomposes inter-organizational electronic health information flow into derivative concepts such as diversity, breadth, volume, structure, standardization and connectivity. The ontology was populated with data from a regional health system and the flows were measured. Individual instance's properties were inferred from their class associations as determined by their data and object property rules. It was also possible to visualize interoperability activity for regional analysis and planning purposes. A property called Impact was created from the total number of patients or clients that a health entity in the region served in a year, and the total number of health service providers or organizations with whom it exchanged information in support of clinical decision-making, diagnosis or treatment. Identifying providers with a high Impact but low Interoperability score could assist planners and policy-makers to optimize technology investments intended to electronically share patient information across the continuum of care. Finally, we demonstrated how linked ontologies were used to identify logical inconsistencies in self-reported data for the study. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Extension of analog network coding in wireless information exchange

    NASA Astrophysics Data System (ADS)

    Chen, Cheng; Huang, Jiaqing

    2012-01-01

    Ever since the concept of analog network coding(ANC) was put forward by S.Katti, much attention has been focused on how to utilize analog network coding to take advantage of wireless interference, which used to be considered generally harmful, to improve throughput performance. Previously, only the case of two nodes that need to exchange information has been fully discussed while the issue of extending analog network coding to more than three nodes remains undeveloped. In this paper, we propose a practical transmission scheme to extend analog network coding to more than two nodes that need to exchange information among themselves. We start with the case of three nodes that need to exchange information and demonstrate that through utilizing our algorithm, the throughput can achieve 33% and 20% increase compared with that of traditional transmission scheduling and digital network coding, respectively. Then, we generalize the algorithm so that it can fit for occasions with any number of nodes. We also discuss some technical issues and throughput analysis as well as the bit error rate.

  4. National Information Exchange Model (NIEM): DoD Adoption and Implications for C2 (Briefing Charts)

    DTIC Science & Technology

    2014-06-18

    Application Data Consumers Information Exchange Package ( IEP ) the data exchanged at runtime Data Producers IES defines Information Exchange...Specification (IES) build-time description of the data to be exchanged Developers System / Application System / Application IEP | 9 | Data...Exchange Package ( IEP ) the data exchanged at runtime Data Producers System / Application System / Application IEP Consumer’s Understanding

  5. A Study of Interlibrary Loan Transactions in the Texas Information Exchange.

    ERIC Educational Resources Information Center

    Texas Information Exchange, Austin.

    A questionnaire was designed and circulated to all member libraries of the Texas Information Exchange to gather data associated with the costs and volume of interlibrary loan activity from September 1, 1975 to February 28, 1976. Forty of the forty-five members of the Exchange participated in the study. In the area of costs, information was…

  6. Database & information tools for transportation research management : Connecticut transportation research peer exchange report of a thematic peer exchange.

    DOT National Transportation Integrated Search

    2006-05-01

    Specific objectives of the Peer Exchange were: : Discuss and exchange information about databases and other software : used to support the program-cycles managed by state transportation : research offices. Elements of the program cycle include: :...

  7. Information Exchange Between Resilient and High-Threat Networks: Techniques for Threat Mitigation

    DTIC Science & Technology

    2004-11-01

    Information Exchange between Resilient and High-Threat Networks : Techniques for Threat Mitigation Tim Dean and Graham Wyatt QinetiQ...SUMMARY High resilience military networks frequently have requirements for exchange of information with networks of low assurance, including networks of...assured, two-way, information flow between high resilience networks and other networks of unknown threat. The techniques include conventional and

  8. Utilizing Information Technology to Facilitate Rapid Acquisition

    DTIC Science & Technology

    2006-06-01

    2005, p. 13. 34 One million merchants sell their sundries on Amazon.com.53 Jeff Bezos , founder of Amazon, started selling books over the...INFORMATION TECHNOLOGY TO FACILITATE RAPID ACQUISITION by Joshua R. Burris June 2006 Thesis Advisor: Ron Tudor Second Reader: Jeff ...Thesis Advisor Jeff Cuskey Second Reader Robert Beck, Dean Graduate School of Business and Public Policy iv

  9. Health information exchange and healthcare utilization.

    PubMed

    Vest, Joshua R

    2009-06-01

    Health information exchange (HIE) makes previously inaccessible data available to clinicians, resulting in more complete information. This study tested the hypotheses that HIE information access reduced emergency room visits and inpatient hospitalizations for ambulatory care sensitive conditions among medically indigent adults. HIE access was quantified by how frequently system users' accessed patients' data. Encounter counts were modeled using zero inflated binomial regression. HIE was not accessed for 43% of individuals. Patient factors associated with accessed data included: prior utilization, chronic conditions, and age. Higher levels of information access were significantly associated with increased counts of all encounter types. Results indicate system users were more likely to access HIE for patients for whom the information might be considered most beneficial. Ultimately, these results imply that HIE information access did not transform care in the ways many would expect. Expectations in utilization reductions, however logical, may have to be reevaluated or postponed.

  10. Why relevant chemical information cannot be exchanged without disclosing structures

    NASA Astrophysics Data System (ADS)

    Filimonov, Dmitry; Poroikov, Vladimir

    2005-09-01

    Both society and industry are interested in increasing the safety of pharmaceuticals. Potentially dangerous compounds could be filtered out at early stages of R&D by computer prediction of biological activity and ADMET characteristics. Accuracy of such predictions strongly depends on the quality & quantity of information contained in a training set. Suggestion that some relevant chemical information can be added to such training sets without disclosing chemical structures was generated at the recent ACS Symposium. We presented arguments that such safety exchange of relevant chemical information is impossible. Any relevant information about chemical structures can be used for search of either a particular compound itself or its close analogues. Risk of identifying such structures is enough to prevent pharma industry from relevant chemical information exchange.

  11. Activation-triggered subunit exchange between CaMKII holoenzymes facilitates the spread of kinase activity

    PubMed Central

    Stratton, Margaret; Lee, Il-Hyung; Bhattacharyya, Moitrayee; Christensen, Sune M; Chao, Luke H; Schulman, Howard; Groves, Jay T; Kuriyan, John

    2014-01-01

    The activation of the dodecameric Ca2+/calmodulin dependent kinase II (CaMKII) holoenzyme is critical for memory formation. We now report that CaMKII has a remarkable property, which is that activation of the holoenzyme triggers the exchange of subunits between holoenzymes, including unactivated ones, enabling the calcium-independent phosphorylation of new subunits. We show, using a single-molecule TIRF microscopy technique, that the exchange process is triggered by the activation of CaMKII, and that exchange is modulated by phosphorylation of two residues in the calmodulin-binding segment, Thr 305 and Thr 306. Based on these results, and on the analysis of molecular dynamics simulations, we suggest that the phosphorylated regulatory segment of CaMKII interacts with the central hub of the holoenzyme and weakens its integrity, thereby promoting exchange. Our results have implications for an earlier idea that subunit exchange in CaMKII may have relevance for information storage resulting from brief coincident stimuli during neuronal signaling. DOI: http://dx.doi.org/10.7554/eLife.01610.001 PMID:24473075

  12. Information Exchange of the Atomic Energy Society of Japan with Nuclear Societies Worldwide

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Masao Hori; Yasushi Tomita

    2000-06-04

    This paper describes committees of the Atomic Energy Society of Japan (AESJ) related to information exchange, AESJ publications, AESJ Internet applications, and means for future information exchange between nuclear societies.

  13. An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study

    PubMed Central

    2018-01-01

    Background The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. Objective The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. Methods A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. Results This study identifies 3 core current perceived value factors and 5 potential perceived value factors—how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Conclusions Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. PMID:29712623

  14. An Early Model for Value and Sustainability in Health Information Exchanges: Qualitative Study.

    PubMed

    Feldman, Sue S

    2018-04-30

    The primary value relative to health information exchange has been seen in terms of cost savings relative to laboratory and radiology testing, emergency department expenditures, and admissions. However, models are needed to statistically quantify value and sustainability and better understand the dependent and mediating factors that contribute to value and sustainability. The purpose of this study was to provide a basis for early model development for health information exchange value and sustainability. A qualitative study was conducted with 21 interviews of eHealth Exchange participants across 10 organizations. Using a grounded theory approach and 3.0 as a relative frequency threshold, 5 main categories and 16 subcategories emerged. This study identifies 3 core current perceived value factors and 5 potential perceived value factors-how interviewees predict health information exchanges may evolve as there are more participants. These value factors were used as the foundation for early model development for sustainability of health information exchange. Using the value factors from the interviews, the study provides the basis for early model development for health information exchange value and sustainability. This basis includes factors from the research: fostering consumer engagement; establishing a provider directory; quantifying use, cost, and clinical outcomes; ensuring data integrity through patient matching; and increasing awareness, usefulness, interoperability, and sustainability of eHealth Exchange. ©Sue S Feldman. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 30.04.2018.

  15. 76 FR 80887 - Proposed Information Collection; Comment Request; Export Trading Companies Contact Facilitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ... Request; Export Trading Companies Contact Facilitation Services AGENCY: International Trade [email protected] ). FOR FURTHER INFORMATION CONTACT: Requests for additional information or copies of the... facilitate contact between producers of exportable goods and services, and firms offering export trade...

  16. 28 CFR 42.602 - Exchange of information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exchange of information. 42.602 Section 42.602 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND PROCEDURES Procedures for Complaints of Employment Discrimination Filed Against Recipients of Federal Financial Assistance § 42.602...

  17. Electronic Tools for Health Information Exchange

    PubMed Central

    2013-01-01

    Background As patients experience transitions in care, there is a need to share information between care providers in an accurate and timely manner. With the push towards electronic medical records and other electronic tools (eTools) (and away from paper-based health records) for health information exchange, there remains uncertainty around the impact of eTools as a form of communication. Objective To examine the impact of eTools for health information exchange in the context of care coordination for individuals with chronic disease in the community. Data Sources A literature search was performed on April 26, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published until April 26, 2012 (no start date limit was applied). Review Methods A systematic literature search was conducted, and meta-analysis conducted where appropriate. Outcomes of interest fell into 4 categories: health services utilization, disease-specific clinical outcomes, process-of-care indicators, and measures of efficiency. The quality of the evidence was assessed individually for each outcome. Expert panels were assembled for stakeholder engagement and contextualization. Results Eleven articles were identified (4 randomized controlled trials and 7 observational studies). There was moderate quality evidence of a reduction in hospitalizations, hospital length of stay, and emergency department visits following the implementation of an electronically generated laboratory report with recommendations based on clinical guidelines. The evidence showed no difference in disease-specific outcomes; there was no evidence of a positive impact on process-of-care indicators or measures of efficiency. Limitations A limited body of research specifically examined eTools for health information exchange in

  18. DEVELOPMENT OF A SYSTEM FOR AN EDUCATIONAL PRODUCTS INFORMATION EXCHANGE. FINAL REPORT.

    ERIC Educational Resources Information Center

    KOMOSKI, P. KENNETH

    THIS STUDY WAS UNDERTAKEN TO DESIGN AN EASILY ACCESSIBLE NATIONWIDE SYSTEM FOR EXCHANGING DESCRIPTIVE, EVALUATIVE PRODUCT INFORMATION AMONG ALL SECTORS OF THE EDUCATIONAL COMMUNITY ON A COOPERATIVE COST-SHARING BASIS. THE FEASIBILITY OF SUCH A COLLECTION AND EXCHANGE OF DESCRIPTIVE AND EVALUATIVE INFORMATION ABOUT INSTRUCTIONAL MATERIALS SYSTEMS…

  19. Creating sustainable local health information exchanges: can barriers to stakeholder participation be overcome?

    PubMed

    Grossman, Joy M; Kushner, Kathryn L; November, Elizabeth A

    2008-02-01

    Local health information exchanges (HIEs) hold the promise of collecting patient clinical data across sites of care to provide more complete and timely information for treatment, as well as supporting quality improvement and reporting, public health activities, and clinical research. Findings from a study of stakeholder perspectives on participation in four HIEs by the Center for Studying Health System Change (HSC) and the National Institute for Health Care Management (NIHCM) Foundation suggest, however, that barriers to achieving data exchange remain high. Concerns about loss of competitive advantage and data misuse impede provider and health plan willingness to contribute patient data. Additionally, uncertainty about who benefits from HIEs is affecting stakeholder willingness to fund the exchanges. The more mature exchanges--Cincinnati-based HealthBridge and the Indiana Health Information Exchange (IHIE)--have achieved some viability by meeting a specific business need--more efficient delivery of hospital test results to physicians. The newer exchanges--CareSpark, serving northeast Tennessee and southwest Virginia, and the Tampa Bay Regional Health Information Organization (RHIO)--have struggled to identify and finance initial services without a similar critical mass of hospital participation. While narrow data exchange efforts that improve transaction efficiency may be a pragmatic first step to overcome barriers to stakeholder participation, expanding HIEs to achieve the broad-based data exchange necessary for quality reporting and pay-for-performance (P4P) activities raises more challenges.

  20. Harnessing the Internet for International Exchanges on Learning Cities: The Pie Experience 2011-2013

    ERIC Educational Resources Information Center

    Kearns, Peter

    2014-01-01

    The PASCAL International Exchanges (PIE) project was developed to facilitate online exchanges of information and experience between learning cities around the world and, in doing this, to test the potential of the internet to enable such low-cost exchanges. The author provides a personal assessment of the PIE experience over the three years 2011…

  1. Associations between perceived crisis mode work climate and poor information exchange within hospitals.

    PubMed

    Patterson, Mark E; Bogart, Miller S; Starr, Kathleen R

    2015-03-01

    Because hospital units operating in crisis mode could create unsafe transitions of care due to miscommunication, our objective was to estimate associations between perceived crisis mode work climate and patient information exchange problems within hospitals. Self-reported data from 247,140 hospital staff members across 884 hospitals were obtained from the 2010 Hospital Survey on Patient Safety Culture. Presence of a crisis mode work climate was defined as respondents agreeing that the hospital unit in which they work tries to do too much too quickly. Presence of patient information exchange problems was defined as respondents agreeing that problems often occur in exchanging patient information across hospital units. Multivariable ordinal regressions estimated the likelihood of perceived problems in exchanging patient information across hospital units, controlling for perceived levels of crisis mode work climate, skill levels, work climate, and hospital infrastructure. Compared to those disagreeing, hospital staff members agreeing that the hospital unit in which they work tries to do too much too quickly were 1.6 times more likely to perceive problems in exchanging patient information across hospital units (odds ratio: 1.6, 95% confidence interval: 1.58-1.65). Hospital staff members perceiving crisis mode work climates within their hospital unit are more likely to perceive problems in exchanging patient information across units, underscoring the need to improve communication during transitions of care. © 2014 Society of Hospital Medicine.

  2. 2017 Fire Protection Informational Exchange Meeting

    DTIC Science & Technology

    documents the results of an information exchange meeting held May 1011, 2017 at the US Army Research Laboratory, which brought together interested...parties across the armed services to outline, as a community, the current state of the art in fire protection research and engineering and determine...where future efforts would be most advantageous. The forum provided the opportunity to strengthen old collaborations, begin new partnerships, and serve

  3. Efficient Numerical Methods for Nonlinear-Facilitated Transport and Exchange in a Blood-Tissue Exchange Unit

    PubMed Central

    Poulain, Christophe A.; Finlayson, Bruce A.; Bassingthwaighte, James B.

    2010-01-01

    The analysis of experimental data obtained by the multiple-indicator method requires complex mathematical models for which capillary blood-tissue exchange (BTEX) units are the building blocks. This study presents a new, nonlinear, two-region, axially distributed, single capillary, BTEX model. A facilitated transporter model is used to describe mass transfer between plasma and intracellular spaces. To provide fast and accurate solutions, numerical techniques suited to nonlinear convection-dominated problems are implemented. These techniques are the random choice method, an explicit Euler-Lagrange scheme, and the MacCormack method with and without flux correction. The accuracy of the numerical techniques is demonstrated, and their efficiencies are compared. The random choice, Euler-Lagrange and plain MacCormack method are the best numerical techniques for BTEX modeling. However, the random choice and Euler-Lagrange methods are preferred over the MacCormack method because they allow for the derivation of a heuristic criterion that makes the numerical methods stable without degrading their efficiency. Numerical solutions are also used to illustrate some nonlinear behaviors of the model and to show how the new BTEX model can be used to estimate parameters from experimental data. PMID:9146808

  4. 21 CFR 26.71 - Exchange of information.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Exchange of information. 26.71 Section 26.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS...

  5. Adoption of health information exchange by emergency physicians at three urban academic medical centers.

    PubMed

    Genes, N; Shapiro, J; Vaidya, S; Kuperman, G

    2011-01-01

    Emergency physicians are trained to make decisions quickly and with limited patient information. Health Information Exchange (HIE) has the potential to improve emergency care by bringing relevant patient data from non-affiliated organizations to the bedside. NYCLIX (New York CLinical Information eXchange) offers HIE functionality among multiple New York metropolitan area provider organizations and has pilot users in several member emergency departments (EDs). We conducted semi-structured interviews at three participating EDs with emergency physicians trained to use NYCLIX. Among "users" with > 1 login, responses to questions regarding typical usage scenarios, successful retrieval of data, and areas for improving the interface were recorded. Among "non-users" with ≤1 login, questions about NYCLIX accessibility and utility were asked. Both groups were asked to recall items from prior training regarding data sources and availability. Eighteen NYCLIX pilot users, all board certified emergency physicians, were interviewed. Of the 14 physicians with more than one login ,half estimated successful retrieval of HIE data affecting patient care. Four non-users (one login or less) cited forgotten login information as a major reason for non-use. Though both groups made errors, users were more likely to recall true NYCLIX member sites and data elements than non-users. Improvements suggested as likely to facilitate usage included a single automated login to both the ED information system (EDIS) and HIE, and automatic notification of HIE data availability in the EDIS All respondents reported satisfaction with their training. Integrating HIE into existing ED workflows remains a challenge, though a substantial fraction of users report changes in management based on HIE data. Though interviewees believed their training was adequate, significant errors in their understanding of available NYCLIX data elements and participating sites persist.

  6. Cosmonauts Solovyev and Dezhurov exchange information on Mir

    NASA Image and Video Library

    1995-07-10

    STS071-118-007 (27 June - 7 July 1995) --- Onboard the Russia?s Mir Space Station Mir Base Block, cosmonauts Anatoly Y. Solovyev (left) and Vladimir N. Dezhurov, Mir 19 and 18 commanders, respectively, exchange information about their research tasks. The two represent a change of guard aboard Mir, as Dezhurov prepares to come back to Earth with the STS-71 crew aboard Space Shuttle Atlantis. Nikolai M. Budarin and Gennadiy M. Strekalov - cosmonaut/flight engineers making the same exchange -- are out of frame.

  7. Simulation Suggests that medical group mergers won't undermine the potential utility of health information exchanges.

    PubMed

    Rudin, Robert S; Schneider, Eric C; Volk, Lynn A; Szolovits, Peter; Salzberg, Claudia A; Simon, Steven R; Bates, David W

    2012-03-01

    Federal and state agencies are investing substantial resources in the creation of community health information exchanges, which are consortia that enable independent health care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private health information exchanges. Such activity could reduce the potential utility of community exchanges-that is, the exchanges' capacity to share patient data across hospitals and physician practices that are independent. Simulations of care transitions based on data from ten Massachusetts communities suggest that there would have to be many such mergers to undermine the potential utility of health information exchanges. At the same time, because hospitals and the largest medical groups account for only 10-20 percent of care transitions in a community, information exchanges will still need to recruit a large proportion of the medical groups in a given community for the exchanges to maintain their usefulness in fostering information exchange across independent providers.

  8. Data Governance and Data Sharing Agreements for Community-Wide Health Information Exchange: Lessons from the Beacon Communities

    PubMed Central

    Allen, Claudia; Des Jardins, Terrisca R.; Heider, Arvela; Lyman, Kristin A.; McWilliams, Lee; Rein, Alison L.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A.

    2014-01-01

    Purpose: Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are “nontraditional” health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. Innovation: While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so – particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities’ experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. Credibility: For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. Conclusions: The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in

  9. Data governance and data sharing agreements for community-wide health information exchange: lessons from the beacon communities.

    PubMed

    Allen, Claudia; Des Jardins, Terrisca R; Heider, Arvela; Lyman, Kristin A; McWilliams, Lee; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A

    2014-01-01

    Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are "nontraditional" health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so - particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities' experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in network data sharing initiatives. More importantly, these

  10. Organizational Uses of Health Information Exchange to Change Cost and Utilization Outcomes: A Typology from a Multi-Site Qualitative Analysis.

    PubMed

    Vest, Joshua R; Abramson, Erika

    2015-01-01

    Health information exchange (HIE) systems facilitate access to patient information for a variety of health care organizations, end users, and clinical and organizational goals. While a complex intervention, organizations' usage of HIE is often conceptualized and measured narrowly. We sought to provide greater specificity to the concept of HIE as an intervention by formulating a typology of organizational HIE usage. We interviewed representatives of a regional health information organization and health care organizations actively using HIE information to change patient utilization and costs. The resultant typology includes three dimensions: user role, usage initiation, and patient set. This approach to categorizing how health care organizations are actually applying HIE information to clinical and business tasks provides greater clarity about HIE as an intervention and helps elucidate the conceptual linkage between HIE an organizational and patient outcomes.

  11. Estimated financial savings associated with health information exchange and ambulatory care referral.

    PubMed

    Frisse, Mark E; Holmes, Rodney L

    2007-12-01

    Data and financial models based on an operational health information exchange suggest that health care delivery costs can be reduced by making clinical data available at the time of care in urban emergency departments. Reductions are the result of decreases in laboratory and radiographic tests, fewer admissions for observation, and lower overall emergency department costs. The likelihood of reducing these costs depends on the extent to which clinicians alter their workflow and take into account information available through the exchange from other institutions prior to initiating a treatment plan. Far greater savings can be realized in theory by identifying individuals presenting to emergency departments whose acute and long-term care needs are more suitably addressed at lower costs in ambulatory settings or medical homes. These alternative ambulatory settings can more effectively address the chronic care needs of those who receive most of their care in emergency departments. To support a shift from emergency room care to clinic care, health care information available through the health information exchange must be made available in both emergency department and ambulatory care settings. If practice workflow and patient behavior can be changed, a more effective and efficient care delivery system will be made possible through the secure exchange of clinical information across regional settings. These projections support the case for the financial viability of regional health information exchanges and motivate participation of hospitals and ambulatory care organizations-particularly in urban settings.

  12. Tweeting the Friendly Skies: Investigating Information Exchange among Twitter Users about Airlines

    ERIC Educational Resources Information Center

    Sreenivasan, Nirupama Dharmavaram; Lee, Chei Sian; Goh, Dion Hoe-Lian

    2012-01-01

    Purpose: The purpose of this study is to investigate airline users' microblog postings pertaining to their travel-related information exchange so as to assess their wants, preferences and feedback about airline products and services. Examining such real-time information exchange is important as users rely on this for various purposes such as…

  13. The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

    PubMed

    Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

    2016-06-01

    Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC. © The Author(s) 2016.

  14. How could health information exchange better meet the needs of care practitioners?

    PubMed

    Kierkegaard, P; Kaushal, R; Vest, J R

    2014-01-01

    Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable.

  15. MIX. The McGraw-Hill Information Exchange.

    ERIC Educational Resources Information Center

    Laliberte, Stephen M.

    1986-01-01

    "MIX" is an online publishing service and information exchange from the Educational Management Services Division of McGraw-Hill. Through computer conferencing and electronic mail, MIX provides access to a network of people across the country who are seeking ways to put computers to use to improve the quality of education. MIX is an…

  16. Satisfying patient-consumer principles for health information exchange: evidence from California case studies.

    PubMed

    Miller, Robert H

    2012-03-01

    In June 2010 sixteen organizations representing California patients and consumers adopted nine principles for electronically exchanging health information among and within provider organizations. The principles were formulated with the goal of improving patient and population health care by increasing the availability and use of patient data while protecting patients' privacy. This study assesses to what extent five health care organizations-all in different stages of increasing their capacity for health information exchange-conformed to the principles in early 2011. Although an increasing amount of electronic data has been exchanged among organizations and with patients, progress has been modest, and patients still have little control over their data. For organizations to comply with all nine patient and consumer principles, clear "rules of the road" for information sharing must be defined, and patient education in health information exchange and control over personal data must be increased.

  17. Collaborative Information Agents on the World Wide Web

    NASA Technical Reports Server (NTRS)

    Chen, James R.; Mathe, Nathalie; Wolfe, Shawn; Koga, Dennis J. (Technical Monitor)

    1998-01-01

    In this paper, we present DIAMS, a system of distributed, collaborative information agents which help users access, collect, organize, and exchange information on the World Wide Web. Personal agents provide their owners dynamic displays of well organized information collections, as well as friendly information management utilities. Personal agents exchange information with one another. They also work with other types of information agents such as matchmakers and knowledge experts to facilitate collaboration and communication.

  18. Information exchange networks for chronic illness care in primary care practices: an observational study

    PubMed Central

    2010-01-01

    Background Information exchange networks for chronic illness care may influence the uptake of innovations in patient care. Valid and feasible methods are needed to document and analyse information exchange networks in healthcare settings. This observational study aimed to examine the usefulness of methods to study information exchange networks in primary care practices, related to chronic heart failure, diabetes and chronic obstructive pulmonary disease. Methods The study was linked to a quality improvement project in the Netherlands. All health professionals in the practices were asked to complete a short questionnaire that documented their information exchange relations. Feasibility was determined in terms of response rates and reliability in terms of reciprocity of reports of receiving and providing information. For each practice, a number of network characteristics were derived for each of the chronic conditions. Results Ten of the 21 practices in the quality improvement project agreed to participate in this network study. The response rates were high in all but one of the participating practices. For the analysis, we used data from 67 health professionals from eight practices. The agreement between receiving and providing information was, on average, 65.6%. The values for density, centralization, hierarchy, and overlap of the information exchange networks showed substantial variation between the practices as well as between the chronic conditions. The most central individual in the information exchange network could be a nurse or a physician. Conclusions Further research is needed to refine the measure of information networks and to test the impact of network characteristics on the uptake of innovations. PMID:20205758

  19. Information retrieval pathways for health information exchange in multiple care settings.

    PubMed

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R

    2014-11-01

    To determine which health information exchange (HIE) technologies and information retrieval pathways healthcare professionals relied on to meet their information needs in the context of laboratory test results, radiological images and reports, and medication histories. Primary data was collected over a 2-month period across 3 emergency departments, 7 primary care practices, and 2 public health clinics in New York state. Qualitative research methods were used to collect and analyze data from semi-structured interviews and participant observation. The study reveals that healthcare professionals used a complex combination of information retrieval pathways for HIE to obtain clinical information from external organizations. The choice for each approach was setting- and information-specific, but was also highly dynamic across users and their information needs. Our findings about the complex nature of information sharing in healthcare provide insights for informatics professionals about the usage of information; indicate the need for managerial support within each organization; and suggest approaches to improve systems for organizations and agencies working to expand HIE adoption.

  20. Project FAST: [Functional Analysis Systems Training]: Adopter/Facilitator Information.

    ERIC Educational Resources Information Center

    Essexville-Hampton Public Schools, MI.

    Presented is adopter/facilitator information of Project FAST (Functional Analysis Systems Training) to provide educational and support services to learning disordered children and their regular elementary teachers. Briefly described are the three schools in the Essexville-Hampton (Michigan) school district; objectives of the program; program…

  1. Models of information exchange between radio interfaces of Wi-Fi group of standards

    NASA Astrophysics Data System (ADS)

    Litvinskaya, O. S.

    2018-05-01

    This paper offers models of information exchange between radio interfaces of the Wi-Fi group of standards by the example of a real facility management system for the oil and gas industry. Interaction between the MU-MIMO and MIMO technologies is analyzed. An optimal variant of information exchange is proposed.

  2. Open exchange of scientific knowledge and European copyright: The case of biodiversity information

    PubMed Central

    Egloff, Willi; Patterson, David J.; Agosti, Donat; Hagedorn, Gregor

    2014-01-01

    Abstract Background. The 7th Framework Programme for Research and Technological Development is helping the European Union to prepare for an integrative system for intelligent management of biodiversity knowledge. The infrastructure that is envisaged and that will be further developed within the Programme “Horizon 2020” aims to provide open and free access to taxonomic information to anyone with a requirement for biodiversity data, without the need for individual consent of other persons or institutions. Open and free access to information will foster the re-use and improve the quality of data, will accelerate research, and will promote new types of research. Progress towards the goal of free and open access to content is hampered by numerous technical, economic, sociological, legal, and other factors. The present article addresses barriers to the open exchange of biodiversity knowledge that arise from European laws, in particular European legislation on copyright and database protection rights. We present a legal point of view as to what will be needed to bring distributed information together and facilitate its re-use by data mining, integration into semantic knowledge systems, and similar techniques. We address exceptions and limitations of copyright or database protection within Europe, and we point to the importance of data use agreements. We illustrate how exceptions and limitations have been transformed into national legislations within some European states to create inconsistencies that impede access to biodiversity information. Conclusions. The legal situation within the EU is unsatisfactory because there are inconsistencies among states that hamper the deployment of an open biodiversity knowledge management system. Scientists within the EU who work with copyright protected works or with protected databases have to be aware of regulations that vary from country to country. This is a major stumbling block to international collaboration and is an

  3. Information Exchange and Information Disclosure in Social Networking Web Sites: Mediating Role of Trust

    ERIC Educational Resources Information Center

    Mital, Monika; Israel, D.; Agarwal, Shailja

    2010-01-01

    Purpose: The purpose of this paper is to examine the mediating effect of trust on the relationship between the type of information exchange (IE) and information disclosure (ID) on social networking web sites (SNWs). Design/methodology/approach: Constructs were developed for type of IE and trust. To understand the mediating role of trust a…

  4. Overcoming obstacles to the exchange of information between risk tools

    NASA Technical Reports Server (NTRS)

    Feather, Martin S.; Cornford, Steven L.; Meshkat, Leila; Voss, Luke

    2005-01-01

    Our work to date in connecting risk tools hs had successes, but also has revealed there to be significant impediments to information exchange between them. These impediments stem from the well-known phenomenon of 'semantic dissonance' - mismatch between conceptual assumptions made by the separately developed tools. This issue represents a fundamental challenge that arises regardless of the mechanism of information exchange. This paper explains the issue and illustrates it with reference to our experiences to date connecting several risk tools. We motivate this work, present and discuss the solutions we have adopted to surmount these impediments, and the implications this work has for future efforts to integrate risk tools.

  5. How could Health Information Exchange Better Meet the Needs of Care Practitioners?

    PubMed Central

    Kaushal, R.; Vest, J.R.

    2014-01-01

    Summary Background Health information exchange (HIE) has the potential to improve the quality of healthcare by enabling providers with better access to patient information from multiple sources at the point of care. However, HIE efforts have historically been difficult to establish in the US and the failure rates of organizations created to foster HIE have been high. Objectives We sought to better understand how RHIO-based HIE systems were used in practice and the challenges care practitioners face using them. The objective of our study were to so investigate how HIE can better meet the needs of care practitioners. Methods We performed a multiple-case study using qualitative methods in three communities in New York State. We conducted interviews onsite and by telephone with HIE users and non-users and observed the workflows of healthcare professionals at multiple healthcare organizations participating in a local HIE effort in New York State. Results The empirical data analysis suggests that challenges still remain in increasing provider usage, optimizing HIE implementations and connecting HIE systems across geographic regions. Important determinants of system usage and perceived value includes users experienced level of available information and the fit of use for physician workflows. Conclusions Challenges still remain in increasing provider adoption, optimizing HIE implementations, and demonstrating value. The inability to find information reduced usage of HIE. Healthcare organizations, HIE facilitating organizations, and states can help support HIE adoption by ensuring patient information is accessible to providers through increasing patient consents, fostering broader participation, and by ensuring systems are usable. PMID:25589903

  6. Information Exchange Procedures. Outcomes Study Procedures. Technical Report No. 66.

    ERIC Educational Resources Information Center

    Byers, Maureen

    The Information Exchange Procedures (IEP) developed by the National Center for Higher Education Management Systems (NCHEMS) are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional characteristics. A fundamental purpose…

  7. An Introduction to the Federal Information Exchange System.

    ERIC Educational Resources Information Center

    De Santi, Vincent; Scheele, D. Sam

    This publication offers a basic introduction to the Federal Information Exchange System (FIXS), a set of procedures for periodically collecting, processing, and publishing data on federal and state expenditures for each program listed in the "Catalog of Federal Assistance Programs." FIXS is designed for use in conjunction with the…

  8. Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

    PubMed

    Vest, Joshua R

    The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

  9. Scoring sensor observations to facilitate the exchange of space surveillance data

    NASA Astrophysics Data System (ADS)

    Weigel, M.; Fiedler, H.; Schildknecht, T.

    2017-08-01

    In this paper, a scoring metric for space surveillance sensor observations is introduced. A scoring metric allows for direct comparison of data quantity and data quality, and makes transparent the effort made by different sensor operators. The concept might be applied to various sensor types like tracking and surveillance radar, active optical laser tracking, or passive optical telescopes as well as combinations of different measurement types. For each measurement type, a polynomial least squares fit is performed on the measurement values contained in the track. The track score is the average sum over the polynomial coefficients uncertainties and scaled by reference measurement accuracy. Based on the newly developed scoring metric, an accounting model and a rating model are introduced. Both models facilitate the exchange of observation data within a network of space surveillance sensors operators. In this paper, optical observations are taken as an example for analysis purposes, but both models can also be utilized for any other type of observations. The rating model has the capability to distinguish between network participants with major and minor data contribution to the network. The level of sanction on data reception is defined by the participants themselves enabling a high flexibility. The more elaborated accounting model translates the track score to credit points earned for data provision and spend for data reception. In this model, data reception is automatically limited for participants with low contribution to the network. The introduced method for observation scoring is first applied for transparent data exchange within the Small Aperture Robotic Telescope Network (SMARTnet). Therefore a detailed mathematical description is presented for line of sight measurements from optical telescopes, as well as numerical simulations for different network setups.

  10. 78 FR 76187 - 30-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-16

    ...: Exchange Programs Alumni Web Site Registration ACTION: Notice of request for public comment and submission... Information Collection: Exchange Programs Alumni Web site Registration. OMB Control Number: 1405-0192. Type of... proposed collection: The International Exchange Alumni Web site requires information to process users...

  11. Benefits of testing for nontested information: retrieval-induced facilitation of episodically bound material.

    PubMed

    Rowland, Christopher A; DeLosh, Edward L

    2014-12-01

    Testing is a powerful means to boost the retention of information. The extent to which the benefits of testing generalize to nontested information, however, is not clear. In three experiments, we found that completing cued-recall tests for a subset of studied materials enhanced retention for the specific information tested, as well as for associated, nontested information during later free-recall testing. In Experiment 1, this generalized benefit was revealed for lists of category-exemplar pairs. Experiment 2 extended the effect to unrelated words, suggesting that retrieval can enhance later free recall of nontested information that is bound solely through episodic context. In Experiment 3, we manipulated the format of the final test and found facilitation in free-recall, but not in cued-recall, testing. The results suggest that testing may facilitate later free recall in part by enhancing access to information that is present during a prior temporal or list context. More generally, these findings suggest that retrieval-induced facilitation extends to a broader range of conditions than has previously been suggested, and they further motivate the adoption of testing as a practical and effective learning tool.

  12. Stable target opinion through power-law bias in information exchange

    NASA Astrophysics Data System (ADS)

    Datta, Amitava

    2018-04-01

    We study a model of binary decision making when a certain population of agents is initially seeded with two different opinions, "+" and "-," with fractions p1 and p2, respectively, p1+p2=1 . Individuals can reverse their initial opinion only once based on this information exchange. We study this model on a completely connected network, where any pair of agents can exchange information, and a two-dimensional square lattice with periodic boundary conditions, where information exchange is possible only between the nearest neighbors. We propose a model in which each agent maintains two counters of opposite opinions and accepts opinions of other agents with a power-law bias until a threshold is reached, when they fix their final opinion. Our model is inspired by the study of negativity bias and positive-negative asymmetry, which has been known in the psychology literature for a long time. Our model can achieve a stable intermediate mix of positive and negative opinions in a population. In particular, we show that it is possible to achieve close to any fraction p3, 0 ≤p3≤1 , of "-" opinion starting from an initial fraction p1 of "-" opinion by applying a bias through adjusting the power-law exponent of p3.

  13. Stable target opinion through power-law bias in information exchange.

    PubMed

    Datta, Amitava

    2018-04-01

    We study a model of binary decision making when a certain population of agents is initially seeded with two different opinions, "+" and "-," with fractions p_{1} and p_{2}, respectively, p_{1}+p_{2}=1. Individuals can reverse their initial opinion only once based on this information exchange. We study this model on a completely connected network, where any pair of agents can exchange information, and a two-dimensional square lattice with periodic boundary conditions, where information exchange is possible only between the nearest neighbors. We propose a model in which each agent maintains two counters of opposite opinions and accepts opinions of other agents with a power-law bias until a threshold is reached, when they fix their final opinion. Our model is inspired by the study of negativity bias and positive-negative asymmetry, which has been known in the psychology literature for a long time. Our model can achieve a stable intermediate mix of positive and negative opinions in a population. In particular, we show that it is possible to achieve close to any fraction p_{3}, 0≤p_{3}≤1, of "-" opinion starting from an initial fraction p_{1} of "-" opinion by applying a bias through adjusting the power-law exponent of p_{3}.

  14. Finnish physicians' experiences with computer-supported patient information exchange and communication in clinical work.

    PubMed

    Viitanen, Johanna; Nieminen, Marko; Hypponen, Hannele; Laaveri, Tinja

    2011-01-01

    Several researchers share the concern of healthcare information systems failing to support communication and collaboration in clinical practices. The objective of this paper is to investigate the current state of computer-supported patient information exchange and associated communication between clinicians. We report findings from a national survey on Finnish physicians? experiences with their currently used clinical information systems with regard to patient information documentation, retrieval, management and exchange-related tasks. The questionnaire study with 3929 physicians indicated the main concern being cross-organisational patient information delivery. In addition, physicians argued computer usage increasingly steals time and attention from caring activities and even disturbs physician?nurse collaboration. Problems in information management were particularly emphasised among those physicians working in hospitals and wards. The survey findings indicated that collaborative applications and mobile or wireless solutions have not been widely adapted in Finnish healthcare and suggested an urgent need for adopting appropriate information and communication technology applications to support information exchange and communication between physicians, and physicians and nurses.

  15. Factors motivating and affecting health information exchange usage

    PubMed Central

    Zhao, Hongwei; Jaspserson, 'Jon; Gamm, Larry D; Ohsfeldt, Robert L

    2011-01-01

    Objective Health information exchange (HIE) is the process of electronically sharing patient-level information between providers. However, where implemented, reports indicate HIE system usage is low. The aim of this study was to determine the factors associated with different types of HIE usage. Design Cross-sectional analysis of clinical data from emergency room encounters included in an operational HIE effort linked to system user logs using crossed random-intercept logistic regression. Measurements Independent variables included factors indicative of information needs. System usage was measured as none, basic usage, or a novel pattern of usage. Results The system was accessed for 2.3% of all encounters (6142 out of 271 305). Novel usage patterns were more likely for more complex patients. The odds of HIE usage were lower in the face of time constraints. In contrast to expectations, system usage was lower when the patient was unfamiliar to the facility. Limitations Because of differences between HIE efforts and the fact that not all types of HIE usage (ie, public health) could be included in the analysis, results are limited in terms of generalizablity. Conclusions This study of actual HIE system usage identifies patients and circumstances in which HIE is more likely to be used and factors that are likely to discourage usage. The paper explores the implications of the findings for system redesign, information integration across exchange partners, and for meaningful usage criteria emerging from provisions of the Health Information Technology for Economic & Clinical Health Act. PMID:21262919

  16. Smart health community: the hidden value of health information exchange.

    PubMed

    Ciriello, James N; Kulatilaka, Nalin

    2010-12-01

    Investments in health information technology are accelerating the digitization of medicine. The value from these investments, however, can grow beyond efficiencies by filling the information gaps between the various stakeholders. New work processes, governance structures, and relationships are needed for the coevolution of healthcare markets and business models. But coevolution is slow, hindered by the scarcity of incentives for legacy delivery systems and constrained by the prevailing patient-healthcare paradigm. The greater opportunity lies in wellness for individuals, families, communities, and society at large: a consumer-community paradigm. Capturing new value from this opportunity can start with investment in health information exchange and the creation of Smart Health Communities. By shifting the focus of exchange from public servant to value-added service provider, these communities can serve as a platform for a wider array of wellness services from consumer care, traditional healthcare, and research.

  17. Scalable and Resilient Middleware to Handle Information Exchange during Environment Crisis

    NASA Astrophysics Data System (ADS)

    Tao, R.; Poslad, S.; Moßgraber, J.; Middleton, S.; Hammitzsch, M.

    2012-04-01

    The EU FP7 TRIDEC project focuses on enabling real-time, intelligent, information management of collaborative, complex, critical decision processes for earth management. A key challenge is to promote a communication infrastructure to facilitate interoperable environment information services during environment events and crises such as tsunamis and drilling, during which increasing volumes and dimensionality of disparate information sources, including sensor-based and human-based ones, can result, and need to be managed. Such a system needs to support: scalable, distributed messaging; asynchronous messaging; open messaging to handling changing clients such as new and retired automated system and human information sources becoming online or offline; flexible data filtering, and heterogeneous access networks (e.g., GSM, WLAN and LAN). In addition, the system needs to be resilient to handle the ICT system failures, e.g. failure, degradation and overloads, during environment events. There are several system middleware choices for TRIDEC based upon a Service-oriented-architecture (SOA), Event-driven-Architecture (EDA), Cloud Computing, and Enterprise Service Bus (ESB). In an SOA, everything is a service (e.g. data access, processing and exchange); clients can request on demand or subscribe to services registered by providers; more often interaction is synchronous. In an EDA system, events that represent significant changes in state can be processed simply, or as streams or more complexly. Cloud computing is a virtualization, interoperable and elastic resource allocation model. An ESB, a fundamental component for enterprise messaging, supports synchronous and asynchronous message exchange models and has inbuilt resilience against ICT failure. Our middleware proposal is an ESB based hybrid architecture model: an SOA extension supports more synchronous workflows; EDA assists the ESB to handle more complex event processing; Cloud computing can be used to increase and

  18. Information model for digital exchange of soil-related data - potential modifications on ISO 28258

    NASA Astrophysics Data System (ADS)

    Schulz, Sina; Eberhardt, Einar; Reznik, Tomas

    2017-04-01

    ABSTRACT The International Standard ISO 28258 "Digital exchange of soil-related data" provides an information model that describes the organization of soil data to facilitate data transfer between data producers, holders and users. The data model contains a fixed set of "core" soil feature types, data types and properties, whereas its customization is on the data provider level, e.g. by adding user-specific properties. Rules for encoding these information are given by a customized XML-based format (called "SoilML"). Some technical shortcomings are currently under consideration in the ISO working group. Directly after publication of ISO 28258 in 2013, also several conceptual and implementation issues concerning the information model had been identified, such as renaming of feature types, modification of data types, and enhancement of definitions or addition of super-classes are part of the current revision process. Conceptual changes for the current ISO data model that are compatible with the Australian/New Zealand soil data model ANZSoilML and the EU INSPIRE Data Specifications Soil are also discussed. The concept of a model with a limited set of properties that can be extended by the data provider should remain unaffected. This presentation aims to introduce and comment on the current ISO soil information model and the proposed modifications. Moreover, we want to discuss these adjustments with respect to enhanced applicability of this International Standard.

  19. The informativity of sound modulates crossmodal facilitation of visual discrimination: a fMRI study.

    PubMed

    Li, Qi; Yu, Hongtao; Li, Xiujun; Sun, Hongzan; Yang, Jingjing; Li, Chunlin

    2017-01-18

    Many studies have investigated behavioral crossmodal facilitation when a visual stimulus is accompanied by a concurrent task-irrelevant sound. Lippert and colleagues reported that a concurrent task-irrelevant sound reduced the uncertainty of the timing of the visual display and improved perceptional responses (informative sound). However, the neural mechanism by which the informativity of sound affected crossmodal facilitation of visual discrimination remained unclear. In this study, we used event-related functional MRI to investigate the neural mechanisms underlying the role of informativity of sound in crossmodal facilitation of visual discrimination. Significantly faster reaction times were observed when there was an informative relationship between auditory and visual stimuli. The functional MRI results showed sound informativity-induced activation enhancement including the left fusiform gyrus and the right lateral occipital complex. Further correlation analysis showed that the right lateral occipital complex was significantly correlated with the behavioral benefit in reaction times. This suggests that this region was modulated by the informative relationship within audiovisual stimuli that was learnt during the experiment, resulting in late-stage multisensory integration and enhanced behavioral responses.

  20. Facilitating informed choice in prenatal testing: how well are we doing?

    PubMed

    Marteau, T M; Dormandy, E

    2001-01-01

    There is a consensus that prenatal testing services need to provide the information and support necessary for women to make informed choices about prenatal testing. Informed choices are those based on relevant information that reflect the decision-maker's values. To date, most research has focused on the information provided to women deciding whether to undergo tests. This has highlighted the poor quality of information provided to many women. There is agreement on the need to provide information on three key aspects of any test: the condition for which testing is being offered, characteristics of the test, and the implications of testing. Very little research has been conducted on decisions after the diagnosis of a fetal abnormality and how information and emotional and decisional support are and should be provided. Research is now needed in four key areas: first, on the optimal ways of organizing services to facilitate choices that are not only based on relevant information, but also reflect the decision-maker's values; second, on the most effective ways of framing information needed for the different decisions involved in prenatal testing; third, on the most effective media in which to deliver information; and, fourth, to identify aspects of counseling that facilitate informed choices following diagnoses of fetal abnormality. If we value women's ability to make informed choices about prenatal tests as highly as we value reliable laboratory tests, evidence-based quality standards need to be developed for the information and support women are given at all stages of the process of prenatal testing.

  1. Using Hypertext to Facilitate Information Sharing in Biomedical Research Groups

    PubMed Central

    Chaney, R. Jesse; Shipman, Frank M.; Gorry, G. Anthony

    1989-01-01

    As part of our effort to create an Integrated Academic Information Management System at Baylor College of Medicine, we are developing information technology to support the efforts of scientific work groups. Many of our ideas in this regard are embodied in a system called the Virtual Notebook which is intended to facilitate information sharing and management in such groups. Here we discuss the foundations of that system - a hypertext system that we have developed using a relational data base and the distributable interface the we have written in the X Window System.

  2. Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study

    PubMed Central

    2011-01-01

    Background Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. Methods The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Results Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. Conclusions The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and

  3. Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study.

    PubMed

    Zwaanswijk, Marieke; Verheij, Robert A; Wiesman, Floris J; Friele, Roland D

    2011-10-07

    Various countries are currently implementing a national electronic patient record (n-EPR). Despite the assumed positive effects of n-EPRs, their overall adoption remains low and meets resistance from health care providers. This study aims to increase our understanding of health care providers' attitude towards the n-EPR, by investigating their perceptions of the benefits and problems of electronic information exchange in health care and the n-EPR in particular. The study was conducted in three Dutch health care settings: acute care, diabetes care, and ambulatory mental health care. Two health care organisations were included per setting. Between January and June 2010, interviews were conducted with 17 stakeholders working in these organisations. Relevant themes were deduced by means of thematic qualitative analysis. Health care providers perceived electronic information exchange to promote the efficiency and quality of care. The problems they perceived in electronic information exchange mainly concerned the confidentiality and safety of information exchange and the reliability and quality of patient data. Many problems perceived by health care providers did not specifically apply to the n-EPR, but to electronic information exchange in general. The implementation of the Dutch n-EPR has mainly followed a top-down approach, thereby neglecting the fact that the perceptions and preferences of its users (health care providers) need to be addressed in order to achieve successful implementation. The results of this study provide valuable suggestions about how to promote health care providers' willingness to adopt electronic information exchange, which can be useful for other countries currently implementing an n-EPR. Apart from providing information about the benefits and usefulness of electronic information exchange, efforts should be focused on minimising the problems as perceived by health care providers. The safety and confidentiality of electronic information exchange

  4. Integrating a health information exchange into a community pharmacy transitions of care service.

    PubMed

    Fanizza, Frank A; Ruisinger, Janelle F; Prohaska, Emily S; Melton, Brittany L

    2018-04-03

    To describe the incorporation of a state health information exchange (HIE) into a community pharmacy transitions of care (TOC) service and to assess its impact on 30-day readmission rates. Three suburban community pharmacies in Olathe, Kansas. Balls Food Stores is a grocery store chain which operates 21 supermarket community pharmacies in the Kansas City metropolitan area. Balls Food Stores launched a pharmacist-led self-referral TOC study in which a state HIE was utilized to collect discharge information from patients' electronic medical records (EMRs) to facilitate TOC comprehensive medication reviews (CMRs). Descriptive statistics were used to assess types and outcomes of identified drug therapy problems and the ability to access Kansas Health Information Network EMRs. A chi-square test was used to assess 30-day readmissions between patients who accepted and declined the service. Forty patients were identified for inclusion and 18 elected to participate in the service. The majority of participants were white females with a median age of 64.5 years. Out of 40 study patients, 85% had an EMR available; 12.5% of patients had a medication list included in their EMR hospitalization documentation. Participants who underwent the service had a statistically significantly lower rate of overall 30-day hospital readmission than those who declined (11.1% vs 36.4%, P = 0.032). Among the 18 TOC CMRs performed, 90 drug therapy problems were identified and 77 were resolved in collaboration with a patient, caregiver, or physician. Incorporation of a state HIE into a community pharmacist-led TOC service is a novel strategy for collecting patient data. During the study, no TOC participants were readmitted within 30 days. However, pharmacists found HIE data alone was insufficient to perform TOC CMRs for the majority of participants. In order to expand state HIE utilization, more health systems will need to upload a minimum standard data set to help facilitate care. Copyright © 2018

  5. Understanding information exchange during disaster response: Methodological insights from infocentric analysis

    Treesearch

    Toddi A. Steelman; Branda Nowell; Deena Bayoumi; Sarah McCaffrey

    2014-01-01

    We leverage economic theory, network theory, and social network analytical techniques to bring greater conceptual and methodological rigor to understand how information is exchanged during disasters. We ask, "How can information relationships be evaluated more systematically during a disaster response?" "Infocentric analysis"—a term and...

  6. Meaningful use: a roadmap for the advancement of health information exchange

    PubMed Central

    2013-01-01

    Frankel and colleagues have compared Israel and the U.S.’s experiences with health information exchange (HIE). They highlight the importance of institutional factors in fostering HIE development, notably the influence of local structures, experience and incentives. Historically, information infrastructure in the U.S. has been limited due to lack of standards, fragmented institutions and competition. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 authorized billions of dollars for the adoption and “Meaningful Use” of electronic health records. HITECH programs and Meaningful Use incentives target the advancement of HIE through 1) building blocks, 2) local support and 3) payment incentives. Meaningful Use requirements create a roadmap to broader electronic exchange of health information among providers and with patients. Ultimately, successful HIE in the U.S. will depend on whether Meaningful Use can address institutional needs within local markets. This is a commentary on http://www.ijhpr.org/content/2/1/722 PMID:23880399

  7. HTML5 microdata as a semantic container for medical information exchange.

    PubMed

    Kimura, Eizen; Kobayashi, Shinji; Ishihara, Ken

    2014-01-01

    Achieving interoperability between clinical electronic medical records (EMR) systems and cloud computing systems is challenging because of the lack of a universal reference method as a standard for information exchange with a secure connection. Here we describe an information exchange scheme using HTML5 microdata, where the standard semantic container is an HTML document. We embed HL7 messages describing laboratory test results in the microdata. We also annotate items in the clinical research report with the microdata. We mapped the laboratory test result data into the clinical research report using an HL7 selector specified in the microdata. This scheme can provide secure cooperation between the cloud-based service and the EMR system.

  8. Good things come to those who wait: late first offers facilitate creative agreements in negotiation.

    PubMed

    Sinaceur, Marwan; Maddux, William W; Vasiljevic, Dimitri; Perez Nückel, Ricardo; Galinsky, Adam D

    2013-06-01

    Although previous research has shown that making the first offer leads to a distributive advantage in negotiations, the current research explored how the timing of first offers affects the creativity of negotiation agreements. We hypothesized that making the first offer later rather than earlier in the negotiation would facilitate the discovery of creative agreements that better meet the parties' underlying interests. Experiment 1 demonstrated that compared with early first offers, late first offers facilitated creative agreements that better met the parties' underlying interests. Experiments 2a and 2b controlled for the duration of the negotiation and conceptually replicated this effect. The last two studies also demonstrated that the beneficial effect of late first offers was mediated by greater information exchange. Thus, negotiators need to consider the timing of first offers to fully capitalize on the first offer advantage. Implications for our understanding of creativity, motivated information exchange, and timing in negotiations are discussed.

  9. 78 FR 15800 - 30-Day Notice of Proposed Information Collection: Exchange Student Survey

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-12

    ... Collection. Originating Office: Educational and Cultural Affairs (ECA/ PE/C/PY). Form Number: SV2012-0007... automated collection techniques or other forms of information technology. Please note that comments... provisions of the Mutual Educational and Cultural Exchange Act, as amended, and the Exchange Visitor Program...

  10. Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

    ERIC Educational Resources Information Center

    Kralewski, John E.; Zink, Therese; Boyle, Raymond

    2012-01-01

    Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

  11. Imperfect information facilitates the evolution of reciprocity.

    PubMed

    Kurokawa, Shun

    2016-06-01

    The existence of cooperation demands explanation since cooperation is costly to the actor. Reciprocity has long been regarded as a potential explanatory mechanism for the existence of cooperation. Reciprocity is a mechanism wherein a cooperator responds to an opponent's behavior by switching his/her own behavior. Hence, a possible problematic case relevant to the theory of reciprocity evolution arises when the mechanism is such that the information regarding an opponent's behavior is imperfect. Although it has been confirmed also by previous theoretical studies that imperfect information interferes with the evolution of reciprocity, this argument is based on the assumption that there are no mistakes in behavior. And, a previous study presumed that it might be expected that when such mistakes occur, reciprocity can more readily evolve in the case of imperfect information than in the case of perfect information. The reason why the previous study considers so is that in the former case, reciprocators can miss defections incurred by other reciprocators' mistakes due to imperfect information, allowing cooperation to persist when such reciprocators meet. However, contrary to this expectation, the previous study has shown that even when mistakes occur, imperfect information interferes with the evolution of reciprocity. Nevertheless, the previous study assumed that payoffs are linear (i.e., that the effect of behavior is additive and there are no synergetic effects). In this study, we revisited the same problem but removed the assumption that payoffs are linear. We used evolutionarily stable strategy analysis to compare the condition for reciprocity to evolve when mistakes occur and information is imperfect with the condition for reciprocity to evolve when mistakes occur and information is perfect. Our study revealed that when payoffs are not linear, imperfect information can facilitate the evolution of reciprocity when mistakes occur; while when payoffs are linear

  12. Synaptic unreliability facilitates information transmission in balanced cortical populations

    NASA Astrophysics Data System (ADS)

    Gatys, Leon A.; Ecker, Alexander S.; Tchumatchenko, Tatjana; Bethge, Matthias

    2015-06-01

    Synaptic unreliability is one of the major sources of biophysical noise in the brain. In the context of neural information processing, it is a central question how neural systems can afford this unreliability. Here we examine how synaptic noise affects signal transmission in cortical circuits, where excitation and inhibition are thought to be tightly balanced. Surprisingly, we find that in this balanced state synaptic response variability actually facilitates information transmission, rather than impairing it. In particular, the transmission of fast-varying signals benefits from synaptic noise, as it instantaneously increases the amount of information shared between presynaptic signal and postsynaptic current. Furthermore we show that the beneficial effect of noise is based on a very general mechanism which contrary to stochastic resonance does not reach an optimum at a finite noise level.

  13. Implementing stakeholder-informed research in the substance abuse treatment sector: strategies used by Connections, a Canadian knowledge translation and exchange project.

    PubMed

    Henderson, Joanna; Sword, Wendy; Niccols, Alison; Dobbins, Maureen

    2014-05-29

    Researcher-stakeholder collaboration has been identified as critical to bridging research and health system change. While collaboration models vary, meaningful stakeholder involvement over time ("integrated knowledge translation") is advocated to improve the relevance of research to knowledge users. This short report describes the integrated knowledge translation efforts of Connections, a knowledge translation and exchange project to improve services for women with substance abuse problems and their children, and implementation barriers and facilitators. Strategies of varying intensities were used to engage diverse stakeholders, including policy makers and people with lived experience, and executive directors, program managers, and service providers from Canadian addiction agencies serving women. Barriers to participation included individual (e.g., interest), organizational (e.g., funding), and system level (e.g., lack of centralized stakeholder database) barriers. Similarly, facilitators included individual (e.g., perceived relevance) and organizational (e.g., support) facilitators, as well as initiative characteristics (e.g., multiple involvement opportunities). Despite barriers, Connections' stakeholder-informed research efforts proved essential for developing clinically relevant and feasible processes, measures, and implementation strategies. Stakeholder-researcher collaboration is possible and robust integrated knowledge translation efforts can be productive. Future work should emphasize developing and evaluating a range of strategies to address stakeholders' knowledge translation needs and to facilitate sustained and meaningful involvement in research.

  14. 36 CFR 254.5 - Assembled land exchanges.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Assembled land exchanges. 254... LANDOWNERSHIP ADJUSTMENTS Land Exchanges § 254.5 Assembled land exchanges. (a) Whenever the authorized officer determines it to be practicable, an assembled land exchange arrangement may be used to facilitate exchanges...

  15. Management of laboratory data and information exchange in the electronic health record.

    PubMed

    Wilkerson, Myra L; Henricks, Walter H; Castellani, William J; Whitsitt, Mark S; Sinard, John H

    2015-03-01

    In the era of the electronic health record, the success of laboratories and pathologists will depend on effective presentation and management of laboratory information, including test orders and results, and effective exchange of data between the laboratory information system and the electronic health record. In this third paper of a series that explores empowerment of pathology in the era of the electronic health record, we review key elements of managing laboratory information within the electronic health record and examine functional issues pertinent to pathologists and laboratories in the exchange of laboratory information between electronic health records and both anatomic and clinical pathology laboratory information systems. Issues with electronic order-entry and results-reporting interfaces are described, and considerations for setting up these interfaces are detailed in tables. The role of the laboratory medical director as mandated by the Clinical Laboratory Improvement Amendments of 1988 and the impacts of discordance between laboratory results and their display in the electronic health record are also discussed.

  16. Cryptographic Combinatorial Securities Exchanges

    NASA Astrophysics Data System (ADS)

    Thorpe, Christopher; Parkes, David C.

    We present a useful new mechanism that facilitates the atomic exchange of many large baskets of securities in a combinatorial exchange. Cryptography prevents information about the securities in the baskets from being exploited, enhancing trust. Our exchange offers institutions who wish to trade large positions a new alternative to existing methods of block trading: they can reduce transaction costs by taking advantage of other institutions’ available liquidity, while third party liquidity providers guarantee execution—preserving their desired portfolio composition at all times. In our exchange, institutions submit encrypted orders which are crossed, leaving a “remainder”. The exchange proves facts about the portfolio risk of this remainder to third party liquidity providers without revealing the securities in the remainder, the knowledge of which could also be exploited. The third parties learn either (depending on the setting) the portfolio risk parameters of the remainder itself, or how their own portfolio risk would change if they were to incorporate the remainder into a portfolio they submit. In one setting, these third parties submit bids on the commission, and the winner supplies necessary liquidity for the entire exchange to clear. This guaranteed clearing, coupled with external price discovery from the primary markets for the securities, sidesteps difficult combinatorial optimization problems. This latter method of proving how taking on the remainder would change risk parameters of one’s own portfolio, without revealing the remainder’s contents or its own risk parameters, is a useful protocol of independent interest.

  17. Neighbourhood Book Exchanges: Localising Information Practices

    ERIC Educational Resources Information Center

    Webster, Tenny; Gollner, Kathleen; Nathan, Lisa

    2015-01-01

    Introduction: Through this paper we report on an exploratory study into the design and use of neighbourhood book exchanges in North America. We identify dominant media framings of these book exchanges in North America, along with claims made concerning the influence of the exchanges. We compare the media claims with insights from interviews with…

  18. Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process.

    PubMed

    Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

    2013-05-01

    Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May-September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding

  19. 75 FR 66413 - 30-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-28

    ...: Exchange Programs Alumni Web Site Registration, DS-7006 ACTION: Notice of request for public comment and... Collection The Exchange Programs Alumni Web site requires information to process users' voluntary requests for participation in the Web site. Other than contact information, which is required for website...

  20. Beyond the exchange--the future of B2B.

    PubMed

    Wise, R; Morrison, D

    2000-01-01

    Using the Internet to facilitate business-to-business commerce promises many benefits, such as dramatic cost reductions and greater access to buyers and sellers. Yet little is known about how B2B e-commerce will evolve. The authors argue that changes in the financial services industry over the past two decades provide important clues. Exchanges, they say, are not the primary source of value in information-intensive markets; value tends to accumulate among a diverse group of specialists that focus on such tasks as packaging, standard setting, arbitrage, and information management. Because scale and liquidity are vitally important to efficient trading, today's exchanges will consolidate into a relatively small set of mega-exchanges. Originators will handle the origination and aggregation of complex transactions before sending them on to mega-exchanges for execution. E-speculators, seeking to capitalize on an abundance of market information, will tend to concentrate where relatively standardized products can be transferred easily among a large group of buyers. In many markets, a handful of independent solution providers with well-known brand names and solid reputations will thrive alongside mega-exchanges. Sell-side asset exchanges will create the networks and provide the tools to allow suppliers to trade orders among themselves, sometimes after initial transactions with customers are made on the mega-exchanges. For many companies, traditional skills in such areas as product development, manufacturing, and marketing may become relatively less important, while the ability to understand and capitalize on market dynamics may become considerably more important.

  1. A strategic gaming model for health information exchange markets.

    PubMed

    Martinez, Diego A; Feijoo, Felipe; Zayas-Castro, Jose L; Levin, Scott; Das, Tapas K

    2018-03-01

    Current market conditions create incentives for some providers to exercise control over patient data in ways that unreasonably limit its availability and use. Here we develop a game theoretic model for estimating the willingness of healthcare organizations to join a health information exchange (HIE) network and demonstrate its use in HIE policy design. We formulated the model as a bi-level integer program. A quasi-Newton method is proposed to obtain a strategy Nash equilibrium. We applied our modeling and solution technique to 1,093,177 encounters for exchanging information over a 7.5-year period in 9 hospitals located within a three-county region in Florida. Under a set of assumptions, we found that a proposed federal penalty of up to $2,000,000 has a higher impact on increasing HIE adoption than current federal monetary incentives. Medium-sized hospitals were more reticent to adopt HIE than large-sized hospitals. In the presence of collusion among multiple hospitals to not adopt HIE, neither federal incentives nor proposed penalties increase hospitals' willingness to adopt. Hospitals' apathy toward HIE adoption may threaten the value of inter-connectivity even with federal incentives in place. Competition among hospitals, coupled with volume-based payment systems, creates no incentives for smaller hospitals to exchange data with competitors. Medium-sized hospitals need targeted actions (e.g., outside technological assistance, group purchasing arrangements) to mitigate market incentives to not adopt HIE. Strategic game theoretic models help to clarify HIE adoption decisions under market conditions at play in an extremely complex technology environment.

  2. Impact of Health Information Exchange on Emergency Medicine Clinical Decision Making.

    PubMed

    Gordon, Bradley D; Bernard, Kyle; Salzman, Josh; Whitebird, Robin R

    2015-12-01

    The objective of the study was to understand the immediate utility of health information exchange (HIE) on emergency department (ED) providers by interviewing them shortly after the information was retrieved. Prior studies of physician perceptions regarding HIE have only been performed outside of the care environment. Trained research assistants interviewed resident physicians, physician assistants and attending physicians using a semi-structured questionnaire within two hours of making a HIE request. The responses were recorded, then transcribed for qualitative analysis. The transcribed interviews were analyzed for emerging qualitative themes. We analyzed 40 interviews obtained from 29 providers. Primary qualitative themes discovered included the following: drivers for requests for outside information; the importance of unexpected information; historical lab values as reference points; providing context when determining whether to admit or discharge a patient; the importance of information in refining disposition; improved confidence of provider; and changes in decisions for diagnostic imaging. ED providers are driven to use HIE when they're missing a known piece of information. This study finds two additional impacts not previously reported. First, providers sometimes find additional unanticipated useful information, supporting a workflow that lowers the threshold to request external information. Second, providers sometimes report utility when no changes to their existing plan are made as their confidence is increased based on external records. Our findings are concordant with previous studies in finding exchanged information is useful to provide context for interpreting lab results, making admission decisions, and prevents repeat diagnostic imaging.

  3. [Information exchange via internet--possibilities, limits, future].

    PubMed

    Schmiedl, S; Geishauser, M; Klöppel, M; Biemer, E

    1998-01-01

    Today, the exchange of information in the Internet is dominated by the WWW and e-mail. Discussion groups like mailing lists and newsgroups also permit communication in groups. Information retrieval becomes a crucial challenge in using the Internet. In the field of medicine, three more aspects are of special importance: privacy, legal requirements, and the necessity of transferring large amounts of data. For these problems, today's Internet doesn't provide a sufficient solution yet. Future developments will not only improve the existing services, but also lead to fundamental changes in the transfer technologies: Safer data transfer is to be ensured by new encrypting software together with the planned transfer protocol IPv6. Introducing the new transfer mode ATM will lead to better and resource saving transmission. Computer, telephone and TV networks will grow together, resulting in convergence of media.

  4. An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams.

    PubMed

    Tscholl, David W; Weiss, Mona; Kolbe, Michaela; Staender, Sven; Seifert, Burkhardt; Landert, Daniel; Grande, Bastian; Spahn, Donat R; Noethiger, Christoph B

    2015-10-01

    An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked). A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork. One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (P < 0.001), knowledge of critical information: 100% vs 90% (P < 0.001), perception of safety: 91% vs 84% (P < 0.001), perception of teamwork: 90% vs 86% (P = 0.028), and clinical performance: 93% vs 93% (P = 0.60). This study provides empirical evidence that the use of a preinduction checklist significantly improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams-all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork.

  5. Enabling Self-Monitoring Data Exchange in Participatory Medicine.

    PubMed

    Lopez-Campos, Guillermo; Ofoghi, Bahadorreza; Martin-Sanchez, Fernando

    2015-01-01

    The development of new methods, devices and apps for self-monitoring have enabled the extension of the application of these approaches for consumer health and research purposes. The increase in the number and variety of devices has generated a complex scenario where reporting guidelines and data exchange formats will be needed to ensure the quality of the information and the reproducibility of results of the experiments. Based on the Minimal Information for Self Monitoring Experiments (MISME) reporting guideline we have developed an XML format (MISME-ML) to facilitate data exchange for self monitoring experiments. We have also developed a sample instance to illustrate the concept and a Java MISME-ML validation tool. The implementation and adoption of these tools should contribute to the consolidation of a set of methods that ensure the reproducibility of self monitoring experiments for research purposes.

  6. Agents Based e-Commerce and Securing Exchanged Information

    NASA Astrophysics Data System (ADS)

    Al-Jaljouli, Raja; Abawajy, Jemal

    Mobile agents have been implemented in e-Commerce to search and filter information of interest from electronic markets. When the information is very sensitive and critical, it is important to develop a novel security protocol that can efficiently protect the information from malicious tampering as well as unauthorized disclosure or at least detect any malicious act of intruders. In this chapter, we describe robust security techniques that ensure a sound security of information gathered throughout agent’s itinerary against various security attacks, as well as truncation attacks. A sound security protocol is described, which implements the various security techniques that would jointly prevent or at least detect any malicious act of intruders. We reason about the soundness of the protocol usingSymbolic Trace Analyzer (STA), a formal verification tool that is based on symbolic techniques. We analyze the protocol in key configurations and show that it is free of flaws. We also show that the protocol fulfils the various security requirements of exchanged information in MAS, including data-integrity, data-confidentiality, data-authenticity, origin confidentiality and data non-repudiability.

  7. The Development of Community-Based Health Information Exchanges: A Comparative Assessment of Organizational Models

    ERIC Educational Resources Information Center

    Champagne, Tiffany

    2013-01-01

    The purpose of this dissertation research was to critically examine the development of community-based health information exchanges (HIEs) and to comparatively analyze the various models of exchanges in operation today nationally. Specifically this research sought to better understand several aspects of HIE: policy influences, organizational…

  8. Technology and Policy Challenges in the Adoption and Operation of Health Information Exchange Systems.

    PubMed

    Ji, Hyerim; Yoo, Sooyoung; Heo, Eun-Young; Hwang, Hee; Kim, Jeong-Whun

    2017-10-01

    This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals. In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work. Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field. The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

  9. Improving EHR Capabilities to Facilitate Stage 3 Meaningful Use Care Coordination Criteria.

    PubMed

    Cross, Dori A; Cohen, Genna R; Nong, Paige; Day, Anya-Victoria; Vibbert, Danielle; Naraharisetti, Ramya; Adler-Milstein, Julia

    Primary care practices have been limited in their ability to leverage electronic health records (EHRs) and health information exchange (HIE) to improve care coordination, but will soon be incentivized to do so under proposed Stage 3 meaningful use criteria. We use mixed methods to understand how primary care practices manage, share and reconcile electronic patient information across care settings, and identify innovations in EHR design to support enhanced care coordination. Opportunities identified by practices focused on availability and usability of features that facilitate (1) generation of customized summary of care records, (2) team-based care approaches, and (3) management of the increased volume of electronic information generated and exchanged during care transitions. More broadly, vendors and policymakers need to continue to work together to improve interoperability as the key to effective care coordination. If these EHR innovations were widespread, the value of meeting the proposed Stage 3 care coordination criteria would be substantially enhanced.

  10. Leader-member exchange relationships in health information management.

    PubMed

    Hunt, T J

    2014-01-01

    This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership.

  11. Using Interactive "Shiny" Applications to Facilitate Research-Informed Learning and Teaching

    ERIC Educational Resources Information Center

    Fawcett, Lee

    2018-01-01

    In this article we discuss our attempt to incorporate research-informed learning and teaching activities into a final year undergraduate Statistics course. We make use of the Shiny web-based application framework for R to develop "Shiny apps" designed to help facilitate student interaction with methods from recently published papers in…

  12. WaterML, an Information Standard for the Exchange of in-situ hydrological observations

    NASA Astrophysics Data System (ADS)

    Valentine, D.; Taylor, P.; Zaslavsky, I.

    2012-04-01

    The WaterML 2.0 Standards Working Group (SWG), working within the Open Geospatial Consortium (OGC) and in cooperation with the joint OGC-World Meteorological Organization (WMO) Hydrology Domain Working Group (HDWG), has developed an open standard for the exchange of water observation data; WaterML 2.0. The focus of the standard is time-series data, commonly generated from in-situ style monitoring. This is high value data for hydrological applications such as flood forecasting, environmental reporting and supporting hydrological infrastructure (e.g. dams, supply systems), which is commonly exchanged, but a lack of standards inhibits efficient reuse and automation. The process of developing WaterML required doing a harmonization analysis of existing standards to identify overlapping concepts and come to agreement on a harmonized definition. Generally the formats captured similar requirements, all with subtle differences, such as how time-series point metadata was handled. The in-progress standard WaterML 2.0 incorporates the semantics of the hydrologic information: location, procedure, and observations, and is implemented as an application schema of the Geography Markup Language version 3.2.1, making use of the OGC Observations & Measurements standards. WaterML2.0 is designed as an extensible schema to allow encoding of data to be used in a variety of exchange scenarios. Example areas of usage are: exchange of data for operational hydrological monitoring programs; supporting operation of infrastructure (e.g. dams, supply systems); cross-border exchange of observational data; release of data for public dissemination; enhancing disaster management through data exchange; and exchange in support of national reporting The first phase of WaterML2.0 focused on structural definitions allowing for the transfer of time-series, with less work on harmonization of vocabulary items such as quality codes. Vocabularies from various organizations tend to be specific and take time to

  13. Program of operation for the National Water Data Exchange (NAWDEX)

    USGS Publications Warehouse

    Edwards, Melvin D.

    1977-01-01

    The National Water Data Exchange (NAWDEX) has been established as a nationwide program directed at improving access to water and water-related data and disseminating information about the availability of these data throughout the entire water-resources community. NAWDEX is composed of a confederation of water-oriented organizations working together to facilitate the exchange of data and to improve the technology of data handling and transfer. This report is intended to provide guidelines to assure that all member organizations participate equally and that a climate of cooperation and open communication is established among participating members. (Woodard-USGS)

  14. 76 FR 8804 - 30-Day Notice of Proposed Information Collection: Form DS-3097, Exchange Visitor Program Annual...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... DS-3097, Exchange Visitor Program Annual Report, OMB Control Number 1405-0151 ACTION: Notice of... Department of State has submitted the following information collection request to the Office of Management... Information Collection: Exchange Visitor Program Annual Report. OMB Control Number: 1405-0151. Type of Request...

  15. "Practice Story Exchanges" and Their Creative Invitation to Informal Learning

    ERIC Educational Resources Information Center

    Willis, Peter

    2013-01-01

    This is a study of how members of a collaborative group interested in promoting convivial civilisation in human society took up exchanging practice stories--stories of doing something or seeing something done as examples of convivial backyard civilisation--in order tacitly to create an informal learning environment where practices of such a…

  16. 47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., may update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... must update the information submitted to NECA on July 31st pursuant to § 36.611(h) according to the schedule. Every non-rural telephone company must update the information submitted to NECA on July 31st...

  17. 47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., may update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... must update the information submitted to NECA on July 31st pursuant to § 36.611(h) according to the schedule. Every non-rural telephone company must update the information submitted to NECA on July 31st...

  18. Leader-Member Exchange Relationships in Health Information Management

    PubMed Central

    Hunt, T.J.

    2014-01-01

    This article seeks to raise awareness of the leader-member exchange (LMX) theory of leadership and its potential benefit to the health information management (HIM) profession. A literature review that was conducted identified a leadership challenge for HIM practitioners. The review also provides examples of leadership definitions, and potential benefits of LMX to HIM professionals in leading people and influencing leaders in their organizations. The LMX concept may be an avenue to investigate in preparing future and current HIM professionals for leadership. PMID:24808805

  19. A Global Information Exchange (GIE) Project in a Graduate Course

    ERIC Educational Resources Information Center

    Thirunarayanan, M. O.; Coccaro-Pons, Jennifer

    2016-01-01

    Graduate students who were enrolled in an introductory educational technology course that met face-to-face completed a Global Information Exchange (GIE) project. The goal of the project was to promote global awareness among the graduate students who were also classroom teachers, and by extension their K-12 students. The graduate students, who also…

  20. 77 FR 28543 - Nationwide Health Information Network: Conditions for Trusted Exchange

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-15

    ... expansion, electronic exchange has been governed by a patchwork of contractual relationships, procurement.... Consequently, this ad-hoc governance approach has led to asymmetries in the policies and technical standards... This request for information (RFI) reflects ONC's current thinking regarding the approach ONC should...

  1. 78 FR 13141 - 30-Day Notice of Proposed Information Collection: Exchange Visitor Program Participant Survey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-26

    ...: Exchange Visitor Program Participant Survey--Summer Work Travel ACTION: Notice of request for public... of Information Collection: Exchange Visitor Program Participant Survey--Summer Work Travel Program... participants in the Summer Work Travel category. Estimated Number of Respondents: 109,000. Estimated Number of...

  2. Health Information Exchange as a Complex and Adaptive Construct: Scoping Review.

    PubMed

    Akhlaq, Ather; Sheikh, Aziz; Pagliari, Claudia

    2017-01-25

    To understand how the concept of Health Information Exchange (HIE) has evolved over time.  Supplementary analysis of data from a systematic scoping review of definitions of HIE from 1900 to 2014, involving temporal analysis of underpinning themes. The search identified 268 unique definitions of HIE dating from 1957 onwards; 103 in scientific databases and 165 in Google. These contained consistent themes, representing the core concept of exchanging health information electronically, as well as fluid themes, reflecting the evolving policy, business, organisational and technological context of HIE (including the emergence of HIE as an organisational 'entity'). These are summarised graphically to show how the concept has evolved around the world with the passage of time.  The term HIE emerged in 1957 with the establishment of Occupational HIE, evolving through the 1990s with concepts such as electronic data interchange and mobile computing technology; then from 2006-10 largely aligning with the US Government's health information technology strategy and the creation of HIEs as organisational entities, alongside the broader interoperability imperative, and continuing to evolve today as part of a broader international agenda for sustainable, information-driven health systems. The concept of HIE is an evolving and adaptive one, reflecting the ongoing quest for integrated and interoperable information to improve the efficiency and effectiveness of health systems, in a changing technological and policy environment.

  3. International School Health Network: an informal network for advocacy and knowledge exchange.

    PubMed

    McCall, Douglas S; Rootman, Irving; Bayley, Dale

    2005-01-01

    In Canada, researchers, policy-makers and non-governmental organisations have re-conceptualized the school setting as being an ecological entity, linked to parallel ecologies of the homes and the community it serves. The school, public health and other systems that seek to deliver programs in that setting are open, loosely coupled and bureaucratic. This reconceived view of the school as a setting for health promotion leads to an emphasis on building organizational, system, professional and community capacity. One of the most effective ways of building such capacities when resources are scarce is to invest in a variety of formal and informal networks that can sustain themselves with little or no external resources. A number of recognised researchers from the health and education sectors have emphasized this systems-based approach and the need to build supportive, small-scale networks or learning communities. In recent health promotion research, networking at various levels, across sectors and within communities is viewed as a key strategy within new, more effective health promotion strategies. In education, the notion of networking for educational change has been described as "learning communities" for continuous school improvement. The authors suggest that this strategy of networking be used at the international level to address several global challenges: There is no single, convenient way to obtain basic information about the status and nature of national and state/provincial school health programs around the world. There is no global research agenda in school health promotion, despite the obvious value of sharing such research and knowledge. There is no global mechanism to facilitate the development of common or shared tools for surveillance of child/youth health and monitoring of school health policies and programs, despite the excellent work being done in individual countries and by the European Network of Health Promoting Schools. There is no international

  4. Best management practices to exchange information between the TOC and district offices.

    DOT National Transportation Integrated Search

    2009-06-01

    The objective of this study was to develop best management practices for exchange information between the Transportation Operation Center (TOC) and the district offices and regional traffic management centers. Data collected for this study included: ...

  5. NASA's experience in the international exchange of scientific and technical information in the aerospace field

    NASA Technical Reports Server (NTRS)

    Thibideau, Philip A.

    1989-01-01

    The early NASA international scientific and technical information (STI) exchange arrangements were usually detailed in correspondence with the librarians of the institutions involved. While this type of exchange, which involved only hardcopy (paper) products, grew to include some 220 organization in 43 countries, NASA's main focus shifted substantially to the STI relationship with the European Space Agency (ESA) which began in 1964. The NASA/ESA Tripartite Exchange Program, which now has more than 500 participants, provides more than 4,000 highly-relevant technical reports, fully processed, for the NASA produced 'Aerospace Database'. In turn, NASA provides an updated copy of this Database, known in Europe as the 'NASA File', for access, through ESA's Information Retrieval Service, by participating European organizations. Our experience in the evolving cooperation with ESA has established the 'model' for our more recent exchange agreements with Israel, Australia, Canada, and one under negotiation with Japan. The results of these agreements are made available to participating European organizations through the NASA File.

  6. Interactional Features of Repair Negotiation in NS-NNS Interaction on Two Task Types: Information Gap and Personal Information Exchange

    ERIC Educational Resources Information Center

    Kitajima, Ryu

    2013-01-01

    The studies in task-based approaches in second language acquisition claim that controlled and goal convergent tasks such as information gap tasks surpass open-ended conversations such as personal information exchange tasks for the development of the learner's interlanguage, in that the formers promote more repair negotiation. And yet, few studies…

  7. Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review.

    PubMed

    Pentland, Duncan; Forsyth, Kirsty; Maciver, Donald; Walsh, Mike; Murray, Richard; Irvine, Linda; Sikora, Simon

    2011-07-01

    This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  8. Developing the foundation for syndromic surveillance and health information exchange for yolo county, california.

    PubMed

    Chaudhary, Osama

    2012-01-01

    This report delineates Yolo County Health Department's process to ascertain its optimal methods of participation in syndromic surveillance and health information exchange. As a health department serving a county of just 200,000 residents, Yolo County Health Department needed to operate within strict financial constraints. Meaningful Use legislation enabled it to pursue both syndromic surveillance and health information exchange participation whilst complying with its budgetary restrictions. The Health Information Technology for Economic and Clinical Health (HITECH), a segment of the American Recovery and Reinvestment Act of 2009, has incentivized the 'Meaningful Use' of electronic health records (EHRs) by providing incentive reimbursements and non-compliance penalties. The Meaningful Use of EHRs is to take place over 3 Stages: Stage 1 has begun, Stage 2 is imminent, and Stage 3 is currently being discussed. Having been solicited by both health information exchange and syndromic surveillance options which were cost-prohibitive, Yolo County Health Department focused attention on BioSense 2.0, a Meaningul Use-ready and virtually free syndromic surveillance program developed by the Federal Centers for Disease Control and Prevention. In collaboration with Sacramento County Department of Health and Human Services, and with support from several other area counties, Yolo County Health Department submitted a Funding Opportunity application for BioSense 2.0 regional implementation. Through this collaboration, Yolo County Health Department has begun participating in the formative stages of the Sacramento Area Center for Advanced Biosurveillance (SAC-B). Via SAC-B, Yolo County Health Department will be able to participate in syndromic surveillance in the BioSense 2.0 program, and simultaneously expand its electronic health data sharing towards a more comprehensive health information exchange. LASTLY, OVER THE COURSE OF THESE PROJECTS, THREE OTHER METHODS OF PARTICIPATING IN

  9. 47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... non-rural telephone company must update the information submitted to NECA on July 31st pursuant to § 36.611 (h) according to the schedule. (1) Submit data covering the last nine months of the previous...

  10. 47 CFR 36.612 - Updating information submitted to the National Exchange Carrier Association.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... update the information submitted to the National Exchange Carrier Association (NECA) on July 31st... non-rural telephone company must update the information submitted to NECA on July 31st pursuant to § 36.611 (h) according to the schedule. (1) Submit data covering the last nine months of the previous...

  11. Retrospective: lessons learned from the Santa Barbara project and their implications for health information exchange.

    PubMed

    Frohlich, Jonah; Karp, Sam; Smith, Mark D; Sujansky, Walter

    2007-01-01

    Despite its closure in December 2006, the Santa Barbara County Care Data Exchange helped focus national attention on the value of health information exchange (HIE). This in turn led to the federal government's plan to establish regional health information organizations (RHIOs). During its existence, the project pioneered innovative approaches, including certification of health information technology vendors, a community-wide governance model, and deployment of a peer-to-peer technical model now in wider use. RHIO efforts will benefit from the project's lessons about the need for an incremental development approach, rigorous implementation processes, early attention to privacy and liability concerns, and planning for a sustainable business model.

  12. Facilitating Cross-Cultural Management Education through Global Faculty Exchanges

    ERIC Educational Resources Information Center

    Clinebell, Sharon K.; Kvedaraviciene, Ieva

    2013-01-01

    According to the AACSB International (Association to Advance Collegiate Schools of Business) (AACSB International, 2011), the next big transformational wave to hit business schools is globalization. Globalizing the faculty is one strategy for enhancing the globalization of business schools and using global faculty exchanges is one method to…

  13. Federal Arctic Research Information Workshop: Workshop proceedings

    NASA Astrophysics Data System (ADS)

    Geiselman, Joy; Mitchell, Kathryn L.

    1991-07-01

    The Federal Arctic Research Information Workshop was organized on behalf of the Inter-Agency Arctic Research Policy Committee (IARPC) in order to facilitate the exchange of information on Federal research to fulfill the intent of the Arctic Research and Policy Act of 1984. The workshop was held on 19-21 Mar. 1991, and representatives from Federal agencies were invited to report on recent accomplishments of research and related activities and to exchange information on current and future projects and programs. The various Federal agencies included the Departments of Agriculture, Commerce, Defense, Energy, Health and Human Services, Interior, and Transportation. The Environmental Protection Agency, NASA, National Science Foundation, and the Smithsonian Institution also presented papers.

  14. Open for business: private networks create a marketplace for health information exchange.

    PubMed

    Dimick, Chris

    2012-05-01

    Large health systems and their IT vendors are creating private information exchange networks at a time when federally funded state operations are gearing up for launch, Is there room for private and public offerings in the new HIE marketplace?

  15. Attention and Facilitation: Converging Information versus Inadvertent Reading in Stroop Task Performance

    ERIC Educational Resources Information Center

    Roelofs, Ardi

    2010-01-01

    Disagreement exists about whether color-word Stroop facilitation is caused by converging information (e.g., Cohen et al., 1990; Roelofs, 2003) or inadvertent reading (MacLeod & MacDonald, 2000). Four experiments tested between these hypotheses by examining Stroop effects on response time (RT) both within and between languages. Words cannot be…

  16. Health information exchange usage in emergency departments and clinics: the who, what, and why.

    PubMed

    Johnson, Kevin B; Unertl, Kim M; Chen, Qingxia; Lorenzi, Nancy M; Nian, Hui; Bailey, James; Frisse, Mark

    2011-01-01

    Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE. We used a mixed-method analysis, consisting of cross-sectional audit log data, semi-structured interviews, and direct observation in a sample of emergency departments and ambulatory safety net clinics actively using HIE. For each site, we measured overall usage trends, user logon statistics, and data types accessed by users. We also assessed reasons for use and outcomes of use. Overall, users accessed HIE for 6.8% of all encounters, with higher rates of access for repeat visits, for patients with comorbidities, for patients known to have data in the exchange, and at sites providing HIE access to both nurses and physicians. Discharge summaries and test reports were the most frequently accessed data in the exchange. Providers consistently noted retrieving additional history, preventing repeat tests, comparing new results to retrieved results, and avoiding hospitalizations as a consequence of HIE access. HIE use in emergency departments and ambulatory clinics was focused on patients where missing information was believed to be present in the exchange and was related to factors including the roles of people with access, the setting, and other site-specific issues that impacted the overall breadth of routine system use. These data should form an important foundation as other sites embark upon HIE implementation.

  17. The use of geospatial web services for exchanging utilities data

    NASA Astrophysics Data System (ADS)

    Kuczyńska, Joanna

    2013-04-01

    Geographic information technologies and related geo-information systems currently play an important role in the management of public administration in Poland. One of these tasks is to maintain and update Geodetic Evidence of Public Utilities (GESUT), part of the National Geodetic and Cartographic Resource, which contains an important for many institutions information of technical infrastructure. It requires an active exchange of data between the Geodesy and Cartography Documentation Centers and institutions, which administrate transmission lines. The administrator of public utilities, is legally obliged to provide information about utilities to GESUT. The aim of the research work was to develop a universal data exchange methodology, which can be implemented on a variety of hardware and software platforms. This methodology use Unified Modeling Language (UML), eXtensible Markup Language (XML), and Geography Markup Language (GML). The proposed methodology is based on the two different strategies: Model Driven Architecture (MDA) and Service Oriented Architecture (SOA). Used solutions are consistent with the INSPIRE Directive and ISO 19100 series standards for geographic information. On the basis of analysis of the input data structures, conceptual models were built for both databases. Models were written in the universal modeling language: UML. Combined model that defines a common data structure was also built. This model was transformed into developed for the exchange of geographic information GML standard. The structure of the document describing the data that may be exchanged is defined in the .xsd file. Network services were selected and implemented in the system designed for data exchange based on open source tools. Methodology was implemented and tested. Data in the agreed data structure and metadata were set up on the server. Data access was provided by geospatial network services: data searching possibilities by Catalog Service for the Web (CSW), data

  18. 75 FR 6237 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-08

    ... additional one hour after the decision making cut off time of 5:30 p.m. to submit a CEA to the various.... The Exchange will continue to enforce the 5:30 p.m. decision making requirement, while also allowing..., processing information with respect to, and facilitating transactions in securities, to remove impediments to...

  19. Text Exchange System

    NASA Technical Reports Server (NTRS)

    Snyder, W. V.; Hanson, R. J.

    1986-01-01

    Text Exchange System (TES) exchanges and maintains organized textual information including source code, documentation, data, and listings. System consists of two computer programs and definition of format for information storage. Comprehensive program used to create, read, and maintain TES files. TES developed to meet three goals: First, easy and efficient exchange of programs and other textual data between similar and dissimilar computer systems via magnetic tape. Second, provide transportable management system for textual information. Third, provide common user interface, over wide variety of computing systems, for all activities associated with text exchange.

  20. Use of Computer-Based Reference Services in Texas Information Exchange Libraries.

    ERIC Educational Resources Information Center

    Menges, Gary L.

    The Texas Information Exchange (TIE) is a state-wide library network organized in 1967 for the purpose of sharing resources among Texas libraries. Its membership includes 37 college and university libraries, the Texas State Library, and ten public libraries that serve as Major Resource Centers in the Texas State Library Communications Network. In…

  1. NASA's experience in the international exchange of scientific and technical information in the aerospace field

    NASA Technical Reports Server (NTRS)

    Thibideau, Philip A.

    1990-01-01

    The early NASA international scientific and technical information exchange arrangements were usually detailed in correspondence with the librarians of the institutions involved. While this type of exchange grew to include some 200 organizations in 43 countries, NASA's main focus shifted to the relationship with the European Space Agency (ESA), which began in 1964. The NASA/ESA Tripartite Exchange Program provides more than 4000 technical reports from the NASA-produced Aerospace Database. The experience in the evolving cooperation between NASA and ESA has established the model for more recent exchange agreements with Israel, Australia, and Canada. The results of these agreements are made available to participating European organizations through the NASA File.

  2. eHealth Networking Information Systems - The New Quality of Information Exchange.

    PubMed

    Messer-Misak, Karin; Reiter, Christoph

    2017-01-01

    The development and introduction of platforms that enable interdisciplinary exchange on current developments and projects in the area of eHealth have been stimulated by different authorities. The aim of this project was to develop a repository of eHealth projects that will make the wealth of eHealth projects visible and enable mutual learning through the sharing of experiences and good practice. The content of the database and search criteria as well as their categories were determined in close co-ordination and cooperation with stakeholders from the specialist areas. Technically, we used Java Server Faces (JSF) for the implementation of the frontend of the web application. Access to structured information on projects can support stakeholders to combining skills and knowledge residing in different places to create new solutions and approaches within a network of evolving competencies and opportunities. A regional database is the beginning of a structured collection and presentation of projects, which can then be incorporated into a broader context. The next step will be to unify this information transparently.

  3. Increments to chiral recognition facilitating enantiomer separations of chiral acids, bases, and ampholytes using Cinchona-based zwitterion exchanger chiral stationary phases.

    PubMed

    Wernisch, Stefanie; Pell, Reinhard; Lindner, Wolfgang

    2012-07-01

    The intramolecular distances of anion and cation exchanger sites of zwitterionic chiral stationary phases represent potential tuning sites for enantiomer selectivity. In this contribution, we investigate the influence of alkanesulfonic acid chain length and flexibility on enantiomer separations of chiral acids, bases, and amphoteric molecules for six Cinchona alkaloid-based chiral stationary phases in comparison with structurally related anion and cation exchangers. Employing polar-organic elution conditions, we observed an intramolecular counterion effect for acidic analytes which led to reduced retention times but did not impair enantiomer selectivities. Retention of amphoteric analytes is based on simultaneous double ion pairing of their charged functional groups with the acidic and basic sites of the zwitterionic selectors. A chiral center in the vicinity of the strong cation exchanger site is vital for chiral separations of bases. Sterically demanding side chains are beneficial for separations of free amino acids. Enantioseparations of free (un-derivatized) peptides were particularly successful in stationary phases with straight-chain alkanesulfonic acid sites, pointing to a beneficial influence of more flexible moieties. In addition, we observed pseudo-enantiomeric behavior of quinine and quinidine-derived chiral stationary phases facilitating reversal of elution orders for all analytes. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. A liver for a kidney: Ethics of trans-organ paired exchange.

    PubMed

    Samstein, Benjamin; de Melo-Martin, Inmaculada; Kapur, Sandip; Ratner, Lloyd; Emond, Jean

    2018-05-01

    Living donation provides important access to organ transplantation, which is the optimal therapy for patients with end-stage liver or kidney failure. Paired exchanges have facilitated thousands of kidney transplants and enable transplantation when the donor and recipient are incompatible. However, frequently willing and otherwise healthy donors have contraindications to the donation of the organ that their recipient needs. Trans-organ paired exchanges would enable a donor associated with a kidney recipient to donate a lobe of liver and a donor associated with a liver recipient to donate a kidney. This article explores some of the ethical concerns that trans-organ exchange might encounter including unbalanced donor risks, the validity of informed consent, and effects on deceased organ donation. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. 75 FR 25025 - 60-Day Notice of Proposed Information Collection: Exchange Programs Alumni Web Site Registration...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ...: Exchange Programs Alumni Web Site Registration, DS-7006 ACTION: Notice of request for public comments... the Paperwork Reduction Act of 1995. Title of Information Collection: Exchange Programs Alumni Web... techniques or other forms of technology. Abstract of proposed collection: The State Alumni Web site requires...

  6. Investigation of the Impact of Extracting and Exchanging Health Information by Using Internet and Social Networks.

    PubMed

    Pistolis, John; Zimeras, Stelios; Chardalias, Kostas; Roupa, Zoe; Fildisis, George; Diomidous, Marianna

    2016-06-01

    Social networks (1) have been embedded in our daily life for a long time. They constitute a powerful tool used nowadays for both searching and exchanging information on different issues by using Internet searching engines (Google, Bing, etc.) and Social Networks (Facebook, Twitter etc.). In this paper, are presented the results of a research based on the frequency and the type of the usage of the Internet and the Social Networks by the general public and the health professionals. The objectives of the research were focused on the investigation of the frequency of seeking and meticulously searching for health information in the social media by both individuals and health practitioners. The exchanging of information is a procedure that involves the issues of reliability and quality of information. In this research, by using advanced statistical techniques an effort is made to investigate the participant's profile in using social networks for searching and exchanging information on health issues. Based on the answers 93 % of the people, use the Internet to find information on health-subjects. Considering principal component analysis, the most important health subjects were nutrition (0.719 %), respiratory issues (0.79 %), cardiological issues (0.777%), psychological issues (0.667%) and total (73.8%). The research results, based on different statistical techniques revealed that the 61.2% of the males and 56.4% of the females intended to use the social networks for searching medical information. Based on the principal components analysis, the most important sources that the participants mentioned, were the use of the Internet and social networks for exchanging information on health issues. These sources proved to be of paramount importance to the participants of the study. The same holds for nursing, medical and administrative staff in hospitals.

  7. The Role of New Information Technologies in Facilitating Professional Reflective Practice across the Supervisory Triad.

    ERIC Educational Resources Information Center

    Hodder, Jacqueline; Carter, David

    This study investigated the role of new information management technologies in facilitating student teacher supervision across the supervisory triad of student teacher, cooperating teacher, and university supervisor. The study investigated how data routinely generated by teachers and stored within an Instructional Information Management System…

  8. 77 FR 70786 - Request for Information Regarding Health Care Quality for Exchanges

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-27

    ...] Request for Information Regarding Health Care Quality for Exchanges AGENCY: Centers for Medicare... Quality Improvement in Health Care (National Quality Strategy) to create national aims and priorities that would guide local, state, and national efforts to improve the quality of health care in the United...

  9. Global microbial commons: institutional challenges for the global exchange and distribution of microorganisms in the life sciences.

    PubMed

    Dedeurwaerdere, Tom

    2010-01-01

    Exchanges of microorganisms between culture collections, laboratories and researchers worldwide have historically occurred in an informal way. These informal exchanges have facilitated research activities, and, as a consequence, our knowledge and exploitation of microbial resources have advanced rapidly. During the last decades of the twentieth century, the increasing economic importance of biotechnology and the introduction of new legislation concerning the use of and access to biological resources has subjected exchanges of genetic resources to greater controls. Their access and distribution are more strictly regulated and, therefore, exchanges are becoming more and more formalized. This paper analyzes one of the main drivers of the movement toward more formal worldwide exchange regimes, which is increasing global interdependency of access to genetic resources. Its main finding is that formalization of exchange practices as such is not necessarily leading to more restrictive licensing conditions. The goal of further formalization and harmonization of institutional frameworks should therefore be to provide the broadest possible access to essential research materials (within the constraints set by biosecurity and quality management requirements), while maximizing the reciprocity benefits of access and exchange (which motivate the exchange practices to start with). (c) 2010 Elsevier Masson SAS. All rights reserved.

  10. Learn about the Environmental Information Exchange Network

    EPA Pesticide Factsheets

    States, territories, and tribes can partner with EPA to exchange standardized data to improve its quality, increase its availability, and integrate it better across different sources using connecting nodes, xml schema, and a data exchange template.

  11. 43 CFR 3905.10 - Oil shale lease exchanges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Oil shale lease exchanges. 3905.10 Section... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL SHALE MANAGEMENT-GENERAL Lease Exchanges § 3905.10 Oil shale lease exchanges. To facilitate the recovery of oil shale, the BLM may consider...

  12. 43 CFR 3905.10 - Oil shale lease exchanges.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Oil shale lease exchanges. 3905.10 Section... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL SHALE MANAGEMENT-GENERAL Lease Exchanges § 3905.10 Oil shale lease exchanges. To facilitate the recovery of oil shale, the BLM may consider...

  13. 43 CFR 3905.10 - Oil shale lease exchanges.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Oil shale lease exchanges. 3905.10 Section... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) OIL SHALE MANAGEMENT-GENERAL Lease Exchanges § 3905.10 Oil shale lease exchanges. To facilitate the recovery of oil shale, the BLM may consider...

  14. Secondary School Course Classification System: School Codes for the Exchange of Data (SCED). NCES 2007-341

    ERIC Educational Resources Information Center

    Bradby, Denise; Pedroso, Rosio; Rogers, Andy

    2007-01-01

    This handbook presents a taxonomy and course descriptions for secondary education. The system is intended to help schools and education agencies maintain longitudinal information about students' coursework in an efficient, standardized format that facilitates the exchange of records as students transfer from one school to another, or to…

  15. What facilitates the entry of persons with disabilities into South African companies?

    PubMed

    Wiggett-Barnard, Cindy; Swartz, Leslie

    2012-01-01

    The persistent high unemployment rate for persons with disabilities (PWDs) is a world-wide concern. The aim of this research was to identify facilitating factors for the entry of PWDs into the labour market. A survey of Human Resources (HR) managers in South African (SA) companies was conducted to explore what would assist with hiring PWDs. The sample population of companies was identified through the Marketline Library database and supplemented with all Johannesburg Stock Exchange companies. This rendered a population size of 348. A response rate of 25% (86) was achieved. Companies that have appointed PWDs in the past seem more willing to appoint PWDs in the future. Companies value information on accommodation (preparation of the environment and cost) and the impact of disability on job performance most. The use of specialised recruitment agencies, the development of targeted recruitment plans and staff sensitisation training, as well as internships are perceived as the best facilitators for the employment of PWDs. Rehabilitation practitioners can inform PWDs on the best strategies for approaching companies. Companies with facilitating factors already in place may also be more willing to employ PWDs and rehabilitation practitioners can target these companies as future employers of PWDs.

  16. A population ecology perspective on the functioning and future of health information organizations.

    PubMed

    Vest, Joshua R; Menachemi, Nir

    2017-11-01

    Increasingly, health care providers need to exchange information to meet policy expectations and business needs. A variety of health information organizations (HIOs) provide services to facilitate health information exchange (HIE). However, the future of these organizations is unclear. The aim of this study was to explore the environmental context, potential futures, and survivability of community HIOs, enterprise HIEs, and electronic health record vendor-mediated exchange using the population ecology theory. Qualitative interviews with 33 key informants representing each type of HIE organization were analyzed using template analysis. Community HIOs, enterprise HIEs, and electronic health record vendors exhibited a high degree of competition for resources, especially in the area of exchange infrastructure services. Competition resulted in closures in some areas. In response to environmental pressures, each organizational type was endeavoring to differentiate its services and unique use case, as well as pursing symbiotic relationships or attempting resource partitioning. HIOs compete for similar resources and are reacting to environmental pressures to better position themselves for continued survival and success. Our ecological research perspective helps move the discourse away from situation of a single exchange organization type toward a view of the broader dynamics and relationships of all organizations involved in facilitating HIE activities. HIOs are attempting to partition the environment and differentiate services. HIE options should not be construed as an "either/or" decision, but one where multiple and complementary participation may be required.

  17. Cryptographic Securities Exchanges

    NASA Astrophysics Data System (ADS)

    Thorpe, Christopher; Parkes, David C.

    While transparency in financial markets should enhance liquidity, its exploitation by unethical and parasitic traders discourages others from fully embracing disclosure of their own information. Traders exploit both the private information in upstairs markets used to trade large orders outside traditional exchanges and the public information present in exchanges' quoted limit order books. Using homomorphic cryptographic protocols, market designers can create "partially transparent" markets in which every matched trade is provably correct and only beneficial information is revealed. In a cryptographic securities exchange, market operators can hide information to prevent its exploitation, and still prove facts about the hidden information such as bid/ask spread or market depth.

  18. Kinesthetic information facilitates saccades towards proprioceptive-tactile targets.

    PubMed

    Voudouris, Dimitris; Goettker, Alexander; Mueller, Stefanie; Fiehler, Katja

    2016-05-01

    Saccades to somatosensory targets have longer latencies and are less accurate and precise than saccades to visual targets. Here we examined how different somatosensory information influences the planning and control of saccadic eye movements. Participants fixated a central cross and initiated a saccade as fast as possible in response to a tactile stimulus that was presented to either the index or the middle fingertip of their unseen left hand. In a static condition, the hand remained at a target location for the entire block of trials and the stimulus was presented at a fixed time after an auditory tone. Therefore, the target location was derived only from proprioceptive and tactile information. In a moving condition, the hand was first actively moved to the same target location and the stimulus was then presented immediately. Thus, in the moving condition additional kinesthetic information about the target location was available. We found shorter saccade latencies in the moving compared to the static condition, but no differences in accuracy or precision of saccadic endpoints. In a second experiment, we introduced variable delays after the auditory tone (static condition) or after the end of the hand movement (moving condition) in order to reduce the predictability of the moment of the stimulation and to allow more time to process the kinesthetic information. Again, we found shorter latencies in the moving compared to the static condition but no improvement in saccade accuracy or precision. In a third experiment, we showed that the shorter saccade latencies in the moving condition cannot be explained by the temporal proximity between the relevant event (auditory tone or end of hand movement) and the moment of the stimulation. Our findings suggest that kinesthetic information facilitates planning, but not control, of saccadic eye movements to proprioceptive-tactile targets. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. 43 CFR 3905.10 - Oil shale lease exchanges.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Oil shale lease exchanges. 3905.10 Section... MANAGEMENT, DEPARTMENT OF THE INTERIOR RANGE MANAGEMENT (4000) OIL SHALE MANAGEMENT-GENERAL Lease Exchanges § 3905.10 Oil shale lease exchanges. To facilitate the recovery of oil shale, the BLM may consider land...

  20. 76 FR 24956 - 30-Day Notice of Proposed Information Collection: Certificate of Eligibility for Exchange Visitor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-03

    ...: Certificate of Eligibility for Exchange Visitor (J-1) Status; Form DS-2019, OMB No. 1405-0119. ACTION: Notice... Management and Budget (OMB) for approval in accordance with the Paperwork Reduction Act of 1995. Title of Information Collection: Certificate of Eligibility for Exchange Visitor (J-1) Status OMB Control Number: 1405...

  1. The strategic use of standardized information exchange technology in a university health system.

    PubMed

    Cheng, Po-Hsun; Chen, Heng-Shuen; Lai, Feipei; Lai, Jin-Shin

    2010-04-01

    This article illustrates a Web-based health information system that is comprised of specific information exchange standards related to health information for healthcare services in National Taiwan University Health System. Through multidisciplinary teamwork, medical and informatics experts collaborated and studied on system scope definition, standard selection challenges, system implementation barriers, system management outcomes, and further expandability of other systems. After user requirement analysis and prototyping, from 2005 to 2008, an online clinical decision support system with multiple functions of reminding and information push was implemented. It was to replace its original legacy systems and serve among the main hospital and three branches of 180-200 clinics and 7,500-8,000 patient visits per day. To evaluate the effectiveness of this system, user surveys were performed, which revealed that the average score of user satisfaction increased from 2.80 to 3.18 on a 4-point scale. Among the items, especially e-learning for training service, courtesy communications for system requests, and courtesy communications for system operations showed statistically significant improvement. From this study, the authors concluded that standardized information exchange technologies can be used to create a brand new enterprise value and steadily obtain more competitive advantages for a prestige healthcare system.

  2. The next step in health data exchanges: trust and privacy in exchange networks.

    PubMed

    Gravely, Steve D; Whaley, Erin S

    2009-01-01

    The rapid development of health information exchanges (HIE), regional health information organizations (RHIO), the Nationwide Health Information Network (NHIN) and other data exchange platforms for health records creates complex and multifaceted challenges for protecting the privacy and security of health information. Often these issues are addressed in a contractual agreement between two parties seeking to exchange data. Until recently, this point-to-point approach has been acceptable because there were few operational HIEs or RHIOs that were ready, willing and able to actually exchange data. With the proliferation of HIEs and RHIOs that are either operational or on the cusp of being operational, the utility of point-to-point is diminishing. It is no longer efficient for a RHIO to negotiate a separate data exchange agreement with every one of its exchange partners. The evolving model for data exchange agreements is a multi-party trust agreement. This article will examine the crucial components of a multi-party trust agreement.

  3. Exploring Business Strategy in Health Information Exchange Organizations.

    PubMed

    Langabeer, James R; Champagne, Tiffany

    2016-01-01

    Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is

  4. Information exchange of the Atomic Energy Society of Japan with nuclear societies worldwide

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hori, Masao; Tomita, Yasushi

    2000-07-01

    The Atomic Energy Society of Japan (AESJ) exchanges information with nuclear societies worldwide by intersocietal communication through international councils of nuclear societies and through bilateral agreements between foreign societies and by such media as international meetings, publications, and Internet applications.

  5. 47 CFR 14.48 - Confidentiality of information produced or exchanged by the parties.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Confidentiality of information produced or exchanged by the parties. 14.48 Section 14.48 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping...

  6. 47 CFR 14.48 - Confidentiality of information produced or exchanged by the parties.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Confidentiality of information produced or exchanged by the parties. 14.48 Section 14.48 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping...

  7. 47 CFR 14.48 - Confidentiality of information produced or exchanged by the parties.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Confidentiality of information produced or exchanged by the parties. 14.48 Section 14.48 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL ACCESS TO ADVANCED COMMUNICATIONS SERVICES AND EQUIPMENT BY PEOPLE WITH DISABILITIES Recordkeeping...

  8. Sharing Service Resource Information for Application Integration in a Virtual Enterprise - Modeling the Communication Protocol for Exchanging Service Resource Information

    NASA Astrophysics Data System (ADS)

    Yamada, Hiroshi; Kawaguchi, Akira

    Grid computing and web service technologies enable us to use networked resources in a coordinated manner. An integrated service is made of individual services running on coordinated resources. In order to achieve such coordinated services autonomously, the initiator of a coordinated service needs to know detailed service resource information. This information ranges from static attributes like the IP address of the application server to highly dynamic ones like the CPU load. The most famous wide-area service discovery mechanism based on names is DNS. Its hierarchical tree organization and caching methods take advantage of the static information managed. However, in order to integrate business applications in a virtual enterprise, we need a discovery mechanism to search for the optimal resources based on the given a set of criteria (search keys). In this paper, we propose a communication protocol for exchanging service resource information among wide-area systems. We introduce the concept of the service domain that consists of service providers managed under the same management policy. This concept of the service domain is similar to that for autonomous systems (ASs). In each service domain, the service information provider manages the service resource information of service providers that exist in this service domain. The service resource information provider exchanges this information with other service resource information providers that belong to the different service domains. We also verified the protocol's behavior and effectiveness using a simulation model developed for proposed protocol.

  9. Obtaining providers' 'buy-in' and establishing effective means of information exchange will be critical to HITECH's success.

    PubMed

    Gold, Marsha R; McLaughlin, Catherine G; Devers, Kelly J; Berenson, Robert A; Bovbjerg, Randall R

    2012-03-01

    In enacting the Health Information Technology for Economic and Clinical Health (HITECH) provisions of the American Recovery and Reinvestment Act, Congress set ambitious goals for the nation to integrate information technology into health care delivery. The provisions called for the electronic exchange of health information and the adoption and meaningful use of health information technology in health care practices and hospitals. We examined the marketplace and regulatory forces that influence HITECH's success and identify outstanding challenges, some beyond the provisions' control. To reach HITECH's goals, providers and patients must be persuaded of the value of health information exchange and support its implementation. Privacy concerns and remaining technical challenges must also be overcome. Achieving HITECH's goals will require well-aligned incentives, both visionary and practical pursuit of exchange infrastructure, and realistic assumptions about how quickly such wholesale change can be accomplished. The use of metrics to show adoption proceeding at a reasonable pace, increased flow of data across parties, and evidence that care is improving, at least in areas with robust systems, will be essential to persuade stakeholders that the initiative is progressing well and warrants continued investment.

  10. U.S. Foundation Funding for Change in South Africa: An Update. South African Information Exchange Working Paper Number 10.

    ERIC Educational Resources Information Center

    Micou, Ann M.

    The South African Information Exchange (SAIE) has published an update of 35 existing organizations who are engaged in funding initiatives for specific areas of South African and United States educational exchange programs. One list is alphabetical by such program categories as: academic exchange, academic support, adult education, advocacy,…

  11. Improving Information Exchange in the Chicken Processing Sector Using Standardised Data Lists

    NASA Astrophysics Data System (ADS)

    Donnelly, Kathryn Anne-Marie; van der Roest, Joop; Höskuldsson, Stefán Torfi; Olsen, Petter; Karlsen, Kine Mari

    Research has shown that to improve electronic communication between companies, universal standardised data lists are necessary. In food supply chains in particular there is an increased need to exchange data in the wake of food safety incidents. Food supply chain companies already record numerous measurements, properties and parameters. These records are necessary for legal reasons, labelling, traceability, profiling desirable characteristics, showing compliance and for meeting customer requirements. Universal standards for name and content of each of these data elements would improve information exchange between buyers, sellers, authorities, consumers and other interested parties. A case study, carried out for the chicken sector, attempted to identify the most relevant parameters including which of these were already communicated to external bodies.

  12. The Earth Information Exchange: A Portal for Earth Science From the ESIP Federation

    NASA Astrophysics Data System (ADS)

    Wertz, R.; Hutchinson, C.; Hardin, D.

    2006-12-01

    The Federation of Earth Science Information Partners is a unique consortium of more than 90 organizations that collect, interpret and develop applications for remotely sensed Earth Observation Information. Included in the ESIP network are NASA, NOAA and USGS data centers, research universities, government research laboratories, supercomputer facilities, education resource providers, information technology innovators, nonprofit organizations and commercial enterprises. The consortium's work is dedicated to providing the most up-to-date, science-based information to researchers and decision-makers who are working to understand and address the environmental, economic and social challenges facing our planet. By increasing the use and usability of Earth observation data and linking it with decision-making tools, the Federation partners leverage the value of these important data resources for the betterment of society and our planet. To further the dissemination of Earth Science data, the Federation is developing the Earth Information Exchange (EIE). The EIE is a portal that will provide access to the vast information holdings of the members' organizations in one web-based location and will provides a robust marketplace in which the products and services needed to use and understand this information can be readily acquired. Since the Federation membership includes the federal government's Earth observing data centers, we believe that the impact of the EIE on Earth science research and education and environmental policy making will be profound. In the EIE, Earth observation data, products and services, are organized by the societal benefits categories defined by the international working group developing the Global Earth Observation System of Systems (GEOSS). The quality of the information is ensured in each of the Exchange's issue areas by maintaining working groups of issue area researchers and practitioners who serve as stewards for their respective communities. The

  13. Uncovering Hospitalists' Information Needs from Outside Healthcare Facilities in the Context of Health Information Exchange Using Association Rule Learning.

    PubMed

    Martinez, D A; Mora, E; Gemmani, M; Zayas-Castro, J

    2015-01-01

    Important barriers to health information exchange (HIE) adoption are clinical workflow disruptions and troubles with the system interface. Prior research suggests that HIE interfaces providing faster access to useful information may stimulate use and reduce barriers for adoption; however, little is known about informational needs of hospitalists. To study the association between patient health problems and the type of information requested from outside healthcare providers by hospitalists of a tertiary care hospital. We searched operational data associated with fax-based exchange of patient information (previous HIE implementation) between hospitalists of an internal medicine department in a large urban tertiary care hospital in Florida, and any other affiliated and unaffiliated healthcare provider. All hospitalizations from October 2011 to March 2014 were included in the search. Strong association rules between health problems and types of information requested during each hospitalization were discovered using Apriori algorithm, which were then validated by a team of hospitalists of the same department. Only 13.7% (2 089 out of 15 230) of the hospitalizations generated at least one request of patient information to other providers. The transactional data showed 20 strong association rules between specific health problems and types of information exist. Among the 20 rules, for example, abdominal pain, chest pain, and anaemia patients are highly likely to have medical records and outside imaging results requested. Other health conditions, prone to have records requested, were lower urinary tract infection and back pain patients. The presented list of strong co-occurrence of health problems and types of information requested by hospitalists from outside healthcare providers not only informs the implementation and design of HIE, but also helps to target future research on the impact of having access to outside information for specific patient cohorts. Our data

  14. Software Prototyping: A Case Report of Refining User Requirements for a Health Information Exchange Dashboard.

    PubMed

    Nelson, Scott D; Del Fiol, Guilherme; Hanseler, Haley; Crouch, Barbara Insley; Cummins, Mollie R

    2016-01-01

    Health information exchange (HIE) between Poison Control Centers (PCCs) and Emergency Departments (EDs) could improve care of poisoned patients. However, PCC information systems are not designed to facilitate HIE with EDs; therefore, we are developing specialized software to support HIE within the normal workflow of the PCC using user-centered design and rapid prototyping. To describe the design of an HIE dashboard and the refinement of user requirements through rapid prototyping. Using previously elicited user requirements, we designed low-fidelity sketches of designs on paper with iterative refinement. Next, we designed an interactive high-fidelity prototype and conducted scenario-based usability tests with end users. Users were asked to think aloud while accomplishing tasks related to a case vignette. After testing, the users provided feedback and evaluated the prototype using the System Usability Scale (SUS). Survey results from three users provided useful feedback that was then incorporated into the design. After achieving a stable design, we used the prototype itself as the specification for development of the actual software. Benefits of prototyping included having 1) subject-matter experts heavily involved with the design; 2) flexibility to make rapid changes, 3) the ability to minimize software development efforts early in the design stage; 4) rapid finalization of requirements; 5) early visualization of designs; 6) and a powerful vehicle for communication of the design to the programmers. Challenges included 1) time and effort to develop the prototypes and case scenarios; 2) no simulation of system performance; 3) not having all proposed functionality available in the final product; and 4) missing needed data elements in the PCC information system.

  15. Joint Atomic Information Exchange Group information management project. Briefing outlining functions and specifications of JAIEG automated information management system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Smith, M.G.

    1983-07-20

    The Joint Atomic Information Exchange Group (JAIEG) was formed in 1959. JAIEG's charter was to be the agent to determine the transmissibility of atomic information to foreign governments or regional defense organizations. JAIEG, operating from the joint policy direction of the Deputy Assistant Secretary for Military Application under the Department of Energy and of the Assistant to the Secretary of Defense for Atomic Energy under the Department of Defense, determines in a uniform and consistent manner the transmissibility of Restricted Data (RD) and Formerly Restricted Data (FRD). JAIEG also maintains records of all transmittal of such data, and maintains recordmore » copies of all information reviewed. This information exists only on paper and must be processed manually. JAIEG's work load has grown continuously with the size of its filing system. This has prompted an investigation of the potential benefits of automating JAIEG activities. Science Applications, Inc. (SAI) has studied JAIEG procedures and has identified several areas where JAIEG information processing activities can be automated to achieve greater system efficiency.« less

  16. Knowledge exchange and integrated services: experiences from an integrated community intellectual (learning) disability service for adults.

    PubMed

    Farrington, C; Clare, I C H; Holland, A J; Barrett, M; Oborn, E

    2015-03-01

    This paper examines knowledge exchange dynamics in a specialist integrated intellectual (learning) disability service, comprising specialist healthcare provision with social care commissioning and management, and considers their significance in terms of integrated service delivery. A qualitative study focusing on knowledge exchange and integrated services. Semi-structured interviews (n = 25) were conducted with members of an integrated intellectual disability service in England regarding their perceptions of knowledge exchange within the service and the way in which knowledge exchange impinges on the operation of the integrated service. Exchange of 'explicit' (codifiable) knowledge between health and care management components of the service is problematic because of a lack of integrated clinical governance and related factors such as IT and care record systems and office arrangements. Team meetings and workplace interactions allowed for informal exchange of explicit and 'tacit' (non-codifiable) knowledge, but presented challenges in terms of knowledge exchange completeness and sustainability. Knowledge exchange processes play an important role in the functioning of integrated services incorporating health and care management components. Managers need to ensure that knowledge exchange processes facilitate both explicit and tacit knowledge exchange and do not rely excessively on informal, 'ad hoc' interactions. Research on integrated services should take account of micro-scale knowledge exchange dynamics and relationships between social dynamics and physical factors. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  17. A distributed framework for health information exchange using smartphone technologies.

    PubMed

    Abdulnabi, Mohamed; Al-Haiqi, Ahmed; Kiah, M L M; Zaidan, A A; Zaidan, B B; Hussain, Muzammil

    2017-05-01

    Nationwide health information exchange (NHIE) continues to be a persistent concern for government agencies, despite the many efforts and the conceived benefits of sharing patient data among healthcare providers. Difficulties in ensuring global connectivity, interoperability, and concerns on security have always hampered the government from successfully deploying NHIE. By looking at NHIE from a fresh perspective and bearing in mind the pervasiveness and power of modern mobile platforms, this paper proposes a new approach to NHIE that builds on the notion of consumer-mediated HIE, albeit without the focus on central health record banks. With the growing acceptance of smartphones as reliable, indispensable, and most personal devices, we suggest to leverage the concept of mobile personal health records (PHRs installed on smartphones) to the next level. We envision mPHRs that take the form of distributed storage units for health information, under the full control and direct possession of patients, who can have ready access to their personal data whenever needed. However, for the actual exchange of data with health information systems managed by healthcare providers, the latter have to be interoperable with patient-carried mPHRs. Computer industry has long ago solved a similar problem of interoperability between peripheral devices and operating systems. We borrow from that solution the idea of providing special interfaces between mPHRs and provider systems. This interface enables the two entities to communicate with no change to either end. The design and operation of the proposed approach is explained. Additional pointers on potential implementations are provided, and issues that pertain to any solution to implement NHIE are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Real Time Alert System: A Disease Management System Leveraging Health Information Exchange

    PubMed Central

    Anand, Vibha; Sheley, Meena E.; Xu, Shawn; Downs, Stephen M.

    2012-01-01

    Background Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Methods: Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA’s performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Results: Our results show that RTA was successfully able to deliver “just in time” patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. Conclusions: We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient’s asthma related emergency room admission so further follow up can happen in near real time. PMID:23569648

  19. Real time alert system: a disease management system leveraging health information exchange.

    PubMed

    Anand, Vibha; Sheley, Meena E; Xu, Shawn; Downs, Stephen M

    2012-01-01

    Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA's performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Our results show that RTA was successfully able to deliver "just in time" patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient's asthma related emergency room admission so further follow up can happen in near real time.

  20. Weather Information Communications (WINCOMM) Project: Dissemination of Weather Information for the Reduction of Aviation Weather-Related Accident Causal Factors

    NASA Technical Reports Server (NTRS)

    Jarrell, Michael; Tanger, Thomas

    2004-01-01

    Weather Information Communications (WINCOMM) is part of the Weather Accident Prevention (WxAP) Project, which is part of the NASA's Aviation Safety and Security Program. The goals of WINCOMM are to facilitate the exchange of tactical and strategic weather information between air and ground. This viewgraph presentation provides information on data link decision factors, architectures, validation goals. WINCOMM is capable of providing en-route communication air-to-ground, ground-to-air, and air-to-air, even on international or intercontinental flights. The presentation also includes information on the capacity, cost, and development of data links.

  1. [Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

    PubMed

    Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

    2018-05-21

    The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  2. Integrating functional and anatomical information to facilitate cardiac resynchronization therapy.

    PubMed

    Tournoux, Francois B; Manzke, Robert; Chan, Raymond C; Solis, Jorge; Chen-Tournoux, Annabel A; Gérard, Olivier; Nandigam, Veena; Allain, Pascal; Reddy, Vivek; Ruskin, Jeremy N; Weyman, Arthur E; Picard, Michael H; Singh, Jagmeet P

    2007-08-01

    Multiple imaging modalities are required in patients receiving cardiac resynchronization therapy. We have developed a strategy to integrate echocardiographic and angiographic information to facilitate left ventricle (LV) lead position. Full three-dimensional LV-volumes (3DLVV) and dyssynchrony maps were acquired before and after resynchronization. At the time of device implantation, 3D-rotational coronary venous angiography was performed. 3D-models of the veins were then integrated with the pre- and post-3DLVV. In the case displayed, prior to implantation, the lateral wall was delayed compared to the septum. The LV lead was positioned into the vein over the most delayed region, resulting in improved LV synchrony.

  3. Beyond needs and expectations: identifying the barriers and facilitators to written medicine information provision and use in Australia

    PubMed Central

    Hamrosi, Kim K.; Aslani, Parisa; Raynor, David K.

    2012-01-01

    Abstract Purpose  This study aimed to explore peoples’ needs and expectations of written medicines information (WMI), and to determine the barriers and facilitators experienced or perceived in the context of WMI provision and use. Methods  We conducted eight focus groups with 62 participants over 6 weeks in late 2008 in New South Wales, Australia. Using a semi‐structured topic schedule and examples of WMI from Australia and other English‐speaking countries as a guide, we explored themes relevant to WMI, including participant experiences, attitudes, beliefs and expectations. Findings  Our findings suggest less than half had previously received WMI, with many unaware of its availability. Many, but not all, wanted WMI to supplement the spoken information they received but not to replace it, and it was predominantly used to facilitate informed choice, ascertain medicine suitability and review instructions. The current leaflets were considered technical and long, and a summary leaflet in addition to comprehensive information was favoured. Accurate side‐effect information was the most important element that participants desired. The most common barriers to effective WMI use were time constraints and patient confidence, with participants citing empowerment, time and health‐care professional (HCP)–patient relationships as important facilitators. Conclusion  The findings provide insight and understanding of peoples needs and expectations, and clarify issues associated with use and non‐use of WMI. Challenges include addressing the barriers, especially of time and HCP attitudes to drive changes to workplace practices, and learning from the facilitating factors to encourage awareness and accessibility to WMI as a tool to empower patients. PMID:22390211

  4. A conceptual model of Verbal Exchange Health Literacy

    PubMed Central

    Harrington, Kathleen F.; Valerio, Melissa A.

    2014-01-01

    Objective To address a gap in understanding of verbal exchange (oral and aural) health literacy by describing the systematic development of a verbal exchange health literacy (VEHL) definition and model which hypothesizes the role of VEHL in health outcomes. Methods Current health literacy and communication literature was systematically reviewed and combined with qualitative patient and provider data that were analyzed using a grounded theory approach. Results Analyses of current literature and formative data indicated the importance of verbal exchange in the clinical setting and revealed various factors associated with the patient-provider relationship and their characteristics that influence decision making and health behaviors. VEHL is defined as the ability to speak and listen that facilitates exchanging, understanding, and interpreting of health information for health-decision making, disease management and navigation of the healthcare system. A model depiction of mediating and influenced factors is presented. Conclusion A definition and model of VEHL is a step towards addressing a gap in health literacy knowledge and provides a foundation for examining the influence of VEHL on health outcomes. Practice Implications VEHL is an extension of current descriptions of health literacy and has implications for patient-provider communication and health decision making. PMID:24291145

  5. The value of health care information exchange and interoperability.

    PubMed

    Walker, Jan; Pan, Eric; Johnston, Douglas; Adler-Milstein, Julia; Bates, David W; Middleton, Blackford

    2005-01-01

    In this paper we assess the value of electronic health care information exchange and interoperability (HIEI) between providers (hospitals and medical group practices) and independent laboratories, radiology centers, pharmacies, payers, public health departments, and other providers. We have created an HIEI taxonomy and combined published evidence with expert opinion in a cost-benefit model. Fully standardized HIEI could yield a net value of dollar 77.8 billion per year once fully implemented. Nonstandardized HIEI offers smaller positive financial returns. The clinical impact of HIEI for which quantitative estimates cannot yet be made would likely add further value. A compelling business case exists for national implementation of fully standardized HIEI.

  6. DIMP: an interoperable solution for software integration and product data exchange

    NASA Astrophysics Data System (ADS)

    Wang, Xi Vincent; Xu, Xun William

    2012-08-01

    Today, globalisation has become one of the main trends of manufacturing business that has led to a world-wide decentralisation of resources amongst not only individual departments within one company but also business partners. However, despite the development and improvement in the last few decades, difficulties in information exchange and sharing still exist in heterogeneous applications environments. This article is divided into two parts. In the first part, related research work and integrating solutions are reviewed and discussed. The second part introduces a collaborative environment called distributed interoperable manufacturing platform, which is based on a module-based, service-oriented architecture (SOA). In the platform, the STEP-NC data model is used to facilitate data-exchange among heterogeneous CAD/CAM/CNC systems.

  7. What should we measure? Conceptualizing usage in health information exchange

    PubMed Central

    Jasperson, Jon

    2010-01-01

    Under the provisions of the Health Information Technology for Economic & Clinical Health act providers need to demonstrate their ‘meaningful use’ of electronic health record systems' health information exchange (HIE) capability. HIE usage is not a simple construct, but the choice of its measurement must attend to the users, context, and objectives of the system being examined. This review examined how usage is reported in the existing literature and also what conceptualizations of usage might best reflect the nature and objectives of HIE. While existing literature on HIE usage included a diverse set of measures, most were theoretically weak, did not attend to the interplay of measure, level of analysis and architectural strategy, and did not reflect how HIE usage affected the actual process of care. Attention to these issues will provide greater insight into the effects of previously inaccessible information on medical decision-making and the process of care. PMID:20442148

  8. A case report in health information exchange for inter-organizational patient transfers.

    PubMed

    Richardson, J E; Malhotra, S; Kaushal, R

    2014-01-01

    To provide a case report of barriers and promoters to implementing a health information exchange (HIE) tool that supports patient transfers between hospitals and skilled nursing facilities. A multi-disciplinary team conducted semi-structured telephone and in-person interviews in a purposive sample of HIE organizational informants and providers in New York City who implemented HIE to share patient transfer information. The researchers conducted grounded theory analysis to identify themes of barriers and promoters and took steps to improve the trustworthiness of the results including vetting from a knowledgeable study participant. Between May and October 2011, researchers recruited 18 participants: informaticians, healthcare administrators, software engineers, and providers from a skilled nursing facility. Subjects perceived the HIE tool's development a success in that it brought together stakeholders who had traditionally not partnered for informatics work, and that they could successfully share patient transfer information between a hospital and a skilled nursing facility. Perceived barriers included lack of hospital stakeholder buy-in and misalignment with clinical workflows that inhibited use of HIE-based patient transfer data. Participants described barriers and promoters in themes related to organizational, technical, and user-oriented issues. The investigation revealed that stakeholders could develop and implement health information technology that technically enables clinicians in both hospitals and skilled nursing facilities to exchange real-time information in support of patient transfers. User level barriers, particularly in the emergency department, should give pause to developers and implementers who plan to use HIE in support of patient transfers. Participants' experiences demonstrate how stakeholders may succeed in developing and piloting an electronic transfer form that relies on HIE to aggregate, communicate, and display relevant patient transfer

  9. Mediated Cross-Cultural Learning through Exchange in Higher Agricultural Education

    ERIC Educational Resources Information Center

    Wals, Arjen E. J.; Sriskandarajah, Nadarajah

    2010-01-01

    This article reports on the long-term impact of an intensive European Union-Australia student exchange programme that took place in 2004 and 2005. The programme, Learning through Exchange about Agriculture, Food Systems and Environment (LEAFSE), was designed to facilitate exchange of post-graduate students on a pilot scale between four…

  10. [A study on facilitators and inhibitors to the introduction of outsourcing in the hospital information systems in Korea].

    PubMed

    Choy, Soon; Shin, Hyeong-Sik; Choi, Inyoung; Kim, Sukil

    2007-01-01

    This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4-7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.

  11. An electronic specimen collection protocol schema (eSCPS). Document architecture for specimen management and the exchange of specimen collection protocols between biobanking information systems.

    PubMed

    Eminaga, O; Semjonow, A; Oezguer, E; Herden, J; Akbarov, I; Tok, A; Engelmann, U; Wille, S

    2014-01-01

    The integrity of collection protocols in biobanking is essential for a high-quality sample preparation process. However, there is not currently a well-defined universal method for integrating collection protocols in the biobanking information system (BIMS). Therefore, an electronic schema of the collection protocol that is based on Extensible Markup Language (XML) is required to maintain the integrity and enable the exchange of collection protocols. The development and implementation of an electronic specimen collection protocol schema (eSCPS) was performed at two institutions (Muenster and Cologne) in three stages. First, we analyzed the infrastructure that was already established at both the biorepository and the hospital information systems of these institutions and determined the requirements for the sufficient preparation of specimens and documentation. Second, we designed an eSCPS according to these requirements. Finally, a prospective study was conducted to implement and evaluate the novel schema in the current BIMS. We designed an eSCPS that provides all of the relevant information about collection protocols. Ten electronic collection protocols were generated using the supplementary Protocol Editor tool, and these protocols were successfully implemented in the existing BIMS. Moreover, an electronic list of collection protocols for the current studies being performed at each institution was included, new collection protocols were added, and the existing protocols were redesigned to be modifiable. The documentation time was significantly reduced after implementing the eSCPS (5 ± 2 min vs. 7 ± 3 min; p = 0.0002). The eSCPS improves the integrity and facilitates the exchange of specimen collection protocols in the existing open-source BIMS.

  12. 77 FR 50692 - Request for Information on Quality Measurement Enabled by Health IT-Extension Date for Responses

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    ... what types of quality measures should a combination of natural language processing and structured data... collection, analysis, processing, and its ability to facilitate information exchange among and across care...

  13. Observability and Estimation of Distributed Space Systems via Local Information-Exchange Networks

    NASA Technical Reports Server (NTRS)

    Rahmani, Amirreza; Mesbahi, Mehran; Fathpour, Nanaz; Hadaegh, Fred Y.

    2008-01-01

    In this work, we develop an approach to formation estimation by explicitly characterizing formation's system-theoretic attributes in terms of the underlying inter-spacecraft information-exchange network. In particular, we approach the formation observer/estimator design by relaxing the accessibility to the global state information by a centralized observer/estimator- and in turn- providing an analysis and synthesis framework for formation observers/estimators that rely on local measurements. The noveltyof our approach hinges upon the explicit examination of the underlying distributed spacecraft network in the realm of guidance, navigation, and control algorithmic analysis and design. The overarching goal of our general research program, some of whose results are reported in this paper, is the development of distributed spacecraft estimation algorithms that are scalable, modular, and robust to variations inthe topology and link characteristics of the formation information exchange network. In this work, we consider the observability of a spacecraft formation from a single observation node and utilize the agreement protocol as a mechanism for observing formation states from local measurements. Specifically, we show how the symmetry structure of the network, characterized in terms of its automorphism group, directly relates to the observability of the corresponding multi-agent system The ramification of this notion of observability over networks is then explored in the context of distributed formation estimation.

  14. Developing a Climate Change Boundary Organization: the Montana Adaptation Exchange

    NASA Astrophysics Data System (ADS)

    Whitlock, C. L.; Brooks, S.; Armstrong, T.; Bryan, B.

    2016-12-01

    Small-population large-area states like Montana are often challenged by a need to offer timely and relevant climate-change information that addresses diverse and widely dispersed stakeholder groups. In Montana, filling the gap between science and various types of decision-makers has motivated development of the first Montana Climate Assessment (MCA1), to be released in 2017 with a focus on climate-change impacts for agricultural, water and forestry sectors. To sustain and build on the MCA1 effort, we are also in the process of creating a Boundary Organization (defined by the National Academy of Sciences) called the Montana Adaptation Exchange (the Exchange); this entity will facilitate the flow of information across the boundaries between science, knowledge and implementation. In Montana, the Exchange brings scientists and practitioners together to seek solutions related to climate-change adaptation and other pressing environmental and social-economic challenges. The Montana Adaptation Exchange (1) is a collaborative partnership of members from the science and practitioner communities under a shared governance and participatory model; (2) presents research that has been vetted by the scientific community at large and represents the current state of knowledge; (3) allows for revision and expansion of assessments like the MCA; (4) communicates relevant, often technical, research and findings to a wide variety of resource managers and other stakeholders; (5) develops and maintains an extensive online database that organizes, regularly updates, and makes research data products readily available; and (6) offers an online portal and expert network of affiliated researchers and climate adaptation specialists to provide effective customer support. Boundary organizations, such as the Montana Adaptation Exchange, offer a scalable path to effectively move from "science to knowledge to action" while also allowing stakeholder needs to help inform research agendas.

  15. Facilitating access to information in large documents with an intelligent hypertext system

    NASA Technical Reports Server (NTRS)

    Mathe, Nathalie

    1993-01-01

    Retrieving specific information from large amounts of documentation is not an easy task. It could be facilitated if information relevant in the current problem solving context could be automatically supplied to the user. As a first step towards this goal, we have developed an intelligent hypertext system called CID (Computer Integrated Documentation) and tested it on the Space Station Freedom requirement documents. The CID system enables integration of various technical documents in a hypertext framework and includes an intelligent context-sensitive indexing and retrieval mechanism. This mechanism utilizes on-line user information requirements and relevance feedback either to reinforce current indexing in case of success or to generate new knowledge in case of failure. This allows the CID system to provide helpful responses, based on previous usage of the documentation, and to improve its performance over time.

  16. The essential role of reconfiguration capabilities in the implementation of HIV-related health information exchanges.

    PubMed

    Steward, Wayne T; Koester, Kimberly A; Collins, Shane P; Maiorana, Andre; Myers, Janet J

    2012-10-01

    To understand the dynamic capabilities that enabled the six demonstration projects of the Information Technology Networks of Care Initiative to implement health information exchanges (HIEs) tailored to their local HIV epidemics and regional care systems. We conducted 111 semi-structured interviews with project staff and information technology (IT) specialists associated with the demonstration projects, staff from community-based organizations and public health agencies collaborating in the design and implementation of the HIEs, and providers who used each HIE. The dynamic capability framework guided analyses. In the context of a HIE, the framework's components include information systems (the actual technological exchange systems and capacity to update them), absorptive capacity (the ability to implement an operating HIE), reconfiguration capacity (the ability to adapt workflows and clinical practices in response to a HIE), and organizational size and human resources (characteristics likely to affect a clinic's ability to respond). Across the projects, we found evidence for the importance of three dynamic capabilities: information systems, reconfiguration capacity, and organizational size and human resources. However, of these three, reconfiguration capacity was the most salient. Implementation outcomes at all six of the projects were shaped substantially by the degree of attention dedicated to reworking procedures and practices so that HIE usage became routine. Electronic information exchange offers the promise of improved coordination of care. However, implementation of HIEs goes beyond programing and hardware installation challenges, and requires close attention to the needs of the HIEs end-users. Providers need to discern value from a HIE because their active participation is essential to ensuring that clinic and agency practices and procedures are reconfigured to incorporate new systems into daily work processes. Copyright © 2012 Elsevier Ireland Ltd. All

  17. 47 CFR 1.731 - Confidentiality of information produced or exchanged by the parties.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... the party believes in good faith that the materials fall within an exemption to disclosure contained... Complaints § 1.731 Confidentiality of information produced or exchanged by the parties. (a) Any materials... confidentiality for such materials shall so indicate by clearly marking each page, or portion thereof, for which a...

  18. The next step towards making use meaningful: electronic information exchange and care coordination across clinicians and delivery sites.

    PubMed

    Graetz, Ilana; Reed, Mary; Shortell, Stephen M; Rundall, Thomas G; Bellows, Jim; Hsu, John

    2014-12-01

    Care for patients with chronic conditions often requires coordination between multiple physicians and delivery sites. Electronic Health Record (EHR) use could improve care quality and efficiency in part by facilitating care coordination. We examined the association between EHR use and clinician perceptions of care coordination for patients transferred across clinicians and delivery sites. Repeated surveys of primary care clinicians during the staggered implementation of an outpatient EHR (2005-2008), followed by an integrated inpatient EHR (2006-2010). We measured the association between EHR use stages (no use, outpatient EHR only, and integrated inpatient-outpatient EHR) and care coordination using logistic regression, adjusting for clinician characteristics, study year, and medical center. Adult primary care clinicians in a large Integrated Delivery System. Three measures of clinician-reported care coordination for patient care transferred across clinicians (eg, from specialist to primary care team) and across delivery sites (eg, from the hospital to outpatient care). Outpatient EHR use was associated with higher reports of access to complete and timely clinical information and higher agreement on clinician roles and responsibilities for patients transferred across clinicians, but not for patients transferred across delivery sites. Use of the integrated outpatient-inpatient EHR was associated with higher reports of access to timely and complete clinical information, clinician agreement on the patient's treatment plan for patients transferred across delivery sites, and with all coordination measures for patients transferred across clinicians. Use of an integrated EHR with health information exchange across delivery settings improved patient care coordination.

  19. Type 2 Diabetes Education and Support in a Virtual Environment: A Secondary Analysis of Synchronously Exchanged Social Interaction and Support

    PubMed Central

    2018-01-01

    Background Virtual environments (VEs) facilitate interaction and support among individuals with chronic illness, yet the characteristics of these VE interactions remain unknown. Objective The objective of this study was to describe social interaction and support among individuals with type 2 diabetes (T2D) who interacted in a VE. Methods Data included VE-mediated synchronous conversations and text-chat and asynchronous emails and discussion board posts from a study that facilitated interaction among individuals with T2D and diabetes educators (N=24) in 2 types of sessions: education and support. Results VE interactions consisted of communication techniques (how individuals interact in the VE), expressions of self-management (T2D-related topics), depth (personalization of topics), and breadth (number of topics discussed). Individuals exchanged support more often in the education (723/1170, 61.79%) than in the support (406/1170, 34.70%) sessions or outside session time (41/1170, 3.50%). Of all support exchanges, 535/1170 (45.73%) were informational, 377/1170 (32.22%) were emotional, 217/1170 (18.55%) were appraisal, and 41/1170 (3.50%) were instrumental. When comparing session types, education sessions predominately provided informational support (357/723, 49.4%), and the support sessions predominately provided emotional (159/406, 39.2%) and informational (159/406, 39.2%) support. Conclusions VE-mediated interactions resemble those in face-to-face environments, as individuals in VEs engage in bidirectional exchanges with others to obtain self-management education and support. Similar to face-to-face environments, individuals in the VE revealed personal information, sought information, and exchanged support during the moderated education sessions and unstructured support sessions. With this versatility, VEs are able to contribute substantially to support for those with diabetes and, very likely, other chronic diseases. PMID:29467118

  20. Model-independent plot of dynamic PET data facilitates data interpretation and model selection.

    PubMed

    Munk, Ole Lajord

    2012-02-21

    When testing new PET radiotracers or new applications of existing tracers, the blood-tissue exchange and the metabolism need to be examined. However, conventional plots of measured time-activity curves from dynamic PET do not reveal the inherent kinetic information. A novel model-independent volume-influx plot (vi-plot) was developed and validated. The new vi-plot shows the time course of the instantaneous distribution volume and the instantaneous influx rate. The vi-plot visualises physiological information that facilitates model selection and it reveals when a quasi-steady state is reached, which is a prerequisite for the use of the graphical analyses by Logan and Gjedde-Patlak. Both axes of the vi-plot have direct physiological interpretation, and the plot shows kinetic parameter in close agreement with estimates obtained by non-linear kinetic modelling. The vi-plot is equally useful for analyses of PET data based on a plasma input function or a reference region input function. The vi-plot is a model-independent and informative plot for data exploration that facilitates the selection of an appropriate method for data analysis. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. A Distributed Multi-Agent System for Collaborative Information Management and Learning

    NASA Technical Reports Server (NTRS)

    Chen, James R.; Wolfe, Shawn R.; Wragg, Stephen D.; Koga, Dennis (Technical Monitor)

    2000-01-01

    In this paper, we present DIAMS, a system of distributed, collaborative agents to help users access, manage, share and exchange information. A DIAMS personal agent helps its owner find information most relevant to current needs. It provides tools and utilities for users to manage their information repositories with dynamic organization and virtual views. Flexible hierarchical display is integrated with indexed query search-to support effective information access. Automatic indexing methods are employed to support user queries and communication between agents. Contents of a repository are kept in object-oriented storage to facilitate information sharing. Collaboration between users is aided by easy sharing utilities as well as automated information exchange. Matchmaker agents are designed to establish connections between users with similar interests and expertise. DIAMS agents provide needed services for users to share and learn information from one another on the World Wide Web.

  2. Repeated Diagnostic Imaging Studies in Ontario and the Impact of Health Information Exchange Systems.

    PubMed

    Welk, Blayne; Liu, Kuan; Al-Jaishi, Ahmed; McArthur, Eric; Jain, Arsh K; Ordon, Michael

    2016-01-01

    Health information exchange systems can link the results of diagnostic imaging tests across hospitals and geographic areas. One of the potential benefits of these systems is a reduction in imaging studies ordered by physicians who do not know about or have access to the previous imaging results. We used administrative data from Ontario, Canada (from the year 2013), to measure how frequently the same cross-sectional imaging study is repeated in a patient. Overall, 12.8% of the specified imaging tests were repeated within 90 days. An area of Southwestern Ontario with a health information exchange system for diagnostic imaging tests had a 13% lower rate of repeat cross-sectional imaging compared with the rest of the province (11.2 vs 12.8%, p < 0.01). The use of linked radiology systems may be able to reduce the number of repeated imaging tests and improve patient safety and hospital efficiency.

  3. The use of conferencing technologies to support drug policy group knowledge exchange processes: an action case approach.

    PubMed

    Househ, Mowafa Said; Kushniruk, Andre; Maclure, Malcolm; Carleton, Bruce; Cloutier-Fisher, Denise

    2011-04-01

    To describe experiences, lessons and the implications related to the use of conferencing technology to support three drug policy research groups within a three-year period, using the action case research method. An action case research field study was executed. Three different drug policy groups participated: research, educator, and decision-maker task groups. There were a total of 61 participants in the study. The study was conducted between 2004 and 2007. Each group used audio-teleconferencing, web-conferencing or both to support their knowledge exchange activities. Data were collected over three years and consisted of observation notes, interviews, and meeting transcripts. Content analysis was used to analyze the data using NIVIO qualitative data analysis software. The study found six key lessons regarding the impact of conferencing technologies on knowledge exchange within drug policy groups. We found that 1) groups adapt to technology to facilitate group communication, 2) web-conferencing communication is optimal under certain conditions, 3) audio conferencing is convenient, 4) web-conferencing forces group interactions to be "within text", 5) facilitation contributes to successful knowledge exchange, and 6) technology impacts information sharing. This study highlights lessons related to the use of conferencing technologies to support distant knowledge exchange within drug policy groups. Key lessons from this study can be used by drug policy groups to support successful knowledge exchange activities using conferencing technologies. 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Information Exchange Procedures for Major Research Universities; Technical Diary of the Major Research Universities' Pilot Test.

    ERIC Educational Resources Information Center

    Topping, Jim

    The applicability and validity of NCHEMS' Information Exchange Procedures (IEP) to major research universities are examined. IEP enables peer institutions to compare information about their resources. Evaluation of the IEP costing methods are examined in this document, which is intended as an appendix to "Evaluation of the IEP Costing…

  5. Administration of International Cooperative Education Exchanges. A Wingspread Consultation.

    ERIC Educational Resources Information Center

    Sprinkle, Robert M., Ed.

    Papers are presented from a consultation program on administration of international cooperative education exchanges. The papers provide the broad context in which the International Association for the Exchange of Students for Technical Experience/United States will develop programs and administrative services to facilitate international placements…

  6. 47 CFR 54.1306 - Updating Information Submitted to the National Exchange Carrier Association.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... incumbent local exchange carrier subject to § 54.1301(a) may update the information submitted to the... on a rolling year basis according to the schedule. (1) Submit data covering the last nine months of... September 30th of the existing year; (2) Submit data covering the last six months of the previous calendar...

  7. Proceedings of the Southern Regional Information Exchange Group Biennial Symposium on Forest Genetics

    Treesearch

    G. Sam Foster; Alex M. Diner; [Editors

    1994-01-01

    This volume is the proceedings of the 1992 Southern Regional Information Exchange Group (SRIEG) Biennial Symposium on Forest Genetics. The meeting was held in Huntsville, Alabama, USA on July 8-10, 1992 and was entitled, "Applications of Vegetative Propagation in Forestry." The nine papers were divided into three sets under the headings: "Tissue Culture...

  8. Regional freight information resources for market opportunities in the Great Lakes maritime transportation system : phase II.

    DOT National Transportation Integrated Search

    2009-11-01

    The Great Lakes Maritime Information Delivery System (GLMIDS) is designed to facilitate the acquisition, storage, management, analysis and exchange of data between analysts and decision-makers within maritime commerce. (See http://maritime.utoledo.ed...

  9. Enabling global exchange of groundwater data: GroundWaterML2 (GWML2)

    NASA Astrophysics Data System (ADS)

    Brodaric, Boyan; Boisvert, Eric; Chery, Laurence; Dahlhaus, Peter; Grellet, Sylvain; Kmoch, Alexander; Létourneau, François; Lucido, Jessica; Simons, Bruce; Wagner, Bernhard

    2018-05-01

    GWML2 is an international standard for the online exchange of groundwater data that addresses the problem of data heterogeneity. This problem makes groundwater data hard to find and use because the data are diversely structured and fragmented into numerous data silos. Overcoming data heterogeneity requires a common data format; however, until the development of GWML2, an appropriate international standard has been lacking. GWML2 represents key hydrogeological entities such as aquifers and water wells, as well as related measurements and groundwater flows. It is developed and tested by an international consortium of groundwater data providers from North America, Europe, and Australasia, and facilitates many forms of data exchange, information representation, and the development of online web portals and tools.

  10. Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges

    PubMed Central

    2012-01-01

    Background Concerns about the confidentiality of personal health information have been identified as a potential obstacle to implementation of Health Information Exchanges (HIEs). Considering the stigma and confidentiality issues historically associated with human immunodeficiency virus (HIV) disease, we examine how trust—in technology, processes, and people—influenced the acceptability of data sharing among stakeholders prior to implementation of six HIEs intended to improve HIV care in parts of the United States. Our analyses identify the kinds of concerns expressed by stakeholders about electronic data sharing and focus on the factors that ultimately facilitated acceptability of the new exchanges. Methods We conducted 549 surveys with patients and 66 semi-structured interviews with providers and other stakeholders prior to implementation of the HIEs to assess concerns about confidentiality in the electronic sharing of patient data. The patient quantitative data were analyzed using SAS 9.2 to yield sample descriptive statistics. The analysis of the qualitative interviews with providers and other stakeholders followed an open-coding process, and convergent and divergent perspectives emerging from those data were examined within and across the HIEs. Results We found widespread acceptability for electronic sharing of HIV-related patient data through HIEs. This acceptability appeared to be driven by growing comfort with information technologies, confidence in the security protocols utilized to protect data, trust in the providers and institutions who use the technologies, belief in the benefits to the patients, and awareness that electronic exchange represents an enhancement of data sharing already taking place by other means. HIE acceptability depended both on preexisting trust among patients, providers, and institutions and on building consensus and trust in the HIEs as part of preparation for implementation. The process of HIE development also resulted in

  11. Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges.

    PubMed

    Maiorana, Andre; Steward, Wayne T; Koester, Kimberly A; Pearson, Charles; Shade, Starley B; Chakravarty, Deepalika; Myers, Janet J

    2012-04-19

    Concerns about the confidentiality of personal health information have been identified as a potential obstacle to implementation of Health Information Exchanges (HIEs). Considering the stigma and confidentiality issues historically associated with human immunodeficiency virus (HIV) disease, we examine how trust-in technology, processes, and people-influenced the acceptability of data sharing among stakeholders prior to implementation of six HIEs intended to improve HIV care in parts of the United States. Our analyses identify the kinds of concerns expressed by stakeholders about electronic data sharing and focus on the factors that ultimately facilitated acceptability of the new exchanges. We conducted 549 surveys with patients and 66 semi-structured interviews with providers and other stakeholders prior to implementation of the HIEs to assess concerns about confidentiality in the electronic sharing of patient data. The patient quantitative data were analyzed using SAS 9.2 to yield sample descriptive statistics. The analysis of the qualitative interviews with providers and other stakeholders followed an open-coding process, and convergent and divergent perspectives emerging from those data were examined within and across the HIEs. We found widespread acceptability for electronic sharing of HIV-related patient data through HIEs. This acceptability appeared to be driven by growing comfort with information technologies, confidence in the security protocols utilized to protect data, trust in the providers and institutions who use the technologies, belief in the benefits to the patients, and awareness that electronic exchange represents an enhancement of data sharing already taking place by other means. HIE acceptability depended both on preexisting trust among patients, providers, and institutions and on building consensus and trust in the HIEs as part of preparation for implementation. The process of HIE development also resulted in forging shared vision among

  12. Practices, technologies, and usage of incident management and traveler information exchange and sharing in Texas

    DOT National Transportation Integrated Search

    2001-12-01

    In this report, researchers present a review of the practices and technologies being used in Texas for incident management and traveler information exchange and sharing. Through interviews and site visits, researchers assimilated data from the Dallas...

  13. Establishing and Enriching School-Community Ties in Small Schools. Small Schools Network Information Exchange Number 6.

    ERIC Educational Resources Information Center

    Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

    This information packet contains 14 articles reprinted from various books and journals. Establishing and enriching school-community ties in small schools is the theme for this "Information Exchange Packet," the sixth in a series developed for Small Schools Network members. The articles and their authors are: "Skills in Building Support for…

  14. Directly connected heat exchanger tube section and coolant-cooled structure

    DOEpatents

    Chainer, Timothy J.; Coico, Patrick A.; Graybill, David P.; Iyengar, Madhusudan K.; Kamath, Vinod; Kochuparambil, Bejoy J.; Schmidt, Roger R.; Steinke, Mark E.

    2015-09-15

    A method is provided for fabricating a cooling apparatus for cooling an electronics rack, which includes an air-to-liquid heat exchanger, one or more coolant-cooled structures, and a tube. The heat exchanger is associated with the electronics rack and disposed to cool air passing through the rack, includes a plurality of coolant-carrying tube sections, each tube section having a coolant inlet and outlet, one of which is coupled in fluid communication with a coolant loop to facilitate flow of coolant through the tube section. The coolant-cooled structure(s) is in thermal contact with an electronic component(s) of the rack, and facilitates transfer of heat from the component(s) to the coolant. The tube connects in fluid communication one coolant-cooled structure and the other of the coolant inlet or outlet of the one tube section, and facilitates flow of coolant directly between that coolant-carrying tube section of the heat exchanger and the coolant-cooled structure.

  15. Directly connected heat exchanger tube section and coolant-cooled structure

    DOEpatents

    Chainer, Timothy J; Coico, Patrick A; Graybill, David P; Iyengar, Madhusudan K; Kamath, Vinod; Kochuparambil, Bejoy J; Schmidt, Roger R; Steinke, Mark E

    2014-04-01

    A cooling apparatus for an electronics rack is provided which includes an air-to-liquid heat exchanger, one or more coolant-cooled structures and a tube. The heat exchanger, which is associated with the electronics rack and disposed to cool air passing through the rack, includes a plurality of distinct, coolant-carrying tube sections, each tube section having a coolant inlet and a coolant outlet, one of which is coupled in fluid communication with a coolant loop to facilitate flow of coolant through the tube section. The coolant-cooled structure(s) is in thermal contact with an electronic component(s) of the rack, and facilitates transfer of heat from the component(s) to the coolant. The tube connects in fluid communication one coolant-cooled structure and the other of the coolant inlet or outlet of the one tube section, and facilitates flow of coolant directly between that coolant-carrying tube section of the heat exchanger and the coolant-cooled structure.

  16. Linking attentional processes and conceptual problem solving: visual cues facilitate the automaticity of extracting relevant information from diagrams

    PubMed Central

    Rouinfar, Amy; Agra, Elise; Larson, Adam M.; Rebello, N. Sanjay; Loschky, Lester C.

    2014-01-01

    This study investigated links between visual attention processes and conceptual problem solving. This was done by overlaying visual cues on conceptual physics problem diagrams to direct participants’ attention to relevant areas to facilitate problem solving. Participants (N = 80) individually worked through four problem sets, each containing a diagram, while their eye movements were recorded. Each diagram contained regions that were relevant to solving the problem correctly and separate regions related to common incorrect responses. Problem sets contained an initial problem, six isomorphic training problems, and a transfer problem. The cued condition saw visual cues overlaid on the training problems. Participants’ verbal responses were used to determine their accuracy. This study produced two major findings. First, short duration visual cues which draw attention to solution-relevant information and aid in the organizing and integrating of it, facilitate both immediate problem solving and generalization of that ability to new problems. Thus, visual cues can facilitate re-representing a problem and overcoming impasse, enabling a correct solution. Importantly, these cueing effects on problem solving did not involve the solvers’ attention necessarily embodying the solution to the problem, but were instead caused by solvers attending to and integrating relevant information in the problems into a solution path. Second, this study demonstrates that when such cues are used across multiple problems, solvers can automatize the extraction of problem-relevant information extraction. These results suggest that low-level attentional selection processes provide a necessary gateway for relevant information to be used in problem solving, but are generally not sufficient for correct problem solving. Instead, factors that lead a solver to an impasse and to organize and integrate problem information also greatly facilitate arriving at correct solutions. PMID:25324804

  17. Linking attentional processes and conceptual problem solving: visual cues facilitate the automaticity of extracting relevant information from diagrams.

    PubMed

    Rouinfar, Amy; Agra, Elise; Larson, Adam M; Rebello, N Sanjay; Loschky, Lester C

    2014-01-01

    This study investigated links between visual attention processes and conceptual problem solving. This was done by overlaying visual cues on conceptual physics problem diagrams to direct participants' attention to relevant areas to facilitate problem solving. Participants (N = 80) individually worked through four problem sets, each containing a diagram, while their eye movements were recorded. Each diagram contained regions that were relevant to solving the problem correctly and separate regions related to common incorrect responses. Problem sets contained an initial problem, six isomorphic training problems, and a transfer problem. The cued condition saw visual cues overlaid on the training problems. Participants' verbal responses were used to determine their accuracy. This study produced two major findings. First, short duration visual cues which draw attention to solution-relevant information and aid in the organizing and integrating of it, facilitate both immediate problem solving and generalization of that ability to new problems. Thus, visual cues can facilitate re-representing a problem and overcoming impasse, enabling a correct solution. Importantly, these cueing effects on problem solving did not involve the solvers' attention necessarily embodying the solution to the problem, but were instead caused by solvers attending to and integrating relevant information in the problems into a solution path. Second, this study demonstrates that when such cues are used across multiple problems, solvers can automatize the extraction of problem-relevant information extraction. These results suggest that low-level attentional selection processes provide a necessary gateway for relevant information to be used in problem solving, but are generally not sufficient for correct problem solving. Instead, factors that lead a solver to an impasse and to organize and integrate problem information also greatly facilitate arriving at correct solutions.

  18. Geographical distribution of patients visiting a health information exchange in New York City

    PubMed Central

    Onyile, Arit; Vaidya, Sandip R; Kuperman, Gilad; Shapiro, Jason S

    2013-01-01

    Objective For a health information exchange (HIE) organization to succeed in any given region, it is important to understand the optimal catchment area for the patient population it is serving. The objective of this analysis was to understand the geographical distribution of the patients being served by one HIE organization in New York City (NYC). Materials and Methods Patient demographic data were obtained from the New York Clinical Information Exchange (NYCLIX), a regional health information organization (RHIO) representing most of the major medical centers in the borough of Manhattan in NYC. Patients’ home address zip codes were used to create a research dataset with aggregate counts of patients by US county and international standards organization country. Times Square was designated as the geographical center point of the RHIO for distance calculations. Results Most patients (87.7%) live within a 30 mile radius from Times Square and there was a precipitous drop off of patients visiting RHIO-affiliated facilities at distances greater than 100 miles. 43.6% of patients visiting NYCLIX facilities were from the other NYC boroughs rather than from Manhattan itself (31.9%). Discussion Most patients who seek care at members of NYCLIX live within a well-defined area and a clear decrease in patients visiting NYCLIX sites with distance was identified. Understanding the geographical distribution of patients visiting the large medical centers in the RHIO can inform the RHIO's planning as it looks to add new participant organizations in the surrounding geographical area. PMID:23104049

  19. Measuring the impact of a health information exchange intervention on provider-based notifiable disease reporting using mixed methods: a study protocol.

    PubMed

    Dixon, Brian E; Grannis, Shaun J; Revere, Debra

    2013-10-30

    Health information exchange (HIE) is the electronic sharing of data and information between clinical care and public health entities. Previous research has shown that using HIE to electronically report laboratory results to public health can improve surveillance practice, yet there has been little utilization of HIE for improving provider-based disease reporting. This article describes a study protocol that uses mixed methods to evaluate an intervention to electronically pre-populate provider-based notifiable disease case reporting forms with clinical, laboratory and patient data available through an operational HIE. The evaluation seeks to: (1) identify barriers and facilitators to implementation, adoption and utilization of the intervention; (2) measure impacts on workflow, provider awareness, and end-user satisfaction; and (3) describe the contextual factors that impact the effectiveness of the intervention within heterogeneous clinical settings and the HIE. The intervention will be implemented over a staggered schedule in one of the largest and oldest HIE infrastructures in the U.S., the Indiana Network for Patient Care. Evaluation will be conducted utilizing a concurrent design mixed methods framework in which qualitative methods are embedded within the quantitative methods. Quantitative data will include reporting rates, timeliness and burden and report completeness and accuracy, analyzed using interrupted time-series and other pre-post comparisons. Qualitative data regarding pre-post provider perceptions of report completeness, accuracy, and timeliness, reporting burden, data quality, benefits, utility, adoption, utilization and impact on reporting workflow will be collected using semi-structured interviews and open-ended survey items. Data will be triangulated to find convergence or agreement by cross-validating results to produce a contextualized portrayal of the facilitators and barriers to implementation and use of the intervention. By applying mixed

  20. Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.

    PubMed

    Swain, Matthew J; Kharrazi, Hadi

    2015-12-01

    Unplanned 30-day hospital readmission account for roughly $17 billion in annual Medicare spending. Many factors contribute to unplanned hospital readmissions and multiple models have been developed over the years to predict them. Most researchers have used insurance claims or administrative data to train and operationalize their Readmission Risk Prediction Models (RRPMs). Some RRPM developers have also used electronic health records data; however, using health informatics exchange data has been uncommon among such predictive models and can be beneficial in its ability to provide real-time alerts to providers at the point of care. We conducted a semi-systematic review of readmission predictive factors published prior to March 2013. Then, we extracted and merged all significant variables listed in those articles for RRPMs. Finally, we matched these variables with common HL7 messages transmitted by a sample of health information exchange organizations (HIO). The semi-systematic review resulted in identification of 32 articles and 297 predictive variables. The mapping of these variables with common HL7 segments resulted in an 89.2% total coverage, with the DG1 (diagnosis) segment having the highest coverage of 39.4%. The PID (patient identification) and OBX (observation results) segments cover 13.9% and 9.1% of the variables. Evaluating the same coverage in three sample HIOs showed data incompleteness. HIOs can utilize HL7 messages to develop unique RRPMs for their stakeholders; however, data completeness of exchanged messages should meet certain thresholds. If data quality standards are met by stakeholders, HIOs would be able to provide real-time RRPMs that not only predict intra-hospital readmissions but also inter-hospital cases. A RRPM derived using HIO data exchanged through may prove to be a useful method to prevent unplanned hospital readmissions. In order for the RRPM derived from HIO data to be effective, hospitals must actively exchange clinical information

  1. South Africans Speak: Discussion Forum Presentations 1987-1989. South African Information Exchange Working Paper Number 12.

    ERIC Educational Resources Information Center

    Micou, Ann M., Ed.

    Ten informal papers given at Discussion Forums to U.S. groups are provided which address current South African related issues as they touch upon the South African Information Exchange (SAIE) initiative. Papers have the following titles and authors: "Is There Space for American Involvement in South African Education?" (Merlyn C. Mehl);…

  2. VHA mental health information system: applying health information technology to monitor and facilitate implementation of VHA Uniform Mental Health Services Handbook requirements.

    PubMed

    Trafton, Jodie A; Greenberg, Greg; Harris, Alex H S; Tavakoli, Sara; Kearney, Lisa; McCarthy, John; Blow, Fredric; Hoff, Rani; Schohn, Mary

    2013-03-01

    To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facilitation-based quality improvement programs led by the VHA Mental Health Operations. To support these programs, tailored site-specific reports were generated. Metric development required close collaboration between program evaluators, policy makers and clinical leadership, and consideration of policy language and intent. Electronic reports supporting different purposes required distinct formatting and presentation features, despite their having similar general goals and using the same metrics. Health information technology can facilitate mental health policy implementation but must be integrated into a process of consensus building and close collaboration with policy makers, evaluators, and practitioners.

  3. Emergency Physicians’ Perceptions of Health Information Exchange

    PubMed Central

    Shapiro, Jason S.; Kannry, Joseph; Kushniruk, Andre W.; Kuperman, Gilad

    2007-01-01

    Background Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians’ current perceptions of HIE. Objectives This study sought to assess emergency physicians’ perceived needs and knowledge of HIE. Methods A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City. Results The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high—85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies. Conclusion There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region. PMID:17712079

  4. Emergency physicians' perceptions of health information exchange.

    PubMed

    Shapiro, Jason S; Kannry, Joseph; Kushniruk, Andre W; Kuperman, Gilad

    2007-01-01

    Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians' current perceptions of HIE. This study sought to assess emergency physicians' perceived needs and knowledge of HIE. A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City. The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high--85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies. There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region.

  5. Verifier-based three-party authentication schemes using extended chaotic maps for data exchange in telecare medicine information systems.

    PubMed

    Lee, Tian-Fu

    2014-12-01

    Telecare medicine information systems provide a communicating platform for accessing remote medical resources through public networks, and help health care workers and medical personnel to rapidly making correct clinical decisions and treatments. An authentication scheme for data exchange in telecare medicine information systems enables legal users in hospitals and medical institutes to establish a secure channel and exchange electronic medical records or electronic health records securely and efficiently. This investigation develops an efficient and secure verified-based three-party authentication scheme by using extended chaotic maps for data exchange in telecare medicine information systems. The proposed scheme does not require server's public keys and avoids time-consuming modular exponential computations and scalar multiplications on elliptic curve used in previous related approaches. Additionally, the proposed scheme is proven secure in the random oracle model, and realizes the lower bounds of messages and rounds in communications. Compared to related verified-based approaches, the proposed scheme not only possesses higher security, but also has lower computational cost and fewer transmissions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Cuticular gas exchange by Antarctic sea spiders.

    PubMed

    Lane, Steven J; Moran, Amy L; Shishido, Caitlin M; Tobalske, Bret W; Woods, H Arthur

    2018-04-25

    Many marine organisms and life stages lack specialized respiratory structures, like gills, and rely instead on cutaneous respiration, which they facilitate by having thin integuments. This respiratory mode may limit body size, especially if the integument also functions in support or locomotion. Pycnogonids, or sea spiders, are marine arthropods that lack gills and rely on cutaneous respiration but still grow to large sizes. Their cuticle contains pores, which may play a role in gas exchange. Here, we examined alternative paths of gas exchange in sea spiders: (1) oxygen diffuses across pores in the cuticle, a common mechanism in terrestrial eggshells, (2) oxygen diffuses directly across the cuticle, a common mechanism in small aquatic insects, or (3) oxygen diffuses across both pores and cuticle. We examined these possibilities by modeling diffusive oxygen fluxes across all pores in the body of sea spiders and asking whether those fluxes differed from measured metabolic rates. We estimated fluxes across pores using Fick's law parameterized with measurements of pore morphology and oxygen gradients. Modeled oxygen fluxes through pores closely matched oxygen consumption across a range of body sizes, which means the pores facilitate oxygen diffusion. Furthermore, pore volume scaled hypermetrically with body size, which helps larger species facilitate greater diffusive oxygen fluxes across their cuticle. This likely presents a functional trade-off between gas exchange and structural support, in which the cuticle must be thick enough to prevent buckling due to external forces but porous enough to allow sufficient gas exchange. © 2018. Published by The Company of Biologists Ltd.

  7. The NIH 3D Print Exchange: A Public Resource for Bioscientific and Biomedical 3D Prints.

    PubMed

    Coakley, Meghan F; Hurt, Darrell E; Weber, Nick; Mtingwa, Makazi; Fincher, Erin C; Alekseyev, Vsevelod; Chen, David T; Yun, Alvin; Gizaw, Metasebia; Swan, Jeremy; Yoo, Terry S; Huyen, Yentram

    2014-09-01

    The National Institutes of Health (NIH) has launched the NIH 3D Print Exchange, an online portal for discovering and creating bioscientifically relevant 3D models suitable for 3D printing, to provide both researchers and educators with a trusted source to discover accurate and informative models. There are a number of online resources for 3D prints, but there is a paucity of scientific models, and the expertise required to generate and validate such models remains a barrier. The NIH 3D Print Exchange fills this gap by providing novel, web-based tools that empower users with the ability to create ready-to-print 3D files from molecular structure data, microscopy image stacks, and computed tomography scan data. The NIH 3D Print Exchange facilitates open data sharing in a community-driven environment, and also includes various interactive features, as well as information and tutorials on 3D modeling software. As the first government-sponsored website dedicated to 3D printing, the NIH 3D Print Exchange is an important step forward to bringing 3D printing to the mainstream for scientific research and education.

  8. A qualitative analysis of information sharing for children with medical complexity within and across health care organizations.

    PubMed

    Quigley, Laura; Lacombe-Duncan, Ashley; Adams, Sherri; Hepburn, Charlotte Moore; Cohen, Eyal

    2014-06-30

    Children with medical complexity (CMC) are characterized by substantial family-identified service needs, chronic and severe conditions, functional limitations, and high health care use. Information exchange is critically important in high quality care of complex patients at high risk for poor care coordination. Written care plans for CMC are an excellent test case for how well information sharing is currently occurring. The purpose of this study was to identify the barriers to and facilitators of information sharing for CMC across providers, care settings, and families. A qualitative study design with data analysis informed by a grounded theory approach was utilized. Two independent coders conducted secondary analysis of interviews with parents of CMC and health care professionals involved in the care of CMC, collected from two studies of healthcare service delivery for this population. Additional interviews were conducted with privacy officers of associated organizations to supplement these data. Emerging themes related to barriers and facilitators to information sharing were identified by the two coders and the research team, and a theory of facilitators and barriers to information exchange evolved. Barriers to information sharing were related to one of three major themes; 1) the lack of an integrated, accessible, secure platform on which summative health care information is stored, 2) fragmentation of the current health system, and 3) the lack of consistent policies, standards, and organizational priorities across organizations for information sharing. Facilitators of information sharing were related to improving accessibility to a common document, expanding the use of technology, and improving upon a structured communication plan. Findings informed a model of how various barriers to information sharing interact to prevent optimal information sharing both within and across organizations and how the use of technology to improve communication and access to

  9. Falling short: how state laws can address health information exchange barriers and enablers.

    PubMed

    Schmit, Cason D; Wetter, Sarah A; Kash, Bita A

    2018-06-01

    Research on the implementation of health information exchange (HIE) organizations has identified both positive and negative effects of laws relating to governance, incentives, mandates, sustainability, stakeholder participation, patient engagement, privacy, confidentiality, and security. We fill a substantial research gap by describing whether comprehensive state and territorial HIE legal frameworks address identified legal facilitators and barriers. We used the Westlaw database to identify state and territorial laws relating to HIEs in effect on June 7, 2016 (53 jurisdictions). We blind-coded all laws and addressed coding discrepancies in peer-review meetings. We recorded a consensus code for each law in a master database. We compared 20 HIE legal attributes with identified barriers to and enablers of HIE activity in the literature. Forty-two states, the District of Columbia, and 2 territories have laws relating to HIEs. On average, jurisdictions address 8.32 of the 20 criteria selected in statutes and regulations. Twenty jurisdictions unambiguously address ≤5 criteria in statutes and regulations. None of the significant legal criteria are unambiguously addressed in >60% of the 53 jurisdictions. Laws can be barriers to or enablers of HIEs. However, jurisdictions are not addressing many significant issues identified by researchers. Consequently, there is a substantial risk that existing legal frameworks are not adequately supporting HIEs. The current evidence base is insufficient for comparative assessments or impact rankings of the various factors. However, the detailed Centers for Disease Control and Prevention dataset of HIE laws could enable investigations into the types of laws that promote or impede HIEs.

  10. Knowledge exchange in the UK CLAHRCs.

    PubMed

    Racko, Girts

    2018-04-09

    Purpose The purpose of this paper is to examine how knowledge exchange between academics and clinicians in Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) is influenced by their social position based on their symbolic and social capitals, that is, their personal professional status and connections to high-status professional peers, knowledge brokers, and unfamiliar professional peers. Design/methodology/approach Using an online survey, the author triangulates the cross-sectional measurement of the effects of academic and clinicians' social position in the initial and later phases of CLAHRCs with the longitudinal measurement of these effects over a two-year period. Findings First, academics and clinicians with a higher personal professional status are more likely to develop joint networks and decision making both in the early and later phases of a CLAHRC. Second, academics and clinicians who are more connected to higher status occupational peers are more likely to develop joint networks in the early phase of a knowledge exchange partnership but are less likely to become engaged in joint networks over time. Third, involvement of knowledge brokers in the networks of academics and clinicians is likely to facilitate their inter-professional networking only in the later partnership phase. Practical implications Academics and clinicians' capitals have a distinctive influence on knowledge exchange in the early and later phases of CLAHRCs and on a change in knowledge exchange over a two-year period. Originality/value Prior research on CLAHRCs has examined how knowledge exchange between academics and clinicians can be encouraged by the creation of shared governance mechanisms. The author advances this research by highlighting the role of their social position in facilitating knowledge exchange.

  11. Towards an optimal flow: Density-of-states-informed replica-exchange simulations

    DOE PAGES

    Vogel, Thomas; Perez, Danny

    2015-11-05

    Here we learn that replica exchange (RE) is one of the most popular enhanced-sampling simulations technique in use today. Despite widespread successes, RE simulations can sometimes fail to converge in practical amounts of time, e.g., when sampling around phase transitions, or when a few hard-to-find configurations dominate the statistical averages. We introduce a generalized RE scheme, density-of-states-informed RE, that addresses some of these challenges. The key feature of our approach is to inform the simulation with readily available, but commonly unused, information on the density of states of the system as the RE simulation proceeds. This enables two improvements, namely,more » the introduction of resampling moves that actively move the system towards equilibrium and the continual adaptation of the optimal temperature set. As a consequence of these two innovations, we show that the configuration flow in temperature space is optimized and that the overall convergence of RE simulations can be dramatically accelerated.« less

  12. The Role of Cooperation and Information Exchange in Transnational River Basins: the Zambezi River case

    NASA Astrophysics Data System (ADS)

    Castelletti, A.; Giuliani, M.; Soncini-Sessa, R.

    2012-12-01

    The presence of multiple, institutionally independent but physically interconnected decision-makers is a distinctive features of many water resources systems, especially of transnational river basins. The adoption of a centralized approach to study the optimal operation of these systems, as mostly done in the water resources literature, is conceptually interesting to quantify the best achievable performance, but of little practical impact given the real political and institutional setting. Centralized management indeed assumes a cooperative attitude and full information exchange by the involved parties. However, when decision-makers belong to different countries or institutions, it is very likely that they act considering only their local objectives, producing global externalities that negatively impact on other objectives. In this work we adopt a Multi-Agent Systems framework, which naturally allows to represent a set of self-interested agents (decision-makers and/or stakeholders) acting in a distributed decision-making process. According to this agent-based approach, each agent represents a decision-maker, whose decisions are defined by an explicit optimization problem considering only the agent's local interests. In particular, this work assesses the role of information exchange and increasing level of cooperation among originally non-cooperative agents. The Zambezi River basin is used to illustrate the methodology: the four largest reservoirs in the basin (Ithezhithezhi, Kafue-Gorge, Kariba and Cahora Bassa) are mainly operated for maximizing the economic revenue from hydropower energy production with considerably negative effects on the aquatic ecosystem in the Zambezi delta due to the alteration of the natural flow regime. We comparatively analyse the ideal centralized solution and the current situation where all the decision-makers act independently and non-cooperatively. Indeed, although a new basin-level institution called Zambezi Watercourse Commission

  13. Exchange Network

    EPA Pesticide Factsheets

    The Environmental Information Exchange Network (EN) is an Internet-based system used by state, tribal and territorial partners to securely share environmental and health information with one another and EPA.

  14. Research peer exchange.

    DOT National Transportation Integrated Search

    2005-10-01

    The Montana Department of Transportation hosted a research management peer exchange October 3-7, 2005. The : objectives of the peer exchange were to: identify strengths, challenges, and opportunities for the information services : component of MDT...

  15. 77 FR 50757 - 60-Day Notice of Proposed Information Collection: Exchange Visitor Program Participant Survey...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-22

    .... Type of Request: New Collection. Originating Office: Bureau of Educational and Cultural Affairs, ECA/EC... of technology. Abstract of proposed collection: This collection of information is under the provisions of the Mutual Educational and Cultural Exchange Act, as amended, and its implementing regulations...

  16. Characteristics of patient portals developed in the context of health information exchanges: early policy effects of incentives in the meaningful use program in the United States.

    PubMed

    Otte-Trojel, Terese; de Bont, Antoinette; van de Klundert, Joris; Rundall, Thomas G

    2014-11-21

    In 2014, the Centers for Medicare & Medicaid Services in the United States launched the second stage of its Electronic Health Record (EHR) Incentive Program, providing financial incentives to providers to meaningfully use their electronic health records to engage patients online. Patient portals are electronic means to engage patients by enabling secure access to personal medical records, communication with providers, various self-management tools, and administrative functionalities. Outcomes of patient portals have mainly been reported in large integrated health systems. This may now change as the EHR Incentive Program enables and supports the use of patient portals in other types of health systems. In this paper, we focus on Health Information Exchanges (HIE): entities that facilitate data exchange within networks of independent providers. In response to the EHR Incentive Program, some Health Information Exchanges in the United States are developing patient portals and offering them to their network of providers. Such patient portals hold high value for patients, especially in fragmented health system contexts, due to the portals' ability to integrate health information from an array of providers and give patients one access point to this information. Our aim was to report on the early effects of the EHR incentives on patient portal development by HIEs. Specifically, we describe the characteristics of these portals, identify factors affecting adoption by providers during the 2013-2014 time frame, and consider what may be the primary drivers of providers' adoption of patient portals in the future. We identified four HIEs that were developing patient portals as of spring 2014. We collected relevant documents and conducted interviews with six HIE leaders as well as two providers that were implementing the portals in their practices. We performed content analysis on these data to extract information pertinent to our study objectives. Our findings suggest that there

  17. 77 FR 20687 - 30-Day Notice of Proposed Information Collection: Form DS-3097, Exchange Visitor Program Annual...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-05

    ... the proposed information collection and supporting documents from Robin J. Lerner, Deputy Assistant.... Robin J. Lerner, Deputy Assistant Secretary for Private Sector Exchange, Bureau of Educational and...

  18. Aeronautical Satellite-Assisted Process for Information Exchange Through Network Technologies (Aero-SAPIENT) Conducted

    NASA Technical Reports Server (NTRS)

    Zernic, Michael J.

    2002-01-01

    Broadband satellite communications for aeronautics marries communication and network technologies to address NASA's goals in information technology base research and development, thereby serving the safety and capacity needs of the National Airspace System. This marriage of technology increases the interactivity between airborne vehicles and ground systems. It improves decision-making and efficiency, reduces operation costs, and improves the safety and capacity of the National Airspace System. To this end, a collaborative project called the Aeronautical Satellite Assisted Process for Information Exchange through Network Technologies, or Aero-SAPIENT, was conducted out of Tinker AFB, Oklahoma, during November and December 2000.

  19. Privacy as an enabler, not an impediment: building trust into health information exchange.

    PubMed

    McGraw, Deven; Dempsey, James X; Harris, Leslie; Goldman, Janlori

    2009-01-01

    Building privacy and security protections into health information technology systems will bolster trust in such systems and promote their adoption. The privacy issue, too long seen as a barrier to electronic health information exchange, can be resolved through a comprehensive framework that implements core privacy principles, adopts trusted network design characteristics, and establishes oversight and accountability mechanisms. The public policy challenges of implementing this framework in a complex and evolving environment will require improvements to existing law, new rules for entities outside the traditional health care sector, a more nuanced approach to the role of consent, and stronger enforcement mechanisms.

  20. GEIA's Vision for Improved Emissions Information

    NASA Astrophysics Data System (ADS)

    Frost, G. J.; Granier, C.; Tarrason, L.; Middleton, P.

    2014-12-01

    Accurate, timely, and accessible emissions information is critical for understanding and making predictions about the atmosphere. We will present recent progress of the Global Emissions InitiAtive (GEIA, http://www.geiacenter.org/), a community-driven joint activity of IGAC, iLEAPS, and AIMES within the International Geosphere-Biosphere Programme. Since 1990, GEIA has served as a forum for the exchange of expertise and information on anthropogenic and natural emissions of trace gases and aerosols. GEIA supports a worldwide network of emissions data developers and users, providing a solid scientific foundation for atmospheric chemistry research. By the year 2020, GEIA envisions being a bridge between the environmental science, regulatory, assessment, policy, and operational communities. GEIA's core activities include 1) facilitating analysis that improves the scientific basis for emissions data, 2) enhancing access to emissions information, and 3) strengthening linkages within the international emissions community. We will highlight GEIA's current work distributing emissions data, organizing the development of new emissions datasets, facilitating regional emissions studies, and initiating analyses aimed at improving emissions information. GEIA welcomes new partnerships that advance emissions knowledge for the future.

  1. Social information use in threat perception: Social buffering, contagion and facilitation of alarm responses

    PubMed Central

    Oliveira, Rui F.; Faustino, Ana I.

    2017-01-01

    ABSTRACT Group living animals can use the behavior of others as cues for the presence of threat in the environment and adjust their behavior accordingly. Therefore, different social phenomena that modulate the response to threat, such as social buffering, social transmission (contagion), and facilitation of alarm responses can be seen as different manifestations of social information use in threat detection. Thus, social phenomena that are functionally antagonistic, such as social buffering and social transmission of fear, may rely on shared neurobehavioral mechanisms related to the use of social information in decision-making about the presence of threat in the environment. Here, we propose a unifying conceptual framework for the study of social information use in threat perception based on signal detection theory.

  2. Tear exchange and contact lenses: A review

    PubMed Central

    Muntz, Alex; Subbaraman, Lakshman N.; Sorbara, Luigina; Jones, Lyndon

    2015-01-01

    Tear exchange beneath a contact lens facilitates ongoing fluid replenishment between the ocular surface and the lens. This exchange is considerably lower during the wear of soft lenses compared with rigid lenses. As a result, the accumulation of tear film debris and metabolic by-products between the cornea and a soft contact lens increases, potentially leading to complications. Lens design innovations have been proposed, but no substantial improvement in soft lens tear exchange has been reported. Researchers have determined post-lens tear exchange using several methods, notably fluorophotometry. However, due to technological limitations, little remains known about tear hydrodynamics around the lens and, to-date, true tear exchange with contact lenses has not been shown. Further knowledge regarding tear exchange could be vital in aiding better contact lens design, with the prospect of alleviating certain adverse ocular responses. This article reviews the literature to-date on the significance, implications and measurement of tear exchange with contact lenses. PMID:25575892

  3. A security framework for nationwide health information exchange based on telehealth strategy.

    PubMed

    Zaidan, B B; Haiqi, Ahmed; Zaidan, A A; Abdulnabi, Mohamed; Kiah, M L Mat; Muzamel, Hussaen

    2015-05-01

    This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

  4. Gaps, disconnections, and discontinuities--the role of information exchange in the delivery of quality long-term care.

    PubMed

    Georgiou, Andrew; Marks, Anne; Braithwaite, Jeffrey; Westbrook, Johanna Irene

    2013-10-01

    The smart use of information and communication technologies (ICT) is widely seen as a means of enhancing the quality of aged care services. One of the barriers to ICT diffusion in aged care is the failure to cater for the complex and interdisciplinary requirements of the aged care environment. The aim of this qualitative study was to identify the layers of information exchange and communication and produce a conceptual model that can help to inform decisions related to the design, implementation, and sustainability of ICT. A qualitative study conducted in 2010 within seven Australian residential aged care facilities. It included 11 focus groups involving 47 staff and 54 individual interviews and observation sessions. The analysis of work processes identified key information exchange components related to the type of information (residential, clinical, and administrative) that is collected, stored, and communicated. This information relies on a diverse number of internal and external communication channels that are important for the organization of care. The findings highlight potential areas of communication dysfunction as a consequence of structural holes, fragmentation, or disconnections that can adversely affect the continuity and coordination of care, its safety, and quality.

  5. 26 CFR 1.468B-6 - Escrow accounts, trusts, and other funds used during deferred exchanges of like-kind property...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Allocation of earnings in commingled accounts. If an exchange facilitator commingles (for investment or... account the time that the exchange funds are in the commingled account, actual rate or rates of return.... Example 7. Marketing fee paid to exchange facilitator. (i) The facts are the same as in Example 4, except...

  6. Facilitated transport of small molecules and ions for energy-efficient membranes.

    PubMed

    Li, Yifan; Wang, Shaofei; He, Guangwei; Wu, Hong; Pan, Fusheng; Jiang, Zhongyi

    2015-01-07

    In nature, the biological membrane can selectively transport essential small molecules/ions through facilitated diffusion via carrier proteins. Intrigued by this phenomenon and principle, membrane researchers have successfully employed synthetic carriers and carrier-mediated reversible reactions to enhance the separation performance of synthetic membranes. However, the existing facilitated transport membranes as well as the relevant facilitated transport theories have scarcely been comprehensively reviewed in the literature. This tutorial review primarily covers the two aspects of facilitated transport theories: carrier-mediated transport mechanisms and facilitated transport chemistries, including the design and fabrication of facilitated transport membranes. The applications of facilitated transport membranes in energy-intensive membrane processes (gas separation, pervaporation, and proton exchange membrane fuel cells) have also been discussed. Hopefully, this review will provide guidelines for the future research and development of facilitated transport membranes with high energy efficiency.

  7. Integrating Human Factors Engineering and Information Processing Approaches to Facilitate Evaluations in Criminal Justice Technology Research.

    PubMed

    Salvemini, Anthony V; Piza, Eric L; Carter, Jeremy G; Grommon, Eric L; Merritt, Nancy

    2015-06-01

    Evaluations are routinely conducted by government agencies and research organizations to assess the effectiveness of technology in criminal justice. Interdisciplinary research methods are salient to this effort. Technology evaluations are faced with a number of challenges including (1) the need to facilitate effective communication between social science researchers, technology specialists, and practitioners, (2) the need to better understand procedural and contextual aspects of a given technology, and (3) the need to generate findings that can be readily used for decision making and policy recommendations. Process and outcome evaluations of technology can be enhanced by integrating concepts from human factors engineering and information processing. This systemic approach, which focuses on the interaction between humans, technology, and information, enables researchers to better assess how a given technology is used in practice. Examples are drawn from complex technologies currently deployed within the criminal justice system where traditional evaluations have primarily focused on outcome metrics. Although this evidence-based approach has significant value, it is vulnerable to fully account for human and structural complexities that compose technology operations. Guiding principles for technology evaluations are described for identifying and defining key study metrics, facilitating communication within an interdisciplinary research team, and for understanding the interaction between users, technology, and information. The approach posited here can also enable researchers to better assess factors that may facilitate or degrade the operational impact of the technology and answer fundamental questions concerning whether the technology works as intended, at what level, and cost. © The Author(s) 2015.

  8. AMCP Partnership Forum: Enabling the Exchange of Clinical and Economic Information Pre-FDA Approval.

    PubMed

    2017-01-01

    Current federal laws and FDA regulations have significantly restricted the sharing of clinical and health economic information on biopharmaceuticals that have yet to receive FDA approval. Over the past several years, organizations that make health care coverage decisions, including those that set copayments, premiums, and formulary placement, have expressed a need for receiving this information before approval, as long as appropriate safeguards exist to prevent this information from reaching unintended entities. Population health decision makers have indicated that waiting until FDA approval is often too late for the critical planning, budgeting, and forecasting associated with health benefit design, especially given the recent influx of high-cost medications and scrutiny for better evaluation and preparation. Recognizing that securities laws restrict the disclosure of nonpublic information and may need to be amended, permissible early dissemination would allow population health decision makers to incorporate clinical and economic information for pipeline drugs or expanded indications into financial forecasting for the following year's plan. Access to this information is needed 12-18 months before FDA approval when organizations are deciding on terms of coverage and budgetary assumptions for state health insurance rate filings, Medicare and Medicaid bids, contracts with health care purchasers, and other financial arrangements. The need for exchange of clinical economic information before FDA approval was first introduced at a previous Academy of Managed Care (AMCP) forum in March 2016, which addressed section 114 of the Food and Drug Administration Modernization Act and the communication of such information after FDA approval. To address preapproval information specifically, AMCP convened a Partnership Forum on September 13-14, 2016. This forum included a diverse group of stakeholders representing managed care, the biopharmaceutical industry, providers, patients

  9. Patient Protection and Affordable Care Act; Exchange functions: standards for Navigators and non-Navigator assistance personnel; consumer assistance tools and programs of an Exchange and certified application counselors. Final rule.

    PubMed

    2013-07-17

    This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. The final rule also directs that each Exchange designate organizations which will then certify their staff members and volunteers to be application counselors that assist consumers and facilitate enrollment in qualified health plans and insurance affordability programs, and provides standards for that designation.

  10. Information infrastructure for consumer health: a health information exchange stakeholder study.

    PubMed

    Thornewill, Judah; Dowling, Alan F; Cox, Barbara A; Esterhay, Robert J

    2011-05-01

    An enabling infrastructure for population-wide health information capture and transfer is beginning to emerge in the U.S. However, the essential infrastructure component that is still missing is effective health information exchange (HIE). Health record banks (HRBs) are one of several possible approaches to achieving HIE. Is the approach viable? If so, what requirements must be satisfied in order for it to succeed? The research, conducted in 2007-2008, explored HRB-related interests, concerns, benefits, payment preferences, design requirements, value propositions, and challenges for 12 healthcare stakeholder groups and the consumers they serve in a U.S. metropolitan area of 1.3 million people. A mixed-methods design was developed in a community action research context. Data were gathered and analyzed through 23 focus groups, 13 web surveys, a consumer phone survey (nonstratified random sample) and follow-up meetings. Recruiting goals for leaders representing targeted groups were achieved using a multi-channel communications strategy. Key themes were identified through data triangulation. Then, requirements, value propositions and challenges were developed through iterative processes of interaction with community members. Results include key themes, design requirements, value propositions, and challenges for 12 stakeholder groups and consumers. The research provides a framework for developing a consumer permission-driven, financially sustainable, community HRB model. However, for such a model to flourish, it will need to be part of a nationwide network of HIEs with compatible HRB approaches able to overcome a number of challenges. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Characteristics associated with regional health information organization viability.

    PubMed

    Adler-Milstein, Julia; Landefeld, John; Jha, Ashish K

    2010-01-01

    Regional Health Information Organizations (RHIOs) will likely play a key role in our nation's effort to catalyze health information exchange. Yet we know little about why some efforts succeed while others fail. We sought to identify factors associated with RHIO viability. Using data from a national survey of RHIOs that we conducted in mid-2008, we examined factors associated with becoming operational and factors associated with financial viability. We used multivariate logistic regression models to identify unique predictors. We classified RHIOs actively facilitating data exchange as operational and measured financial viability as the percent of operating costs covered by revenue from participants in data exchange (0-24%, 25-74%, 75-100%). Predictors included breadth of participants, breadth of data exchanged, whether the RHIO focused on a specific population, whether RHIO participants had a history of collaborating, and sources of revenue during the planning phase. Exchanging a narrow set of data and involving a broad group of stakeholders were independently associated with a higher likelihood of being operational. Involving hospitals and ambulatory physicians, and securing early funding from participants were associated with a higher likelihood of financial viability, while early grant funding seemed to diminish the likelihood. Finding ways to help RHIOs become operational and self-sustaining will bolster the current approach to nationwide health information exchange. Our work suggests that convening a broad coalition of stakeholders to focus on a narrow set of data is an important step in helping RHIOs become operational. Convincing stakeholders to financially commit early in the process may help RHIOs become self-sustaining.

  12. Type 2 Diabetes Education and Support in a Virtual Environment: A Secondary Analysis of Synchronously Exchanged Social Interaction and Support.

    PubMed

    Lewinski, Allison A; Anderson, Ruth A; Vorderstrasse, Allison A; Fisher, Edwin B; Pan, Wei; Johnson, Constance M

    2018-02-21

    Virtual environments (VEs) facilitate interaction and support among individuals with chronic illness, yet the characteristics of these VE interactions remain unknown. The objective of this study was to describe social interaction and support among individuals with type 2 diabetes (T2D) who interacted in a VE. Data included VE-mediated synchronous conversations and text-chat and asynchronous emails and discussion board posts from a study that facilitated interaction among individuals with T2D and diabetes educators (N=24) in 2 types of sessions: education and support. VE interactions consisted of communication techniques (how individuals interact in the VE), expressions of self-management (T2D-related topics), depth (personalization of topics), and breadth (number of topics discussed). Individuals exchanged support more often in the education (723/1170, 61.79%) than in the support (406/1170, 34.70%) sessions or outside session time (41/1170, 3.50%). Of all support exchanges, 535/1170 (45.73%) were informational, 377/1170 (32.22%) were emotional, 217/1170 (18.55%) were appraisal, and 41/1170 (3.50%) were instrumental. When comparing session types, education sessions predominately provided informational support (357/723, 49.4%), and the support sessions predominately provided emotional (159/406, 39.2%) and informational (159/406, 39.2%) support. VE-mediated interactions resemble those in face-to-face environments, as individuals in VEs engage in bidirectional exchanges with others to obtain self-management education and support. Similar to face-to-face environments, individuals in the VE revealed personal information, sought information, and exchanged support during the moderated education sessions and unstructured support sessions. With this versatility, VEs are able to contribute substantially to support for those with diabetes and, very likely, other chronic diseases. ©Allison A Lewinski, Ruth A Anderson, Allison A Vorderstrasse, Edwin B Fisher, Wei Pan, Constance

  13. ANZSoilML: An Australian - New Zealand standard for exchange of soil data

    NASA Astrophysics Data System (ADS)

    Simons, Bruce; Wilson, Peter; Ritchie, Alistair; Cox, Simon

    2013-04-01

    The Australian-New Zealand soil information exchange standard (ANZSoilML) is a GML-based standard designed to allow the discovery, query and delivery of soil and landscape data via standard Open Geospatial Consortium (OGC) Web Feature Services. ANZSoilML modifies the Australian soil exchange standard (OzSoilML), which is based on the Australian Soil Information Transfer and Evaluation System (SITES) database design and exchange protocols, to meet the New Zealand National Soils Database requirements. The most significant change was the removal of the lists of CodeList terms in OzSoilML, which were based on the field methods specified in the 'Australian Soil and Land Survey Field Handbook'. These were replaced with empty CodeLists as placeholders to external vocabularies to allow the use of New Zealand vocabularies without violating the data model. Testing of the use of these separately governed Australian and New Zealand vocabularies has commenced. ANZSoilML attempts to accommodate the proposed International Organization for Standardization ISO/DIS 28258 standard for soil quality. For the most part, ANZSoilML is consistent with the ISO model, although major differences arise as a result of: • The need to specify the properties appropriate for each feature type; • The inclusion of soil-related 'Landscape' features; • Allowing the mapping of soil surfaces, bodies, layers and horizons, independent of the soil profile; • Allowing specifying the relationships between the various soil features; • Specifying soil horizons as specialisations of soil layers; • Removing duplication of features provided by the ISO Observation & Measurements standard. The International Union of Soil Sciences (IUSS) Working Group on Soil Information Standards (WG-SIS) aims to develop, promote and maintain a standard to facilitate the exchange of soils data and information. Developing an international exchange standard that is compatible with existing and emerging national and

  14. e-Government for Development Information Exchange (DIE): Zambia

    NASA Astrophysics Data System (ADS)

    Joseph, Bwalya Kelvin

    In most parts of the world, political systems which utilize authoritative rule and mostly employ top-down decision-making processes are slowly transcending towards democratic norms. Information Technology Systems have been identified and adopted as one of the most efficient vehicles for appropriate, transparent and inclusive / participatory decision making. Zambia has shown a higher propensity to indigenous knowledge systems which are full of inefficiencies, a lot of red tape in public service delivery, and prone to corrupt practices. Despite that being the case, it is slowly trying to implement e-government. The adoption of e-government promises a sharp paradigm shift where public institutions will be more responsive and transparent, promote efficient PPP (Public Private Partnerships), and empower citizens by making knowledge and other resources more directly accessible. This paper examines three cases from Zambia where ICT in support of e-government has been implemented for Development Information Exchange (DIE) - knowledge-based decision making. The paper also assesses the challenges, opportunities, and issues together with e-government adoption criteria regarding successful encapsulation of e-government into the Zambian contextual environment. I propose a conceptual model which offers balanced e-government adoption criteria involving a combination of electronic and participatory services. This conceptual e-government adoption model can later be replicated to be used at the Southern African Development Community (SADC) level given the similarity in the contextual environment.

  15. Software for Sharing and Management of Information

    NASA Technical Reports Server (NTRS)

    Chen, James R.; Wolfe, Shawn R.; Wragg, Stephen D.

    2003-01-01

    DIAMS is a set of computer programs that implements a system of collaborative agents that serve multiple, geographically distributed users communicating via the Internet. DIAMS provides a user interface as a Java applet that runs on each user s computer and that works within the context of the user s Internet-browser software. DIAMS helps all its users to manage, gain access to, share, and exchange information in databases that they maintain on their computers. One of the DIAMS agents is a personal agent that helps its owner find information most relevant to current needs. It provides software tools and utilities for users to manage their information repositories with dynamic organization and virtual views. Capabilities for generating flexible hierarchical displays are integrated with capabilities for indexed- query searching to support effective access to information. Automatic indexing methods are employed to support users queries and communication between agents. The catalog of a repository is kept in object-oriented storage to facilitate sharing of information. Collaboration between users is aided by matchmaker agents and by automated exchange of information. The matchmaker agents are designed to establish connections between users who have similar interests and expertise.

  16. The Arbo‑zoonet Information System.

    PubMed

    Di Lorenzo, Alessio; Di Sabatino, Daria; Blanda, Valeria; Cioci, Daniela; Conte, Annamaria; Bruno, Rossana; Sauro, Francesca; Calistri, Paolo; Savini, Lara

    2016-06-30

    The Arbo‑zoonet Information System has been developed as part of the 'International Network for Capacity Building for the Control of Emerging Viral Vector Borne Zoonotic Diseases (Arbo‑zoonet)' project. The project aims to create common knowledge, sharing data, expertise, experiences, and scientific information on West Nile Disease (WND), Crimean‑Congo haemorrhagic fever (CCHF), and Rift Valley fever (RVF). These arthropod‑borne diseases of domestic and wild animals can affect humans, posing great threat to public health. Since November 2011, when the Schmallenberg virus (SBV) has been discovered for the first time in Northern Europe, the Arbo‑zoonet Information System has been used in order to collect information on newly discovered disease and to manage the epidemic emergency. The system monitors the geographical distribution and epidemiological evolution of CCHF, RVF, and WND since 1946. More recently, it has also been deployed to monitor the SBV data. The Arbo‑zoonet Information System includes a web application for the management of the database in which data are stored and a WebGIS application to explore spatial disease distributions, facilitating the epidemiological analysis. The WebGIS application is an effective tool to show and share the information and to facilitate the exchange and dissemination of relevant data among project's participants.

  17. Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists’ perspectives

    PubMed Central

    Kennelty, Korey A.; Chewning, Betty; Wise, Meg; Kind, Amy; Roberts, Tonya; Kreling, David

    2015-01-01

    useful for identifying barriers and facilitators of medication reconciliation for recently discharged patients from community pharmacists’ perspectives. The elucidation of these specific facilitators and barriers suggest promising avenues for future research interventions to improve exchange of medication information between the community pharmacy, hospitals, and patients. PMID:25586885

  18. Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.

    PubMed

    Kennelty, Korey A; Chewning, Betty; Wise, Meg; Kind, Amy; Roberts, Tonya; Kreling, David

    2015-01-01

    medication reconciliation for recently discharged patients from community pharmacists' perspectives. The elucidation of these specific facilitators and barriers suggest promising avenues for future research interventions to improve exchange of medication information between the community pharmacy, hospitals, and patients. Published by Elsevier Inc.

  19. Are there differences in health information exchange by health system type?

    PubMed

    Opoku-Agyeman, William; Menachemi, Nir

    2016-01-01

    Despite the potential of health information exchange (HIE) to improve safety and reduce cost, hospitals have been slow to adopt HIE with only 30% of U.S. hospitals doing so in 2012. The aim of this study was to explore the relationship between different health system types and how they engage in HIE. Data on health system types and engagement in HIE activity were combined with secondary hospital characteristics. Ordinal logistic regression analyses were used to examine the relationship between a scale measuring the level of HIE engagement and health system type controlling for hospital and market characteristics. Data from 1552 hospitals were available for analyses. Overall, hospital in a health system of any kind exchanged more patient data elements (e.g., patient demographics, clinical summaries, laboratory results, medication history, and radiology report) compared with stand-alone hospitals (3.82 vs. 1.80, p < .001). Overall, 62.2% of hospitals were part of a health system, and among system hospitals, 125 (8.0%) were in centralized health systems, 75 (4.8%) were in centralized physician/insurance health system, 284 (18.3%) were in moderately centralized health system, 391 (25.2%) were in decentralized health system, and 91 (5.9%) were in independent health system. In regression analyses, hospitals belonging to a health system were more likely to exchange patient health data with other hospitals in the same system (OR = 3.94, p < .001) but not with hospitals outside their system (OR = 1.89, p = .445). Across health system types, there was no significant difference in the exchange of patient health data. Hospital engagement in HIE is associated with health system membership. These findings will assist hospital leaders and managers to better understand how the structure and nature of their system may influence what their individual hospital can and cannot do in their decision to engage in HIE and other decisions that support the overall system objectives.

  20. Newly available technologies present expanding opportunities for scientific and technical information exchange

    NASA Technical Reports Server (NTRS)

    Tolzman, Jean M.

    1993-01-01

    The potential for expanded communication among researchers, scholars, and students is supported by growth in the capabilities for electronic communication as well as expanding access to various forms of electronic interchange and computing capabilities. Increased possibilities for information exchange, collegial dialogue, collaboration, and access to remote resources exist as high-speed networks, increasingly powerful workstations, and large, multi-user computational facilities are more frequently linked and more commonly available. Numerous writers speak of the telecommunications revolution and its impact on the development and dissemination of knowledge and learning. One author offers the phrase 'Scholarly skywriting' to represent a new form of scientific communication that he envisions using electronic networks. In the United States (U.S.), researchers associated with the National Science Foundation (NSF) are exploring 'nationwide collaboratories' and 'digital collaboration.' Research supported by the U.S. National Aeronautics and Space Administration (NASA) points to a future where workstations with built-in audio, video monitors, and screen sharing protocols are used to support collaborations with colleagues located throughout the world. Instruments and sensors located worldwide will produce data streams that will be brought together, analyzed, and distributed as new findings. Researchers will have access to machines that can supply domain-specific information in addition to locator and directory assistance. New forms of electronic journals will emerge and provide opportunities for researchers and scientists to exchange information electronically and interactively in a range of structures and formats. Ultimately, the wide-scale use of these technologies in the dissemination of research results and the stimulation of collegial dialogue will change the way we represent and express our knowledge of the world. A new paradigm will evolve--perhaps a truly worldwide

  1. Facilitating biomedical researchers' interrogation of electronic health record data: Ideas from outside of biomedical informatics.

    PubMed

    Hruby, Gregory W; Matsoukas, Konstantina; Cimino, James J; Weng, Chunhua

    2016-04-01

    Electronic health records (EHR) are a vital data resource for research uses, including cohort identification, phenotyping, pharmacovigilance, and public health surveillance. To realize the promise of EHR data for accelerating clinical research, it is imperative to enable efficient and autonomous EHR data interrogation by end users such as biomedical researchers. This paper surveys state-of-art approaches and key methodological considerations to this purpose. We adapted a previously published conceptual framework for interactive information retrieval, which defines three entities: user, channel, and source, by elaborating on channels for query formulation in the context of facilitating end users to interrogate EHR data. We show the current progress in biomedical informatics mainly lies in support for query execution and information modeling, primarily due to emphases on infrastructure development for data integration and data access via self-service query tools, but has neglected user support needed during iteratively query formulation processes, which can be costly and error-prone. In contrast, the information science literature has offered elaborate theories and methods for user modeling and query formulation support. The two bodies of literature are complementary, implying opportunities for cross-disciplinary idea exchange. On this basis, we outline the directions for future informatics research to improve our understanding of user needs and requirements for facilitating autonomous interrogation of EHR data by biomedical researchers. We suggest that cross-disciplinary translational research between biomedical informatics and information science can benefit our research in facilitating efficient data access in life sciences. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

    PubMed

    Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

    2017-01-01

    Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries

  3. On-Line Learning Technologies: Networking in the Classroom. Rural, Small Schools Network Information Exchange No. 16, Summer 1994.

    ERIC Educational Resources Information Center

    Regional Laboratory for Educational Improvement of the Northeast & Islands, Andover, MA.

    This packet includes reprints of articles and other information concerning the use of computer networks in small, rural schools. Computer networks can minimize isolation; develop stronger links to the community; access reference information from remote sources; and create professional and academic exchanges for teachers, administrators, and…

  4. The Matchmaker Exchange API: automating patient matching through the exchange of structured phenotypic and genotypic profiles

    PubMed Central

    Buske, Orion J.; Schiettecatte, François; Hutton, Benjamin; Dumitriu, Sergiu; Misyura, Andriy; Huang, Lijia; Hartley, Taila; Girdea, Marta; Sobreira, Nara; Mungall, Chris; Brudno, Michael

    2016-01-01

    Despite the increasing prevalence of clinical sequencing, the difficulty of identifying additional affected families is a key obstacle to solving many rare diseases. There may only be a handful of similar patients worldwide, and their data may be stored in diverse clinical and research databases. Computational methods are necessary to enable finding similar patients across the growing number of patient repositories and registries. We present the Matchmaker Exchange Application Programming Interface (MME API), a protocol and data format for exchanging phenotype and genotype profiles to enable matchmaking among patient databases, facilitate the identification of additional cohorts, and increase the rate with which rare diseases can be researched and diagnosed. We designed the API to be straightforward and flexible in order to simplify its adoption on a large number of data types and workflows. We also provide a public test data set, curated from the literature, to facilitate implementation of the API and development of new matching algorithms. The initial version of the API has been successfully implemented by three members of the Matchmaker Exchange and was immediately able to reproduce previously-identified matches and generate several new leads currently being validated. The API is available at https://github.com/ga4gh/mme-apis. PMID:26255989

  5. The Matchmaker Exchange API: automating patient matching through the exchange of structured phenotypic and genotypic profiles.

    PubMed

    Buske, Orion J; Schiettecatte, François; Hutton, Benjamin; Dumitriu, Sergiu; Misyura, Andriy; Huang, Lijia; Hartley, Taila; Girdea, Marta; Sobreira, Nara; Mungall, Chris; Brudno, Michael

    2015-10-01

    Despite the increasing prevalence of clinical sequencing, the difficulty of identifying additional affected families is a key obstacle to solving many rare diseases. There may only be a handful of similar patients worldwide, and their data may be stored in diverse clinical and research databases. Computational methods are necessary to enable finding similar patients across the growing number of patient repositories and registries. We present the Matchmaker Exchange Application Programming Interface (MME API), a protocol and data format for exchanging phenotype and genotype profiles to enable matchmaking among patient databases, facilitate the identification of additional cohorts, and increase the rate with which rare diseases can be researched and diagnosed. We designed the API to be straightforward and flexible in order to simplify its adoption on a large number of data types and workflows. We also provide a public test data set, curated from the literature, to facilitate implementation of the API and development of new matching algorithms. The initial version of the API has been successfully implemented by three members of the Matchmaker Exchange and was immediately able to reproduce previously identified matches and generate several new leads currently being validated. The API is available at https://github.com/ga4gh/mme-apis. © 2015 WILEY PERIODICALS, INC.

  6. AAPG exchange format for transfer of geologic and petroleum data

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shaw, B.R.; Waller, H.

    1989-03-01

    One of the most pressing problems of petroleum geology is transferring and exchanging data between sources. Possibly the most significant issue facing their industry is the ability to communicate. The expense and huge effort involved in all aspects of data management are expanding at a rate proportional to the number of individual data bases and software formats being created daily. There must be a common, public format to exchange information to ensure the transfer of data between all aspects of their industry. The AAPG has the opportunity to take a leadership role in addressing this problem by creating an exchangemore » format. There are five basic objectives for the proposed exchange format: (1) provide a mechanism for the exchange of digital geologic data structures, (2) provide an interchange model for the development of related geologic data, (3) facilitate effective communication between commercial data and users, (4) provide a public format independent proprietary formats and implementation environments, and (5) provide a basis for future growth and development. The proposed exchange format is intended for use by the general geologic community but is based upon many concepts currently implemented in the petroleum and natural gas industry. As such, there are no predefined terms or standards either implied or required. Eventually the format must evolve into relational structures, which will require a concept and relation definition; but there is not intent to impose compliance or conformity of the data itself. Ultimately, the effectiveness of this exchange format will be proven by the user community.« less

  7. “Developing Good Taste in Evidence”: Facilitators of and Hindrances to Evidence-Informed Health Policymaking in State Government

    PubMed Central

    Jewell, Christopher J; Bero, Lisa A

    2008-01-01

    Context Policymaking is a highly complex process that is often difficult to predict or influence. Most of the scholarship examining the role of research evidence in policymaking has focused narrowly on characteristics of the evidence and the interactions between scientists and government officials. The real-life context in which policymakers are situated and make decisions also is crucial to the development of evidence-informed policy. Methods This qualitative study expands on other studies of research utilization at the state level through interviews with twenty-eight state legislators and administrators about their real-life experiences incorporating evidence into policymaking. The interviews were coded inductively into the following categories: (1) the important or controversial issue or problem being addressed, (2) the information that was used, (3) facilitators, and (4) hindrances. Findings Hindrances to evidence-informed policymaking included institutional features; characteristics of the evidence supply, such as research quantity, quality, accessibility, and usability; and competing sources of influence, such as interest groups. The policymakers identified a number of facilitators to the use of evidence, including linking research to concrete impacts, costs, and benefits; reframing policy issues to fit the research; training to use evidence-based skills; and developing research venues and collaborative relationships in order to generate relevant evidence. Conclusions Certain hindrances to the incorporation of research into policy, like limited budgets, are systemic and not readily altered. However, some of the barriers and facilitators of evidence-informed health policymaking are amenable to change. Policymakers could benefit from evidence-based skills training to help them identify and evaluate high-quality information. Researchers and policymakers thus could collaborate to develop networks for generating and sharing relevant evidence for policy. PMID

  8. An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.

    PubMed

    Elysee, Gerald; Herrin, Jeph; Horwitz, Leora I

    2017-10-01

    Stagnation in hospitals' adoption of data integration functionalities coupled with reduction in the number of operational health information exchanges could become a significant impediment to hospitals' adoption of 3 critical capabilities: electronic health information exchange, interoperability, and medication reconciliation, in which electronic systems are used to assist with resolving medication discrepancies and improving patient safety. Against this backdrop, we assessed the relationships between the 3 capabilities.We conducted an observational study applying partial least squares-structural equation modeling technique to 27 variables obtained from the 2013 American Hospital Association annual survey Information Technology (IT) supplement, which describes health IT capabilities.We included 1330 hospitals. In confirmatory factor analysis, out of the 27 variables, 15 achieved loading values greater than 0.548 at P < .001, as such were validated as the building blocks of the 3 capabilities. Subsequent path analysis showed a significant, positive, and cyclic relationship between the capabilities, in that decreases in the hospitals' adoption of one would lead to decreases in the adoption of the others.These results show that capability for high quality medication reconciliation may be impeded by lagging adoption of interoperability and health information exchange capabilities. Policies focused on improving one or more of these capabilities may have ancillary benefits.

  9. Enhancing provision of written medicine information in Australia: pharmacist, general practitioner and consumer perceptions of the barriers and facilitators.

    PubMed

    Hamrosi, Kim K; Raynor, David K; Aslani, Parisa

    2014-04-23

    Written medicine information can play an important role in educating consumers about their medicines. In Australia, standardised, comprehensive written information known as Consumer Medicine Information (CMI) is available for all prescription medicines. CMI is reportedly under-utilised by general practitioners (GPs) and community pharmacists in consultations, despite consumer desire for medicine information. This study aimed to determine consumers', GPs' and community pharmacists' preferences for CMI provision and identify barriers and facilitators to its use. Structured questionnaires were developed and administered to a national sample of Australian consumers (phone survey), community pharmacists and GPs (postal surveys) surrounding utilisation of CMI. Descriptive and comparative analyses were conducted. Half of consumers surveyed wanted to receive CMI for their prescription medicine, with spoken information preferable to written medicine information for many consumers and healthcare professionals. GPs and pharmacists remained a preferred source of medicine information for consumers, although package inserts were appealing to many among all three cohorts. Overall pharmacists were the preferred provider of CMI primarily due to their medicine expertise, accessibility and perceived availability. GPs preferred CMI dissemination through both the GP and pharmacist. Some consumers preferred GPs as the provider of medicines information because of their knowledge of the patients' medicines and/or medical history, regularity of seeing the patient and good relationship with the patient. Common barriers to CMI provision cited included: time constraints, CMI length and perceptions that patients are not interested in receiving CMI. Facilitators to enhance provision included: strategies to increase consumer awareness, longer consultation times and counseling appointments, and improvements to pharmacy software technology and workflow. Medicine information is important to

  10. Development of an Exchange Format for the European Environmental Chemical Data and Information Network (ECDIN).

    ERIC Educational Resources Information Center

    And Others; Proctor, David, J.

    1978-01-01

    Uses collection and storage of data in an environmental chemicals data bank to develop an exchange format of hierarchical tree structure between network partners. Rules identify and process the nodes in the tree in such a way that information is neither lost nor degraded upon transfer between network partners. (CWM)

  11. User-Centered Design, Experience, and Usability of an Electronic Consent User Interface to Facilitate Informed Decision-Making in an HIV Clinic.

    PubMed

    Ramos, S Raquel

    2017-11-01

    Health information exchange is the electronic accessibility and transferability of patient medical records across various healthcare settings and providers. In some states, patients have to formally give consent to allow their medical records to be electronically shared. The purpose of this study was to apply a novel user-centered, multistep, multiframework approach to design and test an electronic consent user interface, so patients with HIV can make more informed decisions about electronically sharing their health information. This study consisted of two steps. Step 1 was a cross-sectional, descriptive, qualitative study that used user-centric design interviews to create the user interface. This informed Step 2. Step 2 consisted of a one group posttest to examine perceptions of usefulness, ease of use, preference, and comprehension of a health information exchange electronic consent user interface. More than half of the study population had college experience, but challenges remained with overall comprehension regarding consent. The user interface was not independently successful, suggesting that in addition to an electronic consent user interface, human interaction may also be necessary to address the complexities associated with consenting to electronically share health information. Comprehension is key factor in the ability to make informed decisions.

  12. Assessment of Life Cycle Information Exchanges (LCie): Understanding the Value-Added Benefit of a COBie Process

    DTIC Science & Technology

    2013-10-01

    exchange (COBie), Building Information Modeling ( BIM ), value-added analysis, business processes, project management 16. SECURITY CLASSIFICATION OF: 17...equipment. The innovative aspect of Building In- formation Modeling ( BIM ) is that it creates a computable building descrip- tion. The ability to use a...interoperability. In order for the building information to be interoperable, it must also con- form to a common data model , or schema, that defines the class

  13. Fiscal Year 2018 National Environmental Information Exchange Network Grant Solicitation Notice

    EPA Pesticide Factsheets

    The Exchange Network Grant Program provides funding for projects that are in line with Exchange Network priorities. The primary outcome expected from EN assistance agreements is improved access to, and exchange of, high quality environmental data.

  14. Tear exchange and contact lenses: a review.

    PubMed

    Muntz, Alex; Subbaraman, Lakshman N; Sorbara, Luigina; Jones, Lyndon

    2015-01-01

    Tear exchange beneath a contact lens facilitates ongoing fluid replenishment between the ocular surface and the lens. This exchange is considerably lower during the wear of soft lenses compared with rigid lenses. As a result, the accumulation of tear film debris and metabolic by-products between the cornea and a soft contact lens increases, potentially leading to complications. Lens design innovations have been proposed, but no substantial improvement in soft lens tear exchange has been reported. Researchers have determined post-lens tear exchange using several methods, notably fluorophotometry. However, due to technological limitations, little remains known about tear hydrodynamics around the lens and, to-date, true tear exchange with contact lenses has not been shown. Further knowledge regarding tear exchange could be vital in aiding better contact lens design, with the prospect of alleviating certain adverse ocular responses. This article reviews the literature to-date on the significance, implications and measurement of tear exchange with contact lenses. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  15. Patient Privacy, Consent, and Identity Management in Health Information Exchange

    PubMed Central

    Hosek, Susan D.; Straus, Susan G.

    2013-01-01

    Abstract The Military Health System (MHS) and the Veterans Health Administration (VHA) have been among the nation's leaders in health information technology (IT), including the development of health IT systems and electronic health records that summarize patients' care from multiple providers. Health IT interoperability within MHS and across MHS partners, including VHA, is one of ten goals in the current MHS Strategic Plan. As a step toward achieving improved interoperability, the MHS is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This article contributes to that effort by identifying gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to bring about improved quality and efficiency of care through health information exchange. Major challenges include (1) designing a meaningful patient consent procedure, (2) recording patients' consent preferences and designing procedures to implement restrictions on disclosures of protected health information, and (3) advancing knowledge regarding the best technical approaches to performing patient identity matches and how best to monitor results over time. Using a sociotechnical framework, this article suggests steps for overcoming these challenges and topics for future research. PMID:28083296

  16. Evaluation of immunization data completeness within a large community health care system exchanging data with a state immunization information system.

    PubMed

    Hendrickson, Bryan K; Panchanathan, Sarada S; Petitti, Diana

    2015-01-01

    Information systems are used by most states to maintain registries of immunization data both for monitoring population-level adherence and for use in clinical practice and research. Direct data exchange between such systems and electronic health record systems presents an opportunity to improve the completeness and quality of information available. Our goals were to describe and compare the completeness of the Arizona State Immunization System, the electronic health record at a large community health provider in Arizona exchanging electronic data with the Arizona system, and personal immunization records in an effort to contribute to the discussion on the completeness of state-run immunization registries and data exchange with these registries. Immunization histories from these sources were collected and reviewed sequentially. Unique dates of vaccination administrations were counted for each patient and tagged on the basis of comparisons across sources. We quantified completeness by combining information from all 3 sources and comparing each source with the complete set. We determined that the state registry was 71.8% complete, the hospital electronic health record was 81.9% complete, and personal records were 87.8% complete. Of the 2017 unique vaccination administrations, 65% were present in all 3 sources, 24.6% in 2 of the 3 sources, and 10.4% in only 1 source. Only 11% of patients had records in complete agreement across the 3 sources. This study highlights issues related to data completeness, exchange, and reporting of immunization information to state registries and suggests that there is some degree of deficiency in completeness of immunization registries and other sources. This study indicates that there is a need to strengthen links between electronic data sources with immunization information and describes potential improvements in completeness that such efforts could provide, enabling providers to better rely on state immunization registries and to

  17. Evaluating information literacy educators' practices before and after the course facilitating information literacy education: from tutor to learner-centred.

    PubMed

    Andretta, Susie

    2011-09-01

    The article gives an account of a study on the impact of facilitating information literacy education (FILE) on its participants, health librarians who have attended this course between 2007 and 2010. The analysis presented here is based on the first stage of the research, funded by the Higher Education Academy Information and Computer Sciences and consisting of an online survey. This survey was conducted in Autumn 2010 and examined the respondents' examples of information literacy practice before and after FILE. Two main outcomes can be drawn from the data. First, that overall the respondents' provision of information literacy education has shifted from a tutor-centred approach (where the trainer decides what the learner needs) to a learner-centred approach (where the learner decides what he/she needs). And secondly, that the impact of FILE should be seen in terms of a self-perpetuating professional development, rather than measured in terms of specific changes that occur at set times (e.g., at the end of the course or 6 months after completion). As one FILE participant puts it: 'When FILE ends your career as an information literacy professional starts.' © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  18. Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services.

    PubMed

    Newman, Lareen; Biedrzycki, Kate; Baum, Fran

    2012-05-01

    To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.

  19. SWARMs Ontology: A Common Information Model for the Cooperation of Underwater Robots

    PubMed Central

    Li, Xin; Bilbao, Sonia; Martín-Wanton, Tamara; Bastos, Joaquim; Rodriguez, Jonathan

    2017-01-01

    In order to facilitate cooperation between underwater robots, it is a must for robots to exchange information with unambiguous meaning. However, heterogeneity, existing in information pertaining to different robots, is a major obstruction. Therefore, this paper presents a networked ontology, named the Smart and Networking Underwater Robots in Cooperation Meshes (SWARMs) ontology, to address information heterogeneity and enable robots to have the same understanding of exchanged information. The SWARMs ontology uses a core ontology to interrelate a set of domain-specific ontologies, including the mission and planning, the robotic vehicle, the communication and networking, and the environment recognition and sensing ontology. In addition, the SWARMs ontology utilizes ontology constructs defined in the PR-OWL ontology to annotate context uncertainty based on the Multi-Entity Bayesian Network (MEBN) theory. Thus, the SWARMs ontology can provide both a formal specification for information that is necessarily exchanged between robots and a command and control entity, and also support for uncertainty reasoning. A scenario on chemical pollution monitoring is described and used to showcase how the SWARMs ontology can be instantiated, be extended, represent context uncertainty, and support uncertainty reasoning. PMID:28287468

  20. SWARMs Ontology: A Common Information Model for the Cooperation of Underwater Robots.

    PubMed

    Li, Xin; Bilbao, Sonia; Martín-Wanton, Tamara; Bastos, Joaquim; Rodriguez, Jonathan

    2017-03-11

    In order to facilitate cooperation between underwater robots, it is a must for robots to exchange information with unambiguous meaning. However, heterogeneity, existing in information pertaining to different robots, is a major obstruction. Therefore, this paper presents a networked ontology, named the Smart and Networking Underwater Robots in Cooperation Meshes (SWARMs) ontology, to address information heterogeneity and enable robots to have the same understanding of exchanged information. The SWARMs ontology uses a core ontology to interrelate a set of domain-specific ontologies, including the mission and planning, the robotic vehicle, the communication and networking, and the environment recognition and sensing ontology. In addition, the SWARMs ontology utilizes ontology constructs defined in the PR-OWL ontology to annotate context uncertainty based on the Multi-Entity Bayesian Network (MEBN) theory. Thus, the SWARMs ontology can provide both a formal specification for information that is necessarily exchanged between robots and a command and control entity, and also support for uncertainty reasoning. A scenario on chemical pollution monitoring is described and used to showcase how the SWARMs ontology can be instantiated, be extended, represent context uncertainty, and support uncertainty reasoning.

  1. Predicting adolescents' disclosure of personal information in exchange for commercial incentives: an application of an extended theory of planned behavior.

    PubMed

    Heirman, Wannes; Walrave, Michel; Ponnet, Koen

    2013-02-01

    This study adopts a global theoretical framework to predict adolescents' disclosure of personal information in exchange for incentives offered by commercial Websites. The study postulates and tests the validity of a model based on the theory of planned behavior (TPB), including antecedent factors of attitude and perceived behavioral control (PBC). A survey was conducted among 1,042 respondents. Results from SEM analyses show that the hypothesized model fits the empirical data well. The model accounts for 61.9 percent of the variance in adolescents' intention to disclose and 43.7 percent of the variance in self-reported disclosure. Perceived social pressure exerted by significant others (subjective norm) is the most important TPB factor in predicting intention to disclose personal information in exchange for incentives. This finding suggests that in discussions of adolescents' information privacy, the importance of social factors outweighs the individually oriented TPB factors of attitude and PBC. Moreover, privacy concern and trust propensity are significant predictors of respondents' attitudes toward online disclosure in exchange for commercial incentives, whereas the frequency of Internet use significantly affects their level of PBC.

  2. A Case Study: Follow-Up Assessment of Facilitated Communication.

    ERIC Educational Resources Information Center

    Simon, Elliott W.; And Others

    1996-01-01

    This study of an adolescent with multiple disabilities, including moderate mental retardation, who was reported to engage in validated facilitated communication (FC) found he did not engage in validated FC; performance was equivalent whether food or nonfood reinforcers were used; and the Picture Exchange Communication System was a valid and…

  3. A product lifecycle management framework to support the exchange of prototyping and testing information

    NASA Astrophysics Data System (ADS)

    Toche Fumchum, Luc Boris

    2011-12-01

    The modern perspective on product life cycle and the rapid evolution of Information and Communication Technologies in general have opened a new era in product representation and product information sharing between participants, both inside and outside the enterprise and throughout the product life. In particular, the Product Development Process relies on cross-functional activities involving different domains of expertise that each have their own dedicated tools. This has generated new challenges in terms of collaboration and dissemination of information at large between companies or even within the same organization. Within this context, the work reported herein focuses on a specific stakeholder within product development activities - the prototyping and testing department. Its business is typically related to the planning and building of prototypes in order to perform specific tests on the future product or one of its sub-assemblies. The research project aims at investigating an appropriate framework that leverages configured engineering product information, based on complementary information structures, to share and exchange prototyping and testing information in a Product Lifecycle Management (PLM) perspective. As a first step, a case study based on the retrofit of an aircraft engine is deployed to implement a scenario demonstrating the functionalities to be available within the intended framework. For this purpose, complementary and configurable structures are simulated within the project's PLM system. In a second step are considered the software interoperability issues that don't only affect Design -- Testing interactions, but many other interfaces within either the company -- due to the silo-arrangement -- or the consortiums with partners, in which case the whole PLM platforms could simply be incompatible. A study based on an open source initiative and relying on an improved model of communication is described to show how two natively disparate PLM tools can

  4. Nanomaterials Versus Ambient Ultrafine Particles: An Opportunity to Exchange Toxicology Knowledge

    PubMed Central

    Miller, Mark R.; Clift, Martin J.D.; Elder, Alison; Mills, Nicholas L.; Møller, Peter; Schins, Roel P.F.; Vogel, Ulla; Kreyling, Wolfgang G.; Alstrup Jensen, Keld; Kuhlbusch, Thomas A.J.; Schwarze, Per E.; Hoet, Peter; Pietroiusti, Antonio; De Vizcaya-Ruiz, Andrea; Baeza-Squiban, Armelle; Teixeira, João Paulo; Tran, C. Lang; Cassee, Flemming R.

    2017-01-01

    Background: A rich body of literature exists that has demonstrated adverse human health effects following exposure to ambient air particulate matter (PM), and there is strong support for an important role of ultrafine (nanosized) particles. At present, relatively few human health or epidemiology data exist for engineered nanomaterials (NMs) despite clear parallels in their physicochemical properties and biological actions in in vitro models. Objectives: NMs are available with a range of physicochemical characteristics, which allows a more systematic toxicological analysis. Therefore, the study of ultrafine particles (UFP, <100 nm in diameter) provides an opportunity to identify plausible health effects for NMs, and the study of NMs provides an opportunity to facilitate the understanding of the mechanism of toxicity of UFP. Methods: A workshop of experts systematically analyzed the available information and identified 19 key lessons that can facilitate knowledge exchange between these discipline areas. Discussion: Key lessons range from the availability of specific techniques and standard protocols for physicochemical characterization and toxicology assessment to understanding and defining dose and the molecular mechanisms of toxicity. This review identifies a number of key areas in which additional research prioritization would facilitate both research fields simultaneously. Conclusion: There is now an opportunity to apply knowledge from NM toxicology and use it to better inform PM health risk research and vice versa. https://doi.org/10.1289/EHP424 PMID:29017987

  5. Nanomaterials Versus Ambient Ultrafine Particles: An Opportunity to Exchange Toxicology Knowledge.

    PubMed

    Stone, Vicki; Miller, Mark R; Clift, Martin J D; Elder, Alison; Mills, Nicholas L; Møller, Peter; Schins, Roel P F; Vogel, Ulla; Kreyling, Wolfgang G; Alstrup Jensen, Keld; Kuhlbusch, Thomas A J; Schwarze, Per E; Hoet, Peter; Pietroiusti, Antonio; De Vizcaya-Ruiz, Andrea; Baeza-Squiban, Armelle; Teixeira, João Paulo; Tran, C Lang; Cassee, Flemming R

    2017-10-10

    A rich body of literature exists that has demonstrated adverse human health effects following exposure to ambient air particulate matter (PM), and there is strong support for an important role of ultrafine (nanosized) particles. At present, relatively few human health or epidemiology data exist for engineered nanomaterials (NMs) despite clear parallels in their physicochemical properties and biological actions in in vitro models. NMs are available with a range of physicochemical characteristics, which allows a more systematic toxicological analysis. Therefore, the study of ultrafine particles (UFP, <100 nm in diameter) provides an opportunity to identify plausible health effects for NMs, and the study of NMs provides an opportunity to facilitate the understanding of the mechanism of toxicity of UFP. A workshop of experts systematically analyzed the available information and identified 19 key lessons that can facilitate knowledge exchange between these discipline areas. Key lessons range from the availability of specific techniques and standard protocols for physicochemical characterization and toxicology assessment to understanding and defining dose and the molecular mechanisms of toxicity. This review identifies a number of key areas in which additional research prioritization would facilitate both research fields simultaneously. There is now an opportunity to apply knowledge from NM toxicology and use it to better inform PM health risk research and vice versa. https://doi.org/10.1289/EHP424.

  6. PACS/information systems interoperability using Enterprise Communication Framework.

    PubMed

    alSafadi, Y; Lord, W P; Mankovich, N J

    1998-06-01

    Interoperability among healthcare applications goes beyond connectivity to allow components to exchange structured information and work together in a predictable, coordinated fashion. To facilitate building an interoperability infrastructure, an Enterprise Communication Framework (ECF) was developed by the members of the Andover Working Group for Healthcare Interoperability (AWG-OHI). The ECF consists of four models: 1) Use Case Model, 2) Domain Information Model (DIM), 3) Interaction Model, and 4) Message Model. To realize this framework, a software component called the Enterprise Communicator (EC) is used. In this paper, we will demonstrate the use of the framework in interoperating a picture archiving and communication system (PACS) with a radiology information system (RIS).

  7. Electrically facilitated molecular transport. Analysis of the relative contributions of diffusion, migration, and electroosmosis to solute transport in an ion-exchange membrane.

    PubMed

    Bath, B D; White, H S; Scott, E R

    2000-02-01

    Electrically facilitated molecular transport in an ion-exchange membrane (Nafion, 1100 equiv wt) has been studied using a scanning electrochemical microscope. The transport rates of ferrocenylmethyltrimethylammonium (a cation), acetaminophen (a neutral molecule), and ascorbate (an anion) through approximately 120-micron-thick membranes were measured as a function of the iontophoretic current passed across the membrane (-1.0 to +1.0 A/cm2). Transport rates were analyzed by employing the Nernst-Planck equation, modified to account for electric field-driven convective transport. Excellent agreement between experimental and theoretical values of the molecular flux was obtained using a single fitting parameter for each molecule (electroosmotic drag coefficient). The electroosmotic velocity of the neutral molecule, acetaminophen, was shown to be a factor of approximately 500 larger than that of the cation ferrocenylmethyltrimethylammonium, a consequence of the electrostatic interaction of the cation with the negatively charged pore walls of the ion-exchange membrane. Electroosmotic transport of ascorbate occurred at a negligible rate due to repulsion of the anion by the cation-selective membrane. These results suggest that electroosmotic velocities of solute molecules are determined by specific chemical interactions of the permeant and membrane and may be very different from the average solution velocity. The efficiency of electroosmotic transport was also shown to be a function of the membrane thickness, in addition to membrane/solute interactions.

  8. ADULT EDUCATION IN ASIA, AUSTRALIA, AND NEW ZEALAND. CURRENT INFORMATION SOURCES, NUMBER 13.

    ERIC Educational Resources Information Center

    Syracuse Univ., NY. ERIC Clearinghouse on Adult Education.

    THE 45 ABSTRACTS AND ANNOTATIONS IN THIS BIBLIOGRAPHY COVERING THE PERIOD 1963-67 HAVE BEEN ARRANGED BY GEOGRAPHIC LOCATION TO GIVE THE USER CURRENT AWARENESS OF PUBLICATIONS AVAILABLE ON A GIVEN SEGMENT OF THE WORLD, AND TO FACILITATE THE INTERNATIONAL EXCHANGE OF INFORMATION ON ADULT EDUCATION. ITEMS ON INDIA, AUSTRALIA, NEW ZEALAND, NEPAL, AND…

  9. The NASA Scientific and Technical Information (STI) Program's Implementation of Open Archives Initiative (OAI) for Data Interoperability and Data Exchange.

    ERIC Educational Resources Information Center

    Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.

    Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through Web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI)…

  10. 78 FR 20581 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non-Navigator Assistance..., training and certification, and meaningful access standards applicable to Navigators and non-Navigator assistance personnel in Federally- facilitated Exchanges, including State Partnership Exchanges, and to non...

  11. Fungal oxygen exchange between denitrification intermediates and water.

    PubMed

    Rohe, Lena; Anderson, Traute-Heidi; Braker, Gesche; Flessa, Heinz; Giesemann, Anette; Wrage-Mönnig, Nicole; Well, Reinhard

    2014-02-28

    Fungi can contribute greatly to N2O production from denitrification. Therefore, it is important to quantify the isotopic signature of fungal N2O. The isotopic composition of N2O can be used to identify and analyze the processes of N2O production and N2O reduction. In contrast to bacteria, information about the oxygen exchange between denitrification intermediates and water during fungal denitrification is lacking, impeding the explanatory power of stable isotope methods. Six fungal species were anaerobically incubated with the electron acceptors nitrate or nitrite and (18)O-labeled water to determine the oxygen exchange between denitrification intermediates and water. After seven days of incubation, gas samples were analyzed for N2O isotopologues by isotope ratio mass spectrometry. All the fungal species produced N2O. N2O production was greater when nitrite was the sole electron acceptor (129 to 6558 nmol N2O g dw(-1)  h(-1)) than when nitrate was the electron acceptor (6 to 47 nmol N2O g dw(-1)  h(-1)). Oxygen exchange was complete with nitrate as electron acceptor in one of five fungi and with nitrite in two of six fungi. Oxygen exchange of the other fungi varied (41 to 89% with nitrite and 11 to 61% with nitrate). This is the first report on oxygen exchange with water during fungal denitrification. The exchange appears to be within the range previously reported for bacterial denitrification. This adds to the difficulty of differentiating N2O producing processes based on the origin of N2O-O. However, the large oxygen exchange repeatedly observed for bacteria and now also fungi could lead to less variability in the δ(18)O values of N2O from soils, which could facilitate the assessment of the extent of N2O reduction. Copyright © 2013 John Wiley & Sons, Ltd.

  12. Interchanging lexical information for a multilingual dictionary.

    PubMed

    Baud, R H; Nyström, M; Borin, L; Evans, R; Schulz, S; Zweigenbaum, P

    2005-01-01

    To facilitate the interchange of lexical information for multiple languages in the medical domain. To pave the way for the emergence of a generally available truly multilingual electronic dictionary in the medical domain. An interchange format has to be neutral relative to the target languages. It has to be consistent with current needs of lexicon authors, present and future. An active interaction between six potential authors aimed to determine a common denominator striking the right balance between richness of content and ease of use for lexicon providers. A simple list of relevant attributes has been established and published. The format has the potential for collecting relevant parts of a future multilingual dictionary. An XML version is available. This effort makes feasible the exchange of lexical information between research groups. Interchange files are made available in a public repository. This procedure opens the door to a true multilingual dictionary, in the awareness that the exchange of lexical information is (only) a necessary first step, before structuring the corresponding entries in different languages.

  13. Interchanging Lexical Information for a Multilingual Dictionary

    PubMed Central

    Baud, RH; Nyström, M; Borin, L; Evans, R; Schulz, S; Zweigenbaum, P

    2005-01-01

    Objective To facilitate the interchange of lexical information for multiple languages in the medical domain. To pave the way for the emergence of a generally available truly multilingual electronic dictionary in the medical domain. Methods An interchange format has to be neutral relative to the target languages. It has to be consistent with current needs of lexicon authors, present and future. An active interaction between six potential authors aimed to determine a common denominator striking the right balance between richness of content and ease of use for lexicon providers. Results A simple list of relevant attributes has been established and published. The format has the potential for collecting relevant parts of a future multilingual dictionary. An XML version is available. Conclusion This effort makes feasible the exchange of lexical information between research groups. Interchange files are made available in a public repository. This procedure opens the door to a true multilingual dictionary, in the awareness that the exchange of lexical information is (only) a necessary first step, before structuring the corresponding entries in different languages. PMID:16778996

  14. Incentive compatibility in kidney exchange problems.

    PubMed

    Villa, Silvia; Patrone, Fioravante

    2009-12-01

    The problem of kidney exchanges shares common features with the classical problem of exchange of indivisible goods studied in the mechanism design literature, while presenting additional constraints on the size of feasible exchanges. The solution of a kidney exchange problem can be summarized in a mapping from the relevant underlying characteristics of the players (patients and their donors) to the set of matchings. The goal is to select only matchings maximizing a chosen welfare function. Since the final outcome heavily depends on the private information in possess of the players, a basic requirement in order to reach efficiency is the truthful revelation of this information. We show that for the kidney exchange problem, a class of (in principle) efficient mechanisms does not enjoy the incentive compatibility property and therefore is subject to possible manipulations made by the players in order to profit of the misrepresentation of their private information.

  15. GLYDE-II: The GLYcan data exchange format

    PubMed Central

    Ranzinger, Rene; Kochut, Krys J.; Miller, John A.; Eavenson, Matthew; Lütteke, Thomas; York, William S.

    2017-01-01

    Summary The GLYcan Data Exchange (GLYDE) standard has been developed for the representation of the chemical structures of monosaccharides, glycans and glycoconjugates using a connection table formalism formatted in XML. This format allows structures, including those that do not exist in any database, to be unambiguously represented and shared by diverse computational tools. GLYDE implements a partonomy model based on human language along with rules that provide consistent structural representations, including a robust namespace for specifying monosaccharides. This approach facilitates the reuse of data processing software at the level of granularity that is most appropriate for extraction of the desired information. GLYDE-II has already been used as a key element of several glycoinformatics tools. The philosophical and technical underpinnings of GLYDE-II and recent implementation of its enhanced features are described. PMID:28955652

  16. Enhancing provision of written medicine information in Australia: pharmacist, general practitioner and consumer perceptions of the barriers and facilitators

    PubMed Central

    2014-01-01

    Background Written medicine information can play an important role in educating consumers about their medicines. In Australia, standardised, comprehensive written information known as Consumer Medicine Information (CMI) is available for all prescription medicines. CMI is reportedly under-utilised by general practitioners (GPs) and community pharmacists in consultations, despite consumer desire for medicine information. This study aimed to determine consumers’, GPs’ and community pharmacists’ preferences for CMI provision and identify barriers and facilitators to its use. Method Structured questionnaires were developed and administered to a national sample of Australian consumers (phone survey), community pharmacists and GPs (postal surveys) surrounding utilisation of CMI. Descriptive and comparative analyses were conducted. Results Half of consumers surveyed wanted to receive CMI for their prescription medicine, with spoken information preferable to written medicine information for many consumers and healthcare professionals. GPs and pharmacists remained a preferred source of medicine information for consumers, although package inserts were appealing to many among all three cohorts. Overall pharmacists were the preferred provider of CMI primarily due to their medicine expertise, accessibility and perceived availability. GPs preferred CMI dissemination through both the GP and pharmacist. Some consumers preferred GPs as the provider of medicines information because of their knowledge of the patients’ medicines and/or medical history, regularity of seeing the patient and good relationship with the patient. Common barriers to CMI provision cited included: time constraints, CMI length and perceptions that patients are not interested in receiving CMI. Facilitators to enhance provision included: strategies to increase consumer awareness, longer consultation times and counseling appointments, and improvements to pharmacy software technology and workflow. Conclusion

  17. The benefits of health information exchange: an updated systematic review.

    PubMed

    Menachemi, Nir; Rahurkar, Saurabh; Harle, Christopher A; Vest, Joshua R

    2018-04-28

    Widespread health information exchange (HIE) is a national objective motivated by the promise of improved care and a reduction in costs. Previous reviews have found little rigorous evidence that HIE positively affects these anticipated benefits. However, early studies of HIE were methodologically limited. The purpose of the current study is to review the recent literature on the impact of HIE. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct our systematic review. PubMed and Scopus databases were used to identify empirical articles that evaluated HIE in the context of a health care outcome. Our search strategy identified 24 articles that included 63 individual analyses. The majority of the studies were from the United States representing 9 states; and about 40% of the included analyses occurred in a handful of HIEs from the state of New York. Seven of the 24 studies used designs suitable for causal inference and all reported some beneficial effect from HIE; none reported adverse effects. The current systematic review found that studies with more rigorous designs all reported benefits from HIE. Such benefits include fewer duplicated procedures, reduced imaging, lower costs, and improved patient safety. We also found that studies evaluating community HIEs were more likely to find benefits than studies that evaluated enterprise HIEs or vendor-mediated exchanges. Overall, these finding bode well for the HIEs ability to deliver on anticipated improvements in care delivery and reduction in costs.

  18. Supporting multi-state collaboration on privacy and security to foster health IT and health information exchange.

    PubMed

    Banger, Alison K; Alakoye, Amoke O; Rizk, Stephanie C

    2008-11-06

    As part of the HHS funded contract, Health Information Security and Privacy Collaboration, 41 states and territories have proposed collaborative projects to address cross-state privacy and security challenges related to health IT and health information exchange. Multi-state collaboration on privacy and security issues remains complicated, and resources to support collaboration around these topics are essential to the success of such collaboration. The resources outlined here offer an example of how to support multi-stakeholder, multi-state projects.

  19. The Development and Evaluation of an Information Technology Support System to Facilitate Inter-Organisational Collaboration in HRD

    ERIC Educational Resources Information Center

    Ford, Norma J.

    2006-01-01

    Purpose: The purpose of this article is to evaluate the diffusion of and user response to an information technology support system (ITSS) which was designed to facilitate inter-organisational coordination and collaboration in the professional development of officers employed by local authorities (LAs). Design/methodology/approach: An action…

  20. The Role of the United States Book Exchange in the Nationwide Library and Information Services Network. National Program for Libraries and Information Services Related Paper No. 27.

    ERIC Educational Resources Information Center

    Ball, Alice Dulany

    The National Commission on Libraries and Information Science's (NCLIS) nationwide information program is based in part on the sharing of resources. The United States Book Exchange (USBE) and its existing services may have a role in this program, since the USBE's major function is the preservation and maximum utilization of publications through…

  1. Facilitated Communication: An Experimental Evaluation.

    ERIC Educational Resources Information Center

    Regal, Robert A.; And Others

    1994-01-01

    Nineteen adults with developmental disabilities, judged competent in facilitated communication, participated in a validation study using an information passing design requiring short-term recall of stimulus cards with shapes, colors, and numbers. Results failed to validate facilitated communication for the group as a whole, any individual…

  2. [Comparison of the effects of exchange forms on social solidarity].

    PubMed

    Inaba, Misato; Takahashi, Nobuyuki

    2012-04-01

    Although social solidarity is an essential component that helps maintaining social order, what produces solidarity and how does it work have not been fully investigated. We conducted an experiment to examine whether experiencing different forms of social exchange produces different levels of solidarity. We compared four forms of social exchange: reciprocal exchange (exchange resources without negotiation), negotiated exchange (with negotiation), pure-generalized exchange (giver can choose who to give) and chain-generalized exchange (giver cannot choose who to give). Two dimensions classify these exchanges: the number of players (two vs. more than two), and involvement of negotiation. Reciprocal and negotiated exchanges occur within dyads, while pure- and chain-generalized exchanges involve three or more players. Only the negotiated exchange involves negotiation process; the other exchanges are purely unilateral giving. Participants played a one-shot social dilemma game (SDG) before and after social exchange session. The more the players cooperated in SDG, the stronger the social solidarity. Results show that the cooperation rate in SDG increased more in the reciprocal, pure- and chain-generalized exchange conditions than that in the negotiated exchange condition, suggesting that social solidarity is facilitated by experiencing social exchange which does not involve negotiation.

  3. Leveraging private and public exchanges in an employee benefits strategy.

    PubMed

    Margolis, Susan; Thompson, Michael

    2013-01-01

    Health reform is helping to transform the health insurance marketplace and facilitate new opportunities to reevaluate and restructure the underlying framework of employer-sponsored benefits. Central to these opportunities is the emergence of public health exchanges at the state and federal levels offering a coordinated platform of diverse designs and health plans available on a guaranteed issue basis and often with government-provided subsidies. Parallel and complementary to this trend is the emergence of private health exchanges that similarly offer a diversity of plans on a variety of bases. This article shows why, together, these offerings provide potential streamlined solutions for employers as they reevaluate how they facilitate and support access to affordable coverage for their employees (and retirees).

  4. The Effects of Public Concern for Information Privacy on the Adoption of Health Information Exchanges (HIEs) by Healthcare Entities.

    PubMed

    Esmaeilzadeh, Pouyan

    2018-05-08

    The implementation of Health Information Exchanges (HIEs) by healthcare organizations may not achieve the desired outcomes as consumers may request that their health information remains unshared because of information privacy concerns. Drawing on the insights of concern for information privacy (CFIP) literature, this work extends the application of CFIP to the HIE domain. This study attempts to develop and test a model centered on the four dimensions of CFIP construct (collection, errors, unauthorized access, and secondary use) and their antecedents to predict consumers' opt-in behavioral intention toward HIE in the presence of the perceived health status' effects. We conducted an online survey in the United States using 826 samples. The results demonstrate that the perceived health information sensitivity and computer anxiety meaningfully contribute to information privacy concerns and CFIP construct significantly impedes consumers' opt-in decision to HIEs. Interestingly, contrary to our expectation, perceived poor health status considerably attenuates the negative effects exerted by CFIP on opt-in intention. The model proposed by this study can be used as a useful conceptual tool by both further studies and practitioners to examine the complex nature of patients' reactions to information privacy threats associated with the use of HIE technology in the healthcare industry.

  5. Communities' readiness for health information exchange: the National Landscape in 2004.

    PubMed

    Overhage, J Marc; Evans, Lori; Marchibroda, Janet

    2005-01-01

    The Secretary of Health and Human Services recently released a report calling for the nation to create a national health information network (NHIN) that would interconnect Regional Health Information Organizations (RHIOs). These RHIOs, which others have called Local or Regional Health Information Infrastructures (LHII), would in turn interconnect local as well as national health information resources. Little data exist about the activities taking place in communities to create LHIIs. The authors analyzed data that communities submitted in response to a request for capabilities issued by the Foundation for eHealth as part of their Connecting Communities for Better Health program using descriptive statistics and subjective evaluation. The authors analyzed data from 134 responses from communities in 42 states and the District of Columbia. Communities are enthusiastic about moving forward with health information exchange to create LHIIs to improve the efficiency, quality, and safety of care. They have identified significant local sources of investment and plan to use some clinical data standards but not as broadly as was expected. The communities have not yet developed the specific technical approaches or the sustainable business models that will be required. Many communities are interested in creating an LHII and are developing the leadership commitment needed to translate that interest into an operational reality. Clinical information standards can be incorporated into a community's plans as often as they need to be. Communities have to overcome funding issues, develop deeper understanding of the technical and organizational issues, and aggressively share their learning to succeed within their community and to help other communities succeed.

  6. 45 CFR 156.715 - Compliance reviews of QHP issuers in Federally-facilitated Exchanges.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...'s enrollees; (2) The QHP issuer's policies and procedures, protocols, standard operating procedures... REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES Oversight and Financial Integrity Standards for Issuers of...

  7. Success in health information exchange projects: solving the implementation puzzle.

    PubMed

    Sicotte, Claude; Paré, Guy

    2010-04-01

    Interest in health information exchange (HIE), defined as the use of information technology to support the electronic transfer of clinical information across health care organizations, continues to grow among those pursuing greater patient safety and health care accessibility and efficiency. In this paper, we present the results of a longitudinal multiple-case study of two large-scale HIE implementation projects carried out in real time over 3-year and 2-year periods in Québec, Canada. Data were primarily collected through semi-structured interviews (n=52) with key informants, namely implementation team members and targeted users. These were supplemented with non-participants observation of team meetings and by the analysis of organizational documents. The cross-case comparison was particularly relevant given that project circumstances led to contrasting outcomes: while one project failed, the other was a success. A risk management analysis was performed taking a process view in order to capture the complexity of project implementations as evolving phenomena that are affected by interdependent pre-existing and emergent risks that tend to change over time. The longitudinal case analysis clearly demonstrates that the risk factors were closely intertwined. Systematic ripple effects from one risk factor to another were observed. This risk interdependence evolved dynamically over time, with a snowball effect that rendered a change of path progressively more difficult as time passed. The results of the cross-case analysis demonstrate a direct relationship between the quality of an implementation strategy and project outcomes. Copyright 2010 Elsevier Ltd. All rights reserved.

  8. Physicians' Perceptions and Use of a Health Information Exchange: A Pilot Program in South Korea

    PubMed Central

    Lee, Sang-il; Kim, Jeong-Whun; Hwang, Hee; Cho, Eun-Young; Kim, Yoon; Ha, Kyooseob

    2012-01-01

    Abstract Objective: We examined physicians' perceived needs, benefits, and concerns regarding health information exchange (HIE) technology prior to experiencing it and their actual usage of exchanged information in care processes during an HIE pilot program in South Korea. Materials and Methods: We conducted a survey through a structured questionnaire to collect data on physician perceptions about an HIE prior to implementation. We analyzed responses using descriptive statistics and one-way analyses of variance. We also conducted a post-implementation survey through a computerized tool designed to collect data on physician assessment of HIE item usefulness. We defined two indices to measure the volume of information flow and usefulness for individual HIE items and analyzed the indices with Fisher's exact test. Results: Physicians' overall perceptions about the need for an HIE and benefits of the technology were positive despite their concerns about information safety and security, system costs, and disputes between care providers in cases of malpractice. We found that physician practice settings significantly influenced the details of their perceptions. In the both pre- and post-implementation studies, the most needed and valued information were pathology and lab results, diagnostic imaging, medication, and working diagnosis. Physicians most agreed with the benefit potentials in the quality domain, least agreed with those in time and cost savings of healthcare delivery, and least worried about the decrease in revenues resulting from the technology. Conclusions: The overall physician acceptance of the HIE technology in South Korea is promising, but the adoption and diffusion strategy needs to be tailored to the type of physician practice. Concerted efforts may be needed to realize the much-anticipated potential of healthcare cost savings. PMID:22352898

  9. Simulation Suggests That Medical Group Mergers Won’t Undermine The Potential Utility Of Health Information Exchanges

    PubMed Central

    Schneider, Eric C.; Volk, Lynn A.; Szolovits, Peter; Salzberg, Claudia A.; Simon, Steven R.; Bates, David W.

    2013-01-01

    Substantial resources are being invested in health information exchanges (HIE), community-based consortia that enable independent health-care organizations to exchange clinical data. However, under pressure to form accountable care organizations, medical groups may merge and support private HIE, reducing the potential utility of community HIEs. Simulations of “care transitions” based on data from 10 Massachusetts communities suggest that mergers would have to be considerable to substantially reduce the potential utility of an HIE. Nonetheless, simulations also suggest that HIEs will need to recruit a large proportion of the medical groups in a community, as hospitals and the largest groups account for only 10 to 20% of care transitions in communities. PMID:22392665

  10. High Temperature Composite Heat Exchangers

    NASA Technical Reports Server (NTRS)

    Eckel, Andrew J.; Jaskowiak, Martha H.

    2002-01-01

    High temperature composite heat exchangers are an enabling technology for a number of aeropropulsion applications. They offer the potential for mass reductions of greater than fifty percent over traditional metallics designs and enable vehicle and engine designs. Since they offer the ability to operate at significantly higher operating temperatures, they facilitate operation at reduced coolant flows and make possible temporary uncooled operation in temperature regimes, such as experienced during vehicle reentry, where traditional heat exchangers require coolant flow. This reduction in coolant requirements can translate into enhanced range or system payload. A brief review of the approaches and challengers to exploiting this important technology are presented, along with a status of recent government-funded projects.

  11. What supports do health system organizations have in place to facilitate evidence-informed decision-making? A qualitative study.

    PubMed

    Ellen, Moriah E; Léon, Gregory; Bouchard, Gisèle; Lavis, John N; Ouimet, Mathieu; Grimshaw, Jeremy M

    2013-08-06

    Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a 'knowledge broker') in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff's capacity building. This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision-making. Some of the identified supports may increase the use of

  12. Complications of Impulse Generator Exchange Surgery for Deep Brain Stimulation: A Single-Center, Retrospective Study.

    PubMed

    Helmers, Ann-Kristin; Lübbing, Isabel; Birkenfeld, Falk; Witt, Karsten; Synowitz, Michael; Mehdorn, Hubertus Maximilian; Falk, Daniela

    2018-05-01

    Nonrechargeable deep brain stimulation impulse generators (IGs) with low or empty battery status require surgical IG exchange several years after initial implantation. The aim of this study was to investigate complication rates after IG exchange surgery and identify risk factors. We retrospectively analyzed complications following IG exchange surgery from 2008 to 2015 in our department. Medical records of all patients who underwent IG exchange surgery were systematically reviewed. The shortest follow-up time was 19 months. From 2008 to 2015, 438 IGs were exchanged in 319 patients. Overall complication rate was 8.90%. Infection developed in 12 patients (2.74%). Six patients (1.37%) experienced local wound erosions. Hardware malfunctions were present in 11 patients (2.51%), and local hemorrhage was observed in 3 cases (0.68%). Repeated fixation of the IG was required in 2 patients (0.46%). Traction of the connecting cables necessitated surgical revision in 2 patients (0.46%). In 2 cases (0.46%), the IG was placed abdominally or exchanged for a smaller device owing to patient discomfort resulting from the initial positioning. One 80-year-old patient (0.23%) had severely worsening heart failure and died 4 days after IG exchange surgery. IG exchange surgery, although often considered a minor surgery, was associated with a complication rate of approximately 9% in our center. Patients and physicians should understand the complication rates associated with IG exchange surgery because this information might facilitate selection of a rechargeable IG. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats.

    PubMed

    Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José

    2012-07-01

    This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility.

  14. Semiautomated Sample Preparation for Protein Stability and Formulation Screening via Buffer Exchange.

    PubMed

    Ying, William; Levons, Jaquan K; Carney, Andrea; Gandhi, Rajesh; Vydra, Vicky; Rubin, A Erik

    2016-06-01

    A novel semiautomated buffer exchange process workflow was developed to enable efficient early protein formulation screening. An antibody fragment protein, BMSdab, was used to demonstrate the workflow. The process afforded 60% to 80% cycle time and scientist time savings and significant material efficiencies. These efficiencies ultimately facilitated execution of this stability work earlier in the drug development process, allowing this tool to inform the developability of potential candidates for development from a formulation perspective. To overcome the key technical challenges, the protein solution was buffer-exchanged by centrifuge filtration into formulations for stability screening in a 96-well plate with an ultrafiltration membrane, leveraging automated liquid handling and acoustic volume measurements to allow several cycles of exchanges. The formulations were transferred into a vacuum manifold and sterile filtered into a rack holding 96 glass vials. The vials were sealed with a capmat of individual caps and placed in stability stations. Stability of the samples prepared by this process and by the standard process was demonstrated to be comparable. This process enabled screening a number of formulations of a protein at an early pharmaceutical development stage with a short sample preparation time. © 2015 Society for Laboratory Automation and Screening.

  15. Participants’ perceptions of a knowledge-brokering strategy to facilitate evidence-informed policy-making in Fiji

    PubMed Central

    2013-01-01

    Background Evidence-informed policy-making (EIPM) is optimal when evidence-producers (researchers) and policy developers work collaboratively to ensure the production and use of the best available evidence. This paper examined participants’ perceptions of knowledge-brokering strategies used in the TROPIC (Translational Research in Obesity Prevention in Communities) project to facilitate the use of obesity-related evidence in policy development in Fiji. Method Knowledge-brokers delivered a 12-18 month programme comprising workshops targeting EIPM skills and practical support for developing evidence-informed policy briefs to reduce obesity. The programme was tailored to each of the six participating organizations. Knowledge-brokering strategies included negotiating topics that were aligned to the goals of individual organizations, monitoring and evaluating time-management skills, accommodating other organizational and individual priorities, delivering practical sessions on use of appropriate research tools and supporting individual writing of policy briefs. Two qualitative methods were used to examine individuals’ perceptions of skills obtained, opportunities afforded by the TROPIC project, facilitators and inhibiters to planned policy brief development and suggestions for improved programme delivery. Forty-nine participants completed an electronic word table and then participated in a semi-structured interview. An independent interviewer conducted structured interviews with a high-ranking officer in each organization to examine their perceptions of TROPIC engagement strategies. Data were analyzed descriptively and thematically, with the first author and another experienced qualitative researcher analyzing data sets separately, and then combining analyses. Results Many participants believed that they had increased their skills in acquiring, assessing, adapting and applying evidence, writing policy briefs and presenting evidence-based arguments to higher levels

  16. 78 FR 42823 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ...This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally- facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. The final rule also directs that each Exchange designate organizations which will then certify their staff members and volunteers to be application counselors that assist consumers and facilitate enrollment in qualified health plans and insurance affordability programs, and provides standards for that designation.

  17. Imaging of endogenous exchangeable proton signals in the human brain using frequency labeled exchange transfer imaging.

    PubMed

    Yadav, Nirbhay N; Jones, Craig K; Hua, Jun; Xu, Jiadi; van Zijl, Peter C M

    2013-04-01

    To image endogenous exchangeable proton signals in the human brain using a recently reported method called frequency labeled exchange transfer (FLEX) MRI. As opposed to labeling exchangeable protons using saturation (i.e., chemical exchange saturation transfer, or CEST), FLEX labels exchangeable protons with their chemical shift evolution. The use of short high-power frequency pulses allows more efficient labeling of rapidly exchanging protons, while time domain acquisition allows removal of contamination from semi-solid magnetization transfer effects. FLEX-based exchangeable proton signals were detected in human brain over the 1-5 ppm frequency range from water. Conventional magnetization transfer contrast and the bulk water signal did not interfere in the FLEX spectrum. The information content of these signals differed from in vivo CEST data in that the average exchange rate of these signals was 350-400 s(-1) , much faster than the amide signal usually detected using direct saturation (∼30 s(-1) ). Similarly, fast exchanging protons could be detected in egg white in the same frequency range where amide and amine protons of mobile proteins and peptides are known to resonate. FLEX MRI in the human brain preferentially detects more rapidly exchanging amide/amine protons compared to traditional CEST experiments, thereby changing the information content of the exchangeable proton spectrum. This has the potential to open up different types of endogenous applications as well as more easy detection of rapidly exchanging protons in diaCEST agents or fast exchanging units such as water molecules in paracest agents without interference of conventional magnetization transfer contrast. Copyright © 2013 Wiley Periodicals, Inc.

  18. 8 CFR 214.12 - Preliminary enrollment of schools in the Student and Exchange Visitor Information System (SEVIS).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of schools in the Student and Exchange Visitor Information System (SEVIS). (a) Private elementary and private secondary schools, public high schools, post-secondary schools, language schools, and vocational... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Preliminary enrollment of schools in the...

  19. Politeness Strategies in Collaborative E-Mail Exchanges

    ERIC Educational Resources Information Center

    Vinagre, Margarita

    2008-01-01

    Computer-supported collaborative learning (CSCL) has been the subject of a wide range of studies over the last twenty years. Previous research suggests that CSCL exchanges can facilitate group-based learning and knowledge construction among learners who are in different geographical locations [Littleton, K. & Whitelock, D. (2004). "Guiding the…

  20. Integration of IEEE 1451 and HL7 exchanging information for patients' sensor data.

    PubMed

    Kim, Wooshik; Lim, Suyoung; Ahn, Jinsoo; Nah, Jiyoung; Kim, Namhyun

    2010-12-01

    HL7 (Health Level 7) is a standard developed for exchanging incompatible healthcare information generated from programs or devices among heterogenous medical information systems. At present, HL7 is growing as a global standard. However, the HL7 standard does not support effective methods for treating data from various medical sensors, especially from mobile sensors. As ubiquitous systems are growing, HL7 must communicate with various medical transducers. In the area of sensor fields, IEEE 1451 is a group of standards for controlling transducers and for communicating data from/to various transducers. In this paper, we present the possibility of interoperability between the two standards, i.e., HL7 and IEEE 1451. After we present a method to integrate them and show the preliminary results of this approach.

  1. Information Technologies in Teacher Education. Issues and Experiences for Countries in Transition. Proceedings of a European Workshop, University of Twente (Enschede, Netherlands, February 20-23, 1994).

    ERIC Educational Resources Information Center

    Collis, Betty, Ed.; And Others

    This document contains 21 papers from an international workshop designed to facilitate the exchange of ideas concerning the use of information technology in teacher education among experts from Central, Eastern, and Western Europe. The papers include: (1) "Communication and Information Technologies as Change Agents" (Jef Moonen); (2)…

  2. Use of a simplified consent form to facilitate patient understanding of informed consent for laparoscopic cholecystectomy

    PubMed Central

    Borello, Alessandro; Passera, Roberto; Surace, Alessandra; Marola, Silvia; Buccelli, Claudio; Niola, Massimo; Di Lorenzo, Pierpaolo; Amato, Maurizio; Di Domenico, Lorenza; Solej, Mario; Martino, Valter

    2016-01-01

    Abstract Background Surgical informed consent forms can be complicated for patients to read and understand. We created a consent form with key information presented in bulleted texts and diagrams combined in a graphical format to facilitate the understanding of information during the verbal consent discussion. Methods This prospective, randomized study involved 70 adult patients awaiting cholecystectomy for gallstones. Consent was obtained after standard verbal explanation using either a graphically formatted (study group, n=33) or a standard text document (control group, n=37). Comprehension was evaluated with a 9-item multiple-choice questionnaire administered before surgery and factors affecting comprehension were analyzed. Results Comparison of questionnaire scores showed no effect of age, sex, time between consent and surgery, or document format on understanding of informed consent. Educational level was the only predictor of comprehension. Conclusions Simplified surgical consent documents meet the goals of health literacy and informed consent. Educational level appears to be a strong predictor of understanding. PMID:28352847

  3. Use of a simplified consent form to facilitate patient understanding of informed consent for laparoscopic cholecystectomy.

    PubMed

    Borello, Alessandro; Ferrarese, Alessia; Passera, Roberto; Surace, Alessandra; Marola, Silvia; Buccelli, Claudio; Niola, Massimo; Di Lorenzo, Pierpaolo; Amato, Maurizio; Di Domenico, Lorenza; Solej, Mario; Martino, Valter

    2016-01-01

    Surgical informed consent forms can be complicated for patients to read and understand. We created a consent form with key information presented in bulleted texts and diagrams combined in a graphical format to facilitate the understanding of information during the verbal consent discussion. This prospective, randomized study involved 70 adult patients awaiting cholecystectomy for gallstones. Consent was obtained after standard verbal explanation using either a graphically formatted (study group, n=33) or a standard text document (control group, n=37). Comprehension was evaluated with a 9-item multiple-choice questionnaire administered before surgery and factors affecting comprehension were analyzed. Comparison of questionnaire scores showed no effect of age, sex, time between consent and surgery, or document format on understanding of informed consent. Educational level was the only predictor of comprehension. Simplified surgical consent documents meet the goals of health literacy and informed consent. Educational level appears to be a strong predictor of understanding.

  4. NJDOT research peer exchange, October 2001 : information package.

    DOT National Transportation Integrated Search

    2001-10-01

    Summary of the Peer Exchange Take Home Ideas: : Be proactive in regularly meeting with key stakeholder managers to identify their : strategic needs in moving their program responsibilities forward. : Incorporate discussion of strategic ...

  5. Heat exchanger for reactor core and the like

    DOEpatents

    Kaufman, Jay S.; Kissinger, John A.

    1986-01-01

    A compact bayonet tube type heat exchanger which finds particular application as an auxiliary heat exchanger for transfer of heat from a reactor gas coolant to a secondary fluid medium. The heat exchanger is supported within a vertical cavity in a reactor vessel intersected by a reactor coolant passage at its upper end and having a reactor coolant return duct spaced below the inlet passage. The heat exchanger includes a plurality of relatively short length bayonet type heat exchange tube assemblies adapted to pass a secondary fluid medium therethrough and supported by primary and secondary tube sheets which are releasibly supported in a manner to facilitate removal and inspection of the bayonet tube assemblies from an access area below the heat exchanger. Inner and outer shrouds extend circumferentially of the tube assemblies and cause the reactor coolant to flow downwardly internally of the shrouds over the tube bundle and exit through the lower end of the inner shroud for passage to the return duct in the reactor vessel.

  6. Emotion processing facilitates working memory performance.

    PubMed

    Lindström, Björn R; Bohlin, Gunilla

    2011-11-01

    The effect of emotional stimulus content on working memory performance has been investigated with conflicting results, as both emotion-dependent facilitation and impairments are reported in the literature. To clarify this issue, 52 adult participants performed a modified visual 2-back task with highly arousing positive stimuli (sexual scenes), highly arousing negative stimuli (violent death) and low-arousal neutral stimuli. Emotional stimulus processing was found to facilitate task performance relative to that of neutral stimuli, both in regards to response accuracy and reaction times. No emotion-dependent differences in false-alarm rates were found. These results indicate that emotional information can have a facilitating effect on working memory maintenance and processing of information.

  7. Insurance Exchange Marketplace: Implications for Emergency Medicine Practice

    PubMed Central

    Rankey, David S.

    2012-01-01

    The Patient Protection and Affordable Care Act of 2010 requires states to establish healthcare insurance exchanges by 2014 to facilitate the purchase of qualified health plans. States are required to establish exchanges for small businesses and individuals. A federally operated exchange will be established, and states failing to participate in any other exchanges will be mandated to join the federal exchange. Policymakers and health economists believe that exchanges will improve healthcare at lower cost by promoting competition among insurers and by reducing burdensome transaction costs. Consumers will no longer be isolated from monthly insurance premium costs. Exchanges will increase the number of patients insured with more cost-conscious managed care and high-deductible plans. These insurance plan models have historically undervalued emergency medical services, while also underinsuring patients and limiting their healthcare system access to the emergency department. This paradoxically increases demand for emergency services while decreasing supply. The continual devaluation of emergency medical services by insurance payers will result in inadequate distribution of resources to emergency care, resulting in further emergency department closures, increases in emergency department crowding, and the demise of acute care services provided to families and communities. PMID:22900107

  8. Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE)

    PubMed Central

    Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

    2016-01-01

    The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE’s effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation. PMID:28269897

  9. Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE).

    PubMed

    Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

    2016-01-01

    The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.

  10. 77 FR 76336 - Self-Regulatory Organizations; International Securities Exchange, LLC; Notice of Filing of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-27

    ... Reduce the Response Times in the Block Mechanism, Facilitation Mechanism, Solicited Order Mechanism and... Change The Exchange proposes to amend Rules 716 (Block Trades) and 723 (Price Improvement Mechanism for Crossing Transactions) to reduce the response times in the Block Mechanism, Facilitation Mechanism...

  11. Climate Change Information Dashboards for Water Resource Managers

    NASA Astrophysics Data System (ADS)

    Buja, Lawrence

    2016-04-01

    It is in the context of its application that one needs to determine if climate information is of high quality and ultimately useful. Therefore, it is important that the intersection between data providers and data consumers is structured in form of an iterative and collaborative exchange where science and application viewpoints can be brought together. A traditional "loading dock"-style hand-off of data fails to optimally inform decisions. It is now broadly recognized that a collaborative, open exchange is better suited to generate credible and salient products and knowledge that can be more confidently used in decisions. But in order for this exchange to be successful in practice, it needs to be sufficiently efficient to actually facilitate an exploratory process that is inherently iterative to determine the most informative products. It also requires a transparent approach that is easily understood and communicated. We will present prototypes of Climate Information Dashboards that collect on a single page to integrate a suite of key climate information for resource managers. The content of dashboards is based on standardized products that can be assembled to meet specific needs. They were co-designed with the water resource managers and are tailored to selected management and decision topics. The visualizations are tuned to quickly provide the basic information, yet below individual diagnostics are more detailed analyses that can be consulted. These dashboards offer a flexible way to connect decision-makers to climate model output. Conversely, such dashboards can also be applied to inform model development by providing insight into a suite of key characteristics of model performance that have been identified as critical by a sector.

  12. An Overview of Practice Facilitation Programs in Canada: Current Perspectives and Future Directions

    PubMed Central

    Liddy, Clare; Laferriere, Dianne; Baskerville, Bruce; Dahrouge, Simone; Knox, Lyndee; Hogg, William

    2013-01-01

    Practice facilitation has proven to be effective in improving the quality of primary care. A practice facilitator is a health professional, usually external to the practice, who regularly visits the practice to provide support in change management that targets improvements in the delivery of care. Our environmental scan shows that several initiatives across Canada utilize practice facilitation as a quality improvement method; however, many are conducted in isolation as there is a lack of coordinated effort, knowledge translation and dissemination in this field across the country. We recommend that investments be made in capacity building, knowledge exchange and facilitator training, and that partnership building be considered a priority in this field. PMID:23968627

  13. Exploring Health Information Exchange Implementation Using Qualitative Assessments of Nursing Home Leaders

    PubMed Central

    Alexander, Gregory L.; Popejoy, Lori; Lyons, Vanessa; Shumate, Sue; Mueller, Jessica; Galambos, Colleen; Vogelsmeier, Amy; Rantz, Marilyn; Flesner, Marcia

    2016-01-01

    Objectives Limited research exists on nursing home information technologies, such as health information exchange (HIE) systems. Capturing the experiences of early HIE adopters provides vital information about how these systems are used. In this study, we conduct a secondary analysis of qualitative data captured during interviews with 15 nursing home leaders representing 14 nursing homes in the midwestern United States that are part of the Missouri Quality Improvement Initiative (MOQI) national demonstration project. Methods The interviews were conducted as part of an external evaluation of the HIE vendor contracting with the MOQI initiative with the purpose of understanding the challenges and successes of HIE implementation, with a particular focus on Direct HIE services. Results Emerging themes included (1) incorporating HIE into existing work processes, (2) participation inside and outside the facility, (3) appropriate training and retraining, (4) getting others to use the HIE, (5) getting the HIE operational, and 6) putting policies for technology into place. Discussion Three essential areas should be considered for nursing homes considering HIE adoption: readiness to adopt technology, availability of technology resources, and matching of new clinical workflows. PMID:27843423

  14. Characterizing the Networks of Digital Information that Support Collaborative Adaptive Forest Management in Sierra Nevada Forests.

    PubMed

    Lei, Shufei; Iles, Alastair; Kelly, Maggi

    2015-07-01

    Some of the factors that can contribute to the success of collaborative adaptive management--such as social learning, open communication, and trust--are built upon a foundation of the open exchange of information about science and management between participants and the public. Despite the importance of information transparency, the use and flow of information in collaborative adaptive management has not been characterized in detail in the literature, and currently there exist opportunities to develop strategies for increasing the exchange of information, as well as to track information flow in such contexts. As digital information channels and networks have been increased over the last decade, powerful new information monitoring tools have also been evolved allowing for the complete characterization of information products through their production, transport, use, and monitoring. This study uses these tools to investigate the use of various science and management information products in a case study--the Sierra Nevada Adaptive Management Project--using a mixed method (citation analysis, web analytics, and content analysis) research approach borrowed from the information processing and management field. The results from our case study show that information technologies greatly facilitate the flow and use of digital information, leading to multiparty collaborations such as knowledge transfer and public participation in science research. We conclude with recommendations for expanding information exchange in collaborative adaptive management by taking advantage of available information technologies and networks.

  15. Characterizing the Networks of Digital Information that Support Collaborative Adaptive Forest Management in Sierra Nevada Forests

    NASA Astrophysics Data System (ADS)

    Lei, Shufei; Iles, Alastair; Kelly, Maggi

    2015-07-01

    Some of the factors that can contribute to the success of collaborative adaptive management—such as social learning, open communication, and trust—are built upon a foundation of the open exchange of information about science and management between participants and the public. Despite the importance of information transparency, the use and flow of information in collaborative adaptive management has not been characterized in detail in the literature, and currently there exist opportunities to develop strategies for increasing the exchange of information, as well as to track information flow in such contexts. As digital information channels and networks have been increased over the last decade, powerful new information monitoring tools have also been evolved allowing for the complete characterization of information products through their production, transport, use, and monitoring. This study uses these tools to investigate the use of various science and management information products in a case study—the Sierra Nevada Adaptive Management Project—using a mixed method (citation analysis, web analytics, and content analysis) research approach borrowed from the information processing and management field. The results from our case study show that information technologies greatly facilitate the flow and use of digital information, leading to multiparty collaborations such as knowledge transfer and public participation in science research. We conclude with recommendations for expanding information exchange in collaborative adaptive management by taking advantage of available information technologies and networks.

  16. Health and sexual behaviour among exchange students.

    PubMed

    Petersson, Carina; Peterson, Ulla; Swahnberg, Katarina; Oscarsson, Marie

    2016-08-26

    The objective was to describe the exchange students' health and sexual behaviour associated with their exchange studies, and examine the extent to which they had received preventive efforts against human immunodeficiency virus (HIV)/sexually transmitted infection (STI) and safer sex before departure. A cross-sectional study was conducted based on a web survey with questions about sexual behaviour, self-esteem and psychological well-being. Data were analysed using descriptive and analytical statistics. A total of 136 outgoing exchange students from a Swedish University participated. Most of the exchange students rated their health as good, had psychological well-being and rated their self-esteem as being high. Approximately half of the exchange students had sex with a new partner during the exchange semester, and 87% of them had sexually risky behaviour. More than half (61%) of the exchange students had received preventive efforts before departure. No statistically significant difference regarding preventive information was found between those who reported sexually risky behaviour and those who did not. The group that had sexually risky behaviour desired free condoms and access to clinics for sexual health. CONCLUSIONS EXCHANGE STUDENTS RATED THEIR HEALTH AS GOOD, AND THE MAJORITY OF THEM PARTICIPATED IN INFORMATION SESSIONS THAT ADDRESSED PREVENTIVE EFFORTS ON HIV/STI AND SAFER SEX BEFORE DEPARTURE SEXUALLY RISKY BEHAVIOUR DURING EXCHANGE STUDIES WAS REPORTED AND HIGHLIGHTS THE NEED FOR MORE EFFECTIVE PREVENTIVE MEASURES; FOR EXAMPLE, A RECOLLECTION OF READING STI INFORMATION. © Author(s) 2016.

  17. Alert Exchange Process Protocol

    NASA Technical Reports Server (NTRS)

    Groen, Frank

    2015-01-01

    The National Aeronautics and Space Administration of the United States of America (NASA), and the European Space Agency (ESA), and the Japanese Aerospace Exploration Agency (JAXA), acknowledging that NASA, ESA and JAXA have a mutual interest in exchanging Alerts and Alert Status Lists to enhance the information base for each system participant while fortifying the general level of cooperation between the policy agreement subscribers, and each Party will exchange Alert listings on regular basis and detailed Alert information on a need to know basis to the extent permitted by law.

  18. Patients' support for health information exchange: a literature review and classification of key factors.

    PubMed

    Esmaeilzadeh, Pouyan; Sambasivan, Murali

    2017-04-04

    Literature indicates that one of the most important factors affecting the widespread adoption of Health Information Exchange (HIE) is patient support and endorsement. In order to reap all the expected benefits of HIE, patients' acceptance of technology is a challenge that is not fully studied. There are a few studies which have focused on requirements of electronic medical information exchange from consumers' views and expectations. This study is aimed at reviewing the literature to articulate factors that affect patients to support HIE efforts. A literature review of current studies addressing patients' views on HIE from 2005 was undertaken. Five electronic research databases (Science Direct, PubMed, Web of Science, CINAHL, and Academic Search Premiere) were searched to retrieve articles reporting pros and cons of HIE from patients' opinion. One hundred and ninety six articles were initially retrieved from the databases. Out of 196, 36 studies met the inclusion criteria and were fully reviewed. Our findings indicate that patient's attitude toward HIE is affected by seven main factors: perceived benefits, perceived concerns, patient characteristics, patient participation level in HIE, type of health information, identity of recipients, and patient preferences regarding consent and features. The findings provide useful theoretical implications for research by developing a classification of significant factors and a framework based on the lessons learned from the literature to help guide HIE efforts. Our results also have fundamental practical implications for policy makers, current and potential organizers of HIEs by highlighting the role of patients in the widespread implementation of HIE. The study indicates that new approaches should be applied to completely underline HIE benefits for patients and also address their concerns.

  19. Implementation of a Tool to Enhance Evidence-Informed Decision Making in Public Health: Identifying Barriers and Facilitating Factors

    ERIC Educational Resources Information Center

    van der Heide, Iris; van der Noordt, Maaike; Proper, Karin I.; Schoemaker, Casper; van den Berg, Matthijs; Hamberg-van Reenen, Heleen H.

    2016-01-01

    One of the barriers regarding evidence-informed decision making is the gap between the needs of policy makers and the ways researchers present evidence. This pilot study evaluates the barriers and facilitators to the implementation of a tool to enhance transparent and unambiguous communication on scientific evidence by knowledge workers.…

  20. Local Health Departments' Partners and Challenges in Electronic Exchange of Health Information

    PubMed Central

    Vest, Joshua R.; Lovelace, Kay; McCullough, J. Mac

    2016-01-01

    Background: Unprecedented amounts of data are produced by the health care and other sectors, presenting opportunities for local health departments (LHDs) to access these data. LHDs will need to participate in health information exchange (HIE) with a number of partners in order to benefit from these data resources. LHDs' participation in HIEs with specific partners has not been studied. Objectives: To describe the level of and challenges in LHD participation in HIE with other partners, and variation by LHD population size and governance type. Data and Methods: This research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States. A representative sample of 650 LHDs was drawn using a stratified random sampling design. A total of 324 completed responses were received with a 50% response rate. Survey data were cleaned, and bivariate comparisons were conducted using χ2 and Somer's D. Results: Substantial variation existed in LHDs' participation in HIE by type of exchange partner. Although 71% participated in HIE with the state departments of health, only 12% with jail/correctional health, 14% with health or county-based purchasing plans, and 15% with home health agencies. Compared with large LHDs (jurisdiction populations of ≥500 000), smaller LHDs were more likely to participate in HIE with state departments of health, but less likely with other exchange partners. The challenges to HIE participation were technological, and organizational/interorganizational in nature and variation existed by LHDs' population size and governance structure with respect to state authority. Conclusions: Local public health agencies more commonly participate in HIE with some partners, but may need to improve HIE with many others. National strategies targeting an increase in HIE of LHDs may use our findings to focus those initiatives. PMID:27684617

  1. Chemical information matters: an e-Research perspective on information and data sharing in the chemical sciences.

    PubMed

    Bird, Colin L; Frey, Jeremy G

    2013-08-21

    Recently, a number of organisations have called for open access to scientific information and especially to the data obtained from publicly funded research, among which the Royal Society report and the European Commission press release are particularly notable. It has long been accepted that building research on the foundations laid by other scientists is both effective and efficient. Regrettably, some disciplines, chemistry being one, have been slow to recognise the value of sharing and have thus been reluctant to curate their data and information in preparation for exchanging it. The very significant increases in both the volume and the complexity of the datasets produced has encouraged the expansion of e-Research, and stimulated the development of methodologies for managing, organising, and analysing "big data". We review the evolution of cheminformatics, the amalgam of chemistry, computer science, and information technology, and assess the wider e-Science and e-Research perspective. Chemical information does matter, as do matters of communicating data and collaborating with data. For chemistry, unique identifiers, structure representations, and property descriptors are essential to the activities of sharing and exchange. Open science entails the sharing of more than mere facts: for example, the publication of negative outcomes can facilitate better understanding of which synthetic routes to choose, an aspiration of the Dial-a-Molecule Grand Challenge. The protagonists of open notebook science go even further and exchange their thoughts and plans. We consider the concepts of preservation, curation, provenance, discovery, and access in the context of the research lifecycle, and then focus on the role of metadata, particularly the ontologies on which the emerging chemical Semantic Web will depend. Among our conclusions, we present our choice of the "grand challenges" for the preservation and sharing of chemical information.

  2. 77 FR 67844 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Granting...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... Regulatory Circular the required layout for the data that would be submitted to the Exchange.\\7\\ \\5\\ See... Section 6(b)(5) of the Act,\\10\\ which requires, among other things, that the Exchange's rules be designed... that CBOE's proposed rule change is designed to facilitate the production of uniform data by TPHs...

  3. A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care.

    PubMed

    Klapman, Seth; Sher, Emily; Adler-Milstein, Julia

    2018-06-01

    Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians. We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA. We characterized the state of health information exchange (HIE) by country and used thematic analysis to identify the perceived benefits of access to complete past medical history (PMH), the conditions under which PMH is sought, and the challenges to accessing and using HIE capabilities. HIE approaches, and the information electronically accessible to clinicians, differed by country. Benefits of access to PMH included safer care, reduced patient length of stay, and fewer lab and imaging orders. Conditions under which PMH was sought included moderate-acuity patients, patients with chronic conditions, and instances where accessing PMH was convenient. Challenges to HIE access and use included difficulty knowing where information is located, delay in receiving information, and difficulty finding information within documents. Even with different HIE approaches across countries, all clinicians reported shortcomings in their country's approach. Notably, challenges were similar and shaped the conditions under which PMH was sought. As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another.

  4. Information Infrastructure, Information Environments, and Long-Term Collaboration

    NASA Astrophysics Data System (ADS)

    Baker, K. S.; Pennington, D. D.

    2009-12-01

    Information infrastructure that supports collaborative science is a complex system of people, organizational arrangements, and tools that require co-management. Contemporary studies are exploring how to establish and characterize effective collaborative information environments. Collaboration depends on the flow of information across the human and technical system components through mechanisms that create linkages, both conceptual and technical. This transcends the need for requirements solicitation and usability studies, highlighting synergistic interactions between humans and technology that can lead to emergence of group level cognitive properties. We consider the ramifications of placing priority on establishing new metaphors and new types of learning environments located near-to-data-origin for the field sciences. In addition to changes in terms of participant engagement, there are implications in terms of innovative contributions to the design of information systems and data exchange. While data integration occurs in the minds of individual participants, it may be facilitated by collaborative thinking and community infrastructure. Existing learning frameworks - from Maslow’s hierarchy of needs to organizational learning - require modification and extension if effective approaches to decentralized information management and systems design are to emerge. Case studies relating to data integration include ecological community projects: development of cross-disciplinary conceptual maps and of a community unit registry.

  5. The Department of Veterans Affairs' (VA) implementation of the Virtual Lifetime Electronic Record (VLER): findings and lessons learned from Health Information Exchange at 12 sites.

    PubMed

    Byrne, Colene M; Mercincavage, Lauren M; Bouhaddou, Omar; Bennett, Jamie R; Pan, Eric C; Botts, Nathan E; Olinger, Lois M; Hunolt, Elaine; Banty, Karl H; Cromwell, Tim

    2014-08-01

    We describe the Department of Veterans Affairs' (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally. A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed. Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified. VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Improving performance in the ED through laboratory information exchange systems.

    PubMed

    Raymond, Louis; Paré, Guy; Maillet, Éric; Ortiz de Guinea, Ana; Trudel, Marie-Claude; Marsan, Josianne

    2018-03-12

    The accessibility of laboratory test results is crucial to the performance of emergency departments and to the safety of patients. This study aims to develop a better understanding of which laboratory information exchange (LIE) systems emergency care physicians (ECPs) are using to consult their patients' laboratory test results and which benefits they derive from such use. A survey of 163 (36%) ECPs in Quebec was conducted in collaboration with the Quebec's Department of Health and Social Services. Descriptive statistics, chi-square tests, cluster analyses, and ANOVAs were conducted. The great majority of respondents indicated that they use several LIE systems including interoperable electronic health record (iEHR) systems, laboratory results viewers (LRVs), and emergency department information systems (EDIS) to consult their patients' laboratory results. Three distinct profiles of LIE users were observed. The extent of LIE usage was found to be primarily determined by the functional design differences between LIE systems available in the EDs. Our findings also indicate that the more widespread LIE usage, the higher the perceived benefits. More specifically, physicians who make extensive use of iEHR systems and LRVs obtain the widest range of benefits in terms of efficiency, quality, and safety of emergency care. Extensive use of LIE systems allows ECPs to better determine and monitor the health status of their patients, verify their diagnostic assumptions, and apply evidence-based practices in laboratory medicine. But for such benefits to be possible, ECPs must be provided with LIE systems that produce accurate, up-to-date, complete, and easy-to-interpret information.

  7. Ontology-Based Exchange and Immediate Application of Business Calculation Definitions for Online Analytical Processing

    NASA Astrophysics Data System (ADS)

    Kehlenbeck, Matthias; Breitner, Michael H.

    Business users define calculated facts based on the dimensions and facts contained in a data warehouse. These business calculation definitions contain necessary knowledge regarding quantitative relations for deep analyses and for the production of meaningful reports. The business calculation definitions are implementation and widely organization independent. But no automated procedures facilitating their exchange across organization and implementation boundaries exist. Separately each organization currently has to map its own business calculations to analysis and reporting tools. This paper presents an innovative approach based on standard Semantic Web technologies. This approach facilitates the exchange of business calculation definitions and allows for their automatic linking to specific data warehouses through semantic reasoning. A novel standard proxy server which enables the immediate application of exchanged definitions is introduced. Benefits of the approach are shown in a comprehensive case study.

  8. What supports do health system organizations have in place to facilitate evidence-informed decision-making? a qualitative study

    PubMed Central

    2013-01-01

    Background Decisions regarding health systems are sometimes made without the input of timely and reliable evidence, leading to less than optimal health outcomes. Healthcare organizations can implement tools and infrastructures to support the use of research evidence to inform decision-making. Objectives The purpose of this study was to profile the supports and instruments (i.e., programs, interventions, instruments or tools) that healthcare organizations currently have in place and which ones were perceived to facilitate evidence-informed decision-making. Methods In-depth semi-structured telephone interviews were conducted with individuals in three different types of positions (i.e., a senior management team member, a library manager, and a ‘knowledge broker’) in three types of healthcare organizations (i.e., regional health authorities, hospitals and primary care practices) in two Canadian provinces (i.e., Ontario and Quebec). The interviews were taped, transcribed, and then analyzed thematically using NVivo 9 qualitative data analysis software. Results A total of 57 interviews were conducted in 25 organizations in Ontario and Quebec. The main findings suggest that, for the healthcare organizations that participated in this study, the following supports facilitate evidence-informed decision-making: facilitating roles that actively promote research use within the organization; establishing ties to researchers and opinion leaders outside the organization; a technical infrastructure that provides access to research evidence, such as databases; and provision and participation in training programs to enhance staff’s capacity building. Conclusions This study identified the need for having a receptive climate, which laid the foundation for the implementation of other tangible initiatives and supported the use of research in decision-making. This study adds to the literature on organizational efforts that can increase the use of research evidence in decision

  9. Association between use of a health information exchange system and hospital admissions.

    PubMed

    Vest, J R; Kern, L M; Campion, T R; Silver, M D; Kaushal, R

    2014-01-01

    Relevant patient information is frequently difficult to obtain in emergency department (ED) visits. Improved provider access to previously inaccessible patient information may improve the quality of care and reduce hospital admissions. Health information exchange (HIE) systems enable access to longitudinal, community-wide patient information at the point of care. However, the ability of HIE to avert admissions is not well demonstrated. We sought to determine if HIE system usage is correlated with a reduction in admissions via the ED. We identified 15,645 adults from New York State with an ED visit during a 6-month period, all of whom consented to have their information accessible in the HIE system, and were continuously enrolled in two area health plans. Using claims we determined if the ED encounter resulted in an admission. We used the HIE's system log files to determine usage during the encounter. We determined the association between HIE system use and the likelihood of admission to the hospital from the ED and potential cost savings. The HIE system was accessed during 2.4% of encounters. The odds of an admission were 30% lower when the system was accessed after controlling for confounding (odds ratio = 0.70; 95%C I= 0.52, 0.95). The annual savings in the sample was $357,000. These findings suggest that the use of an HIE system may reduce hospitalizations from the ED with resultant cost savings. This is an important outcome given the substantial financial investment in interventions designed to improve provider access to patient information in the US.

  10. Using hub technology to facilitate information system integration in a health-care enterprise.

    PubMed

    Gendler, S M; Friedman, B A; Henricks, W H

    1996-04-01

    The deployment and maintenance of multiple point-to-point interfaces between a clinical information system, such as a laboratory information system, and other systems within a healthcare enterprise is expensive and time consuming. Moreover, the demand for such interfaces is increasing as hospitals consolidate and clinical laboratories participate in the development of regional laboratory networks and create host-to-host links with laboratory outreach clients. An interface engine, also called a hub, is an evolving technology that could replace multiple point-to-point interfaces from a laboratory information system with a single interface to the hub, preferably HL7 based. The hub then routes and translates laboratory information to other systems within the enterprise. Changes in application systems in an enterprise where a centralized interface engine has been implemented then amount to thorough analysis, an update of the enterprise's data dictionary, purchase of a single new vendor-supported interface, and table-based parameter changes on the hub. Two other features of an interface engine, support for structured query language and information store-and-forward, will facilitate the development of clinical data repositories and provide flexibility when interacting with other host systems. This article describes the advantages and disadvantages of an interface engine and lists some problems not solved by the technology. Finally, early developmental experience with an interface engine at the University of Michigan Medical Center and the benefits of the project on system integration efforts are described, not the least of which has been the enthusiastic adoption of the HL7 standard for all future interface projects.

  11. Health information exchange associated with improved emergency department care through faster accessing of patient information from outside organizations.

    PubMed

    Everson, Jordan; Kocher, Keith E; Adler-Milstein, Julia

    2017-04-01

    To assess whether electronic health information exchange (HIE) is associated with improved emergency department (ED) care processes and utilization through more timely clinician viewing of information from outside organizations. Our data included 2163 patients seen in the ED of a large academic medical center for whom clinicians requested and viewed outside information from February 14, 2014, to February 13, 2015. Outside information requests w.ere fulfilled via HIE (Epic's Care Everywhere) or fax/scan to the electronic health record (EHR). We used EHR audit data to capture the time between the information request and when a clinician accessed the data. We assessed whether the relationship between method of information return and ED outcomes (length of visit, odds of imaging [computed tomography (CT), magnetic resonance imaging (MRI), radiographs] and hospitalization, and total charges) was mediated by request-to-access time, controlling for patient demographics, case mix, and acuity. In multivariate analysis, there was no direct association between return of information via HIE vs fax/scan and ED outcomes. HIE was associated with faster outside information access (58.5 minutes on average), and faster access was associated with changes in ED care. For each 1-hour reduction in access time, visit length was 52.9 minutes shorter, the likelihood of imaging was lower (by 2.5, 1.6, and 2.4 percentage points for CT, MRI, and radiographs, respectively), the likelihood of admission was 2.4 percentage points lower, and average charges were $1187 lower ( P  ≤ .001 for all). The relationship between HIE and improved care processes and reduced utilization in the ED is mediated by faster accessing of information from outside organizations. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Is this what you need? Direct feedback help climate change information exchange

    NASA Astrophysics Data System (ADS)

    Bachelet, D. M.; Brown, M.; Gough, M.; Basin, D.

    2015-12-01

    The combination of projected climate change and land use adds uncertainty to the long-term effectiveness of current management strategies. Managers need reliable information to adjust their strategies as population density increases. However they are currently overwhelmed by the diversity of available information and the multiplicity of sources. CBI's goal is to centralize and package effectively the usable information for land managers and for the general public in order to increase awareness and promote preparation for the challenges ahead. We are designing conservation planning atlases in Data Basin for a number of landscape conservation cooperatives to address this need. We are adding some user-friendly tools to specifically serve the available climate projections and land use data in a meaningful way. By working closely with a group of managers, our goal is to understand how consideration of these projections figures into the decision-making process and refine the ways we can deliver relevant metrics. We have been holding interviews to gather information and critical feedback on existing climate-related web pages and tools, providing us with benchmarks for improvement. As it turned out, the student-manager dialogue added a component of climate change education and awareness of available tools to the project. Through an iterative process we plan to continue this exchange and address the variety of issues managers continually have to face to maintain healthy ecosystems.

  13. Patient information, education and self-management in bronchiectasis: facilitating improvements to optimise health outcomes.

    PubMed

    Hester, Katy L M; Newton, Julia; Rapley, Tim; De Soyza, Anthony

    2018-05-22

    Bronchiectasis is an incurable lung disease characterised by irreversible airway dilatation. It causes symptoms including chronic productive cough, dyspnoea, and recurrent respiratory infections often requiring hospital admission. Fatigue and reductions in quality of life are also reported in bronchiectasis. Patients often require multi-modal treatments that can be burdensome, leading to issues with adherence. In this article we review the provision of, and requirement for, education and information in bronchiectasis. To date, little research has been undertaken to improve self-management in bronchiectasis in comparison to other chronic conditions, such as COPD, for which there has been a wealth of recent developments. Qualitative work has begun to establish that information deficit is one of the potential barriers to self-management, and that patients feel having credible information is fundamental when learning to live with and manage bronchiectasis. Emerging research offers some insights into ways of improving treatment adherence and approaches to self-management education; highlighting ways of addressing the specific unmet information needs of patients and their families who are living with bronchiectasis. We propose non-pharmacological recommendations to optimise patient self-management and symptom recognition; with the aim of facilitating measurable improvements in health outcomes for patients with bronchiectasis.

  14. A Review on Community-Based Knowledge Transfer and Exchange (KTE) Initiatives for Promoting Well-Being in Older Adults.

    PubMed

    Syed, M Anum; Moorhouse, Aynsley; McDonald, Lynn; Hitzig, Sander L

    2017-01-01

    Knowledge transfer and exchange (KTE) processes can facilitate evidence-informed community-based care for seniors, but understanding effective KTE in gerontology is limited. A scoping review was conducted to evaluate the current state of KTE in the community-based sector for seniors. Twelve articles met the inclusion criteria, which addressed a broad variety of topics including caregiving, elder abuse, falls prevention, home-rehabilitation, hospice and dementia care. Studies evaluated KTE practices (n = 8), developed a KTE intervention (n = 3), or explored research uptake (n = 1). Community-based initiatives for seniors informed by KTE processes are scarce, requiring further efforts at the research, practice and policy levels.

  15. The utilization rate of the regional health information exchange: how it impacts on health care delivery outcomes.

    PubMed

    Mäenpää, Tiina; Asikainen, Paula; Gissler, Mika; Siponen, Kimmo; Maass, Marianne; Saranto, Kaija; Suominen, Tarja

    2012-01-01

    Interest in improving quality and effectiveness is the primary driver for health information exchange efforts across a health care system to improve the provision of public health care services. The aim here was to describe and identify the impact of a regional health information exchange (HIE) using quantitative statistics for 2004-2008 in one hospital district in Finland. We conducted a comparative, longitudinal 5-year follow-up study to evaluate the utilization rates of HIE, and the impact on health care delivery outcomes. The selected outcomes were total laboratory tests, radiology examinations, appointments, emergency visits, and referrals. The HIE utilization rates increased annually in all 10 federations of municipalities, and the viewing of reference information increased steadily in each professional group over the 5-year study period. In these federations, a significant connection was found to the number of laboratory tests and radiology examinations, with a statistically significant increase in the number of viewed references and use of HIE. The higher the numbers of emergency visits and appointments, the higher the numbers of emergency referrals to specialized care, viewed references, and HIE usage among the groups of different health care professionals. There is increasing interest in HIE usage through regional health information system among health professionals to improve health care delivery regionally and bring information on the patient directly to care delivery. It will be important to study which changes in working methods in the service system are explained by RHIS. Also, the experiences of the change that has taken place should be studied among the different stakeholders, administrative representatives, and patients.

  16. A qualitative study of sign-out processes between primary and on-call residents: relationships in information exchange, responsibility and accountability.

    PubMed

    Lee, Soo-Hoon; Fisher, Dale A; Mah, Heidi; Goh, Wei-Ping; Phan, Phillip H

    2017-10-01

    To review a quality improvement event on the process of sign-outs between the primary and on-call residents. A retrospective qualitative study using semi-structured interviews. A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Residents, registrars and consultants. Quality improvement event on sign-out. Effectiveness of sign-out comprises exchange of patient information, professional responsibility and task accountability. The following process of sign-outs was noted. Primary teams were accountable to the on-call resident by selecting at-risk patients and preparing contingency plans for sign-out. Structured information exchanged included patient history, active problems and plans of care. On-call residents took ownership of at-risk patients by actively asking questions during sign-out and reporting back the agreed care plan. On-call residents were accountable to the primary team by reporting back at-risk patients the next day. A structured information exchange at sign-out increased the on-call resident's ability to care for at-risk patients when it was supported by two-way transfers of responsibility and accountability. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. SLA before ABC: Factors Facilitating Second Language Acquisition in Irish-Medium Playgroups.

    ERIC Educational Resources Information Center

    Mhathuna, Maire Mhic

    1995-01-01

    This study investigated factors facilitating acquisition of Irish in Irish-medium playgroups designed for children who are native English-speakers. Data were gathered in four visits each to two such playgroups, each containing approximately 20 children. Four aspects of conversational exchanges were examined: understanding; code mixing; formulaic…

  18. Scoliosis and the Social Media: Facebook as a Means of Information Exchange.

    PubMed

    Ng, Jonathan P; Tarazi, Nadim; Byrne, Damien P; Baker, Joseph F; McCabe, John P

    2017-03-01

    Over the last decade, the emergence of social networking websites such as Facebook have revolutionized information dissemination and broadened opportunities to engage in discussions. In particular, having been widely adopted in the younger generation, the use of this medium has become more prevalent in health disorders such as scoliosis in the adolescent population. However, the quality of information on Facebook is unregulated and variable, which may mislead patients in their decision making. To document the various types of information available and assess the quality of information on Facebook discussion boards using recognized scoring systems. To evaluate the quality of information on the social network. A search for the keyword "scoliosis" on Facebook was performed and the first 100 pages generated were reviewed. SCSS and DISCERN score. Content analysis was performed on discussion boards and personal blogs. Two independent examiners evaluated each site according to scoliosis-specific content score (SCSS) and the DISCERN criteria, both previously used instruments to judge the quality of information on the Internet pertaining to scoliosis. The SCSS range from 0 to 32 (higher score better) and the DISCERN 16 to 80 (higher score better). Of the 100 sites reviewed, 33 were discussion boards and personal blogs. Of these, the overall average SCSS was 5.7 (SD 5.8, range 0-20) and the DISCERN was 22.5 (SD 7.6, range 16-45), indicating that using general scoring systems the quality of information provided was overall poor. Using recognized scoring systems to analyze Facebook pages used as discussion forums or blogs, we showed that the quality in general was poor. For modern practices to adapt to an era of information exchange via the social network, the orthopedic community should develop ways to incorporate the social media in future patient education. Copyright © 2016 Scoliosis Research Society. All rights reserved.

  19. Spatial part-set cuing facilitation.

    PubMed

    Kelley, Matthew R; Parasiuk, Yuri; Salgado-Benz, Jennifer; Crocco, Megan

    2016-07-01

    Cole, Reysen, and Kelley [2013. Part-set cuing facilitation for spatial information. Journal of Experimental Psychology: Learning, Memory, & Cognition, 39, 1615-1620] reported robust part-set cuing facilitation for spatial information using snap circuits (a colour-coded electronics kit designed for children to create rudimentary circuit boards). In contrast, Drinkwater, Dagnall, and Parker [2006. Effects of part-set cuing on experienced and novice chess players' reconstruction of a typical chess midgame position. Perceptual and Motor Skills, 102(3), 645-653] and Watkins, Schwartz, and Lane [1984. Does part-set cuing test for memory organization? Evidence from reconstructions of chess positions. Canadian Journal of Psychology/Revue Canadienne de Psychologie, 38(3), 498-503] showed no influence of part-set cuing for spatial information when using chess boards. One key difference between the two procedures was that the snap circuit stimuli were explicitly connected to one another, whereas chess pieces were not. Two experiments examined the effects of connection type (connected vs. unconnected) and cue type (cued vs. uncued) on memory for spatial information. Using chess boards (Experiment 1) and snap circuits (Experiment 2), part-set cuing facilitation only occurred when the stimuli were explicitly connected; there was no influence of cuing with unconnected stimuli. These results are potentially consistent with the retrieval strategy disruption hypothesis, as well as the two- and three-mechanism accounts of part-set cuing.

  20. The enhanced knowledge translation and exchange framework for road safety: a brief report on its development and potential impacts.

    PubMed

    Hinchcliff, Reece; Senserrick, Teresa; Travaglia, Joanne; Greenfield, David; Ivers, Rebecca

    2017-04-01

    Knowledge translation and exchange (KTE) can enable evidence-informed road safety policy and practice by reducing the gap between what is known to be effective and what actually occurs. A quality improvement project, undertaken within a government policy frame, was implemented in 2015 to produce an enhanced KTE framework for road safety (the framework). Information was collected from 35 road safety stakeholders in the UK, the Netherlands, Norway and Sweden. Thirteen KTE facilitators were identified that covered research funding and production, the expertise of knowledge users and dissemination practices. The framework was subsequently developed, which separated facilitators seen as essential for a KTE system, from others perceived as aspirational due to their lesser influence and the considerable time and resources required for their implementation. The framework provides a heuristic device to enable policy agencies to holistically assess and improve current KTE systems for road safety, to encourage evidence-informed policy and practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. DOD Commissaries and Exchanges: Plan and Additional Information Needed on Cost Savings and Metrics for DOD Efforts to Achieve Budget Neutrality

    DTIC Science & Technology

    2016-11-14

    the best practices in project management related to the establishment of goals and time frames.9 We obtained documentary and testimonial evidence...have created new incentives for DOD to assess its approach for managing the commissaries and exchanges. Congress identified $1.3 billion in fiscal...have relevant and reliable information to help management make informed decisions.8 We also reviewed relevant information in the report compared with

  2. Novel Method for Exchange of Impella Circulatory Assist Catheter: The "Trojan Horse" Technique.

    PubMed

    Phillips, Colin T; Tamez, Hector; Tu, Thomas M; Yeh, Robert W; Pinto, Duane S

    2017-07-01

    Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.

  3. RISE-306; State Facilitator Program Evaluation, 1975-1976.

    ERIC Educational Resources Information Center

    Communication Technology Corp., Marlton, NJ.

    As an arm of the National Diffusion Network, the Pennsylvania State Facilitator's responsibilities include informing the schools about Title III approved programs and aiding in the actual adoption of such programs by school districts. Two aspects of the facilitator's role were identified for evaluation: (1) whether the facilitator had implemented…

  4. Association Between Use of a Health Information Exchange System and Hospital Admissions

    PubMed Central

    Vest, J.R.; Kern, L.M.; Campion, T.R.; Silver, M.D.; Kaushal, R.

    2014-01-01

    Summary Objective Relevant patient information is frequently difficult to obtain in emergency department (ED) visits. Improved provider access to previously inaccessible patient information may improve the quality of care and reduce hospital admissions. Health information exchange (HIE) systems enable access to longitudinal, community-wide patient information at the point of care. However, the ability of HIE to avert admissions is not well demonstrated. We sought to determine if HIE system usage is correlated with a reduction in admissions via the ED. Methods We identified 15,645 adults from New York State with an ED visit during a 6-month period, all of whom consented to have their information accessible in the HIE system, and were continuously enrolled in two area health plans. Using claims we determined if the ED encounter resulted in an admission. We used the HIE’s system log files to determine usage during the encounter. We determined the association between HIE system use and the likelihood of admission to the hospital from the ED and potential cost savings. Results The HIE system was accessed during 2.4% of encounters. The odds of an admission were 30% lower when the system was accessed after controlling for confounding (odds ratio = 0.70; 95%C I= 0.52, 0.95). The annual savings in the sample was $357,000. Conclusion These findings suggest that the use of an HIE system may reduce hospitalizations from the ED with resultant cost savings. This is an important outcome given the substantial financial investment in interventions designed to improve provider access to patient information in the US. PMID:24734135

  5. Project Integration Architecture: Inter-Application Propagation of Information

    NASA Technical Reports Server (NTRS)

    Jones, William Henry

    2005-01-01

    A principal goal of the Project Integration Architecture (PIA) is to facilitate the meaningful inter-application transfer of application-value-added information. Such exchanging applications may be largely unrelated to each other except through their applicability to an overall project; however, the PIA effort recognizes as fundamental the need to make such applications cooperate despite wide disparaties either in the fidelity of the analyses carried out, or even the disciplines of the analysis. This paper discusses the approach and techniques applied and anticipated by the PIA project in treating this need.

  6. How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant study.

    PubMed

    van der Weijden, Trudy; Pieterse, Arwen H; Koelewijn-van Loon, Marije S; Knaapen, Loes; Légaré, France; Boivin, Antoine; Burgers, Jako S; Stiggelbout, Anne M; Faber, Marjan; Elwyn, Glyn

    2013-10-01

    To explore how clinical practice guidelines can be adapted to facilitate shared decision making. This was a qualitative key-informant study with group discussions and semi-structured interviews. First, 75 experts in guideline development or shared decision making participated in group discussions at two international conferences. Next, health professionals known as experts in depression or breast cancer, experts on clinical practice guidelines and/or shared decision making, and patient representatives were interviewed (N=20). Using illustrative treatment decisions on depression or breast cancer, we asked the interviewees to indicate as specifically as they could how guidelines could be used to facilitate shared decision making. Interviewees suggested some generic strategies, namely to include a separate chapter on the importance of shared decision making, to use language that encourages patient involvement, and to develop patient versions of guidelines. Recommendation-specific strategies, related to specific decision points in the guideline, were also suggested: These include structuring the presentation of healthcare options to increase professionals' option awareness; structuring the deliberation process between professionals and patients; and providing relevant patient support tools embedded at important decision points in the guideline. This study resulted in an overview of strategies to adapt clinical practice guidelines to facilitate shared decision making. Some strategies seemed more contentious than others. Future research should assess the feasibility and impact of these strategies to make clinical practice guidelines more conducive to facilitate shared decision making.

  7. Pulmonary gas exchange in acute respiratory failure.

    PubMed

    Rodriguez-Roisin, R

    1994-01-01

    The principal function of the lung is to facilitate the exchange of the respiratory gases, oxygen (O2) and carbon dioxide (CO2). When the lung fails as a gas exchanger respiratory failure ensues. Clinically, it is generally accepted that an arterial oxygen tension (PaO2) of less than 60 mmHg or a PaCO2 of greater than 50 mmHg, or both, whilst breathing room air are values consistent with the concept of respiratory failure. This article will deal, firstly, with some basic aspects of the physiology of pulmonary gas exchange and more specifically on the measurement of ventilation-perfusion (VA/Q) relationships, the most influential factor determining hypoxaemia. The second part highlights the most important findings on pulmonary gas exchange in the adult respiratory distress syndrome (ARDS) and other common acute respiratory failure conditions, such as pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD) and status asthmaticus, based on the data obtained by means of the multiple inert gas elimination approach, a technique which gives a detailed picture of VA/Q ratio distributions.

  8. Minimizing back exchange in the hydrogen exchange-mass spectrometry experiment.

    PubMed

    Walters, Benjamin T; Ricciuti, Alec; Mayne, Leland; Englander, S Walter

    2012-12-01

    The addition of mass spectrometry (MS) analysis to the hydrogen exchange (HX) proteolytic fragmentation experiment extends powerful HX methodology to the study of large biologically important proteins. A persistent problem is the degradation of HX information due to back exchange of deuterium label during the fragmentation-separation process needed to prepare samples for MS measurement. This paper reports a systematic analysis of the factors that influence back exchange (solution pH, ionic strength, desolvation temperature, LC column interaction, flow rates, system volume). The many peptides exhibit a range of back exchange due to intrinsic amino acid HX rate differences. Accordingly, large back exchange leads to large variability in D-recovery from one residue to another as well as one peptide to another that cannot be corrected for by reference to any single peptide-level measurement. The usual effort to limit back exchange by limiting LC time provides little gain. Shortening the LC elution gradient by 3-fold only reduced back exchange by ~2%, while sacrificing S/N and peptide count. An unexpected dependence of back exchange on ionic strength as well as pH suggests a strategy in which solution conditions are changed during sample preparation. Higher salt should be used in the first stage of sample preparation (proteolysis and trapping) and lower salt (<20 mM) and pH in the second stage before electrospray injection. Adjustment of these and other factors together with recent advances in peptide fragment detection yields hundreds of peptide fragments with D-label recovery of 90% ± 5%.

  9. Minimizing Back Exchange in the Hydrogen Exchange-Mass Spectrometry Experiment

    NASA Astrophysics Data System (ADS)

    Walters, Benjamin T.; Ricciuti, Alec; Mayne, Leland; Englander, S. Walter

    2012-12-01

    The addition of mass spectrometry (MS) analysis to the hydrogen exchange (HX) proteolytic fragmentation experiment extends powerful HX methodology to the study of large biologically important proteins. A persistent problem is the degradation of HX information due to back exchange of deuterium label during the fragmentation-separation process needed to prepare samples for MS measurement. This paper reports a systematic analysis of the factors that influence back exchange (solution pH, ionic strength, desolvation temperature, LC column interaction, flow rates, system volume). The many peptides exhibit a range of back exchange due to intrinsic amino acid HX rate differences. Accordingly, large back exchange leads to large variability in D-recovery from one residue to another as well as one peptide to another that cannot be corrected for by reference to any single peptide-level measurement. The usual effort to limit back exchange by limiting LC time provides little gain. Shortening the LC elution gradient by 3-fold only reduced back exchange by ~2 %, while sacrificing S/N and peptide count. An unexpected dependence of back exchange on ionic strength as well as pH suggests a strategy in which solution conditions are changed during sample preparation. Higher salt should be used in the first stage of sample preparation (proteolysis and trapping) and lower salt (<20 mM) and pH in the second stage before electrospray injection. Adjustment of these and other factors together with recent advances in peptide fragment detection yields hundreds of peptide fragments with D-label recovery of 90 % ± 5 %.

  10. The potential role of sea spray droplets in facilitating air-sea gas transfer

    NASA Astrophysics Data System (ADS)

    Andreas, E. L.; Vlahos, P.; Monahan, E. C.

    2016-05-01

    For over 30 years, air-sea interaction specialists have been evaluating and parameterizing the role of whitecap bubbles in air-sea gas exchange. To our knowledge, no one, however, has studied the mirror image process of whether sea spray droplets can facilitate air-sea gas exchange. We are therefore using theory, data analysis, and numerical modeling to quantify the role of spray on air-sea gas transfer. In this, our first formal work on this subject, we seek the rate-limiting step in spray-mediated gas transfer by evaluating the three time scales that govern the exchange: τ air , which quantifies the rate of transfer between the atmospheric gas reservoir and the surface of the droplet; τ int , which quantifies the exchange rate across the air-droplet interface; and τ aq , which quantifies gas mixing within the aqueous solution droplet.

  11. Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

    PubMed Central

    Johnson, Kevin B; Lorenzi, Nancy M

    2011-01-01

    Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

  12. Information retrieval for a document writing assistance program

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Corral, M.L.; Simon, A.; Julien, C.

    This paper presents an Information Retrieval mechanism to facilitate the writing of technical documents in the space domain. To address the need for document exchange between partners in a given project, documents are standardized. The writing of a new document requires the re-use of existing documents or parts thereof. These parts can be identified by {open_quotes}tagging{close_quotes} the logical structure of documents and restored by means of a purpose-built Information Retrieval System (I.R.S.). The I.R.S. implemented in our writing assistance tool uses natural language queries and is based on a statistical linguistic approach which is enhanced by the use of documentmore » structure module.« less

  13. Facilitating the improved management of waste in South Africa through a national waste information system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Godfrey, Linda

    2008-07-01

    Developing a waste information system (WIS) for a country is more than just about collecting routine data on waste; it is about facilitating the improved management of waste by providing timely, reliable information to the relevant role-players. It is a means of supporting the waste governance challenges facing South Africa - challenges ranging from strategic waste management issues at national government to basic operational challenges at local government. The paper addresses two hypotheses. The first is that the identified needs of government can provide a platform from which to design a national WIS framework for a developing country such asmore » South Africa, and the second is that the needs for waste information reflect greater, currently unfulfilled challenges in the sustainable management of waste. Through a participatory needs analysis process, it is shown that waste information is needed by the three spheres of government, to support amongst others, informed planning and decision-making, compliance monitoring and enforcement, community participation through public access to information, human, infrastructure and financial resource management and policy development. These needs for waste information correspond closely with key waste management challenges currently facing the country. A shift in governments approach to waste, in line with national and international policy, is evident from identified current and future waste information needs. However, the need for information on landfilling remains entrenched within government, possibly due to the poor compliance of landfill sites in South Africa and the problems around the illegal disposal of both general and hazardous waste.« less

  14. Information technology equipment cooling method

    DOEpatents

    Schultz, Mark D.

    2015-10-20

    According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools air utilized by the rack of information technology equipment to cool the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat generated by the rack of information technology equipment.

  15. Partnering Healthy@Work: an Australian university-government partnership facilitating policy-relevant research.

    PubMed

    Jose, Kim; Venn, Alison; Jarman, Lisa; Seal, Judy; Teale, Brook; Scott, Jennifer; Sanderson, Kristy

    2017-12-01

    Research funding is increasingly supporting collaborations between knowledge users and researchers. Partnering Healthy@Work (pH@W), an inaugural recipient of funding through Australia's Partnership for Better Health Grants scheme, was a 5-year partnership between the Menzies Institute for Medical Research, University of Tasmania and the Tasmanian State Service (TSS). The partnerships purpose was to evaluate a comprehensive workplace health promotion programme (Healthy@Work) targeting 30 000 public sector employees; generating new knowledge and influencing workplace health promotion policy and decision-making. This mixed methods study evaluates the partnership between policy-makers and academics and identifies strategies that enabled pH@W to deliver key project outcomes. A pH@W document review was conducted, two partnership assessment tools completed and semi-structured interviews conducted with key policy-makers and academics. Analysis of the partnership assessment tools and interviews found that pH@W had reached a strong level of collaboration. Policy-relevant knowledge was generated about the health of TSS employees and their engagement with workplace health promotion. Knowledge exchange of a conceptual and instrumental nature occurred and was facilitated by the shared grant application, clear governance structures, joint planning, regular information exchange between researchers and policy-makers and research student placements in the TSS. Flexibility and acknowledgement of different priorities and perspectives of partner organizations were identified as critical factors for enabling effective partnership working and research relevance. Academic-policy-maker partnerships can be a powerful mechanism for improving policy relevance of research, but need to incorporate strategies that facilitate regular input from researchers and policy-makers in order to achieve this. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions

  16. Oncology information on the Internet.

    PubMed

    Goto, Yasushi; Nagase, Takahide

    2012-05-01

    Owing to new developments in Internet technologies, the amount of available oncology information is growing. Both patients and caregivers are increasingly using the Internet to obtain medical information. However, while it is easy to provide information, ensuring its quality is always a concern. Thus, many instruments for evaluating the quality of health information have been created, each with its own advantages and disadvantages. The increasing importance of online search engines such as Google warrants the examination of the correlation between their rankings and medical quality. The Internet also mediates the exchange of information from one individual to another. Mailing lists of advocate groups and social networking sites help spread information to patients and caregivers. While text messages are still the main medium of communication, audio and video messages are also increasing rapidly, accelerating the communication on the Internet. Future health information developments on the Internet include merging patients' personal information on the Internet with their traditional health records and facilitating the interaction among patients, caregivers and health-care providers. Through these developments, the Internet is expected to strengthen the mutually beneficial relationships among all stakeholders in the field of medicine.

  17. Knowledge exchange throughout the dementia care journey by Canadian rural community-based health care practitioners, persons with dementia, and their care partners: an interpretive descriptive study.

    PubMed

    Forbes, Dorothy A; Finkelstein, Sara; Blake, Catherine M; Gibson, Maggie; Morgan, Debra G; Markle-Reid, Maureen; Culum, Ivan; Thiessen, Emily

    2012-10-01

    Accessing, assessing, exchanging, and applying dementia care information can be challenging in rural communities for healthcare practitioners (HCPs), persons with dementia (PWD), and their care partners. The overall purpose of this research was to enable HCPs, care partners, and PWD to use dementia care information more effectively by examining their information needs, how these change over time, and how they access, assess, and apply the knowledge. A qualitative interpretive descriptive approach was used. A convenience sample was initially recruited through study collaborators in Southwestern Ontario, followed by purposive sampling. Nine rural dementia care networks consisting of PWD (n = 5), care partners (n = 14), and HCPs (n = 14) were recruited and 80 interviews were conducted at three time points. Transcripts were coded using Lubrosky's thematic analysis. Six stages of the dementia care journey were identified: (1) recognizing the symptoms; (2) receiving a diagnosis; (3) loss of independence; (4) initiating and using home care and respite services; (5) long-term care (LTC) placement; and (6) decisions related to end-of-life care. Rural care partners identified the need for different types of knowledge during each of these critical decision points of the dementia care journey. They accessed information from family members, friends, local organizations, and dementia internet sites. Persons with dementia tended not to identify the need for dementia care information. The HCPs accessed dementia care information from their own organization, other organizations, and internet sites. Care partners and HCPs assessed the trustworthiness of the information based on whether the source was a well-known agency or their own organization. Barriers to knowledge exchange included: lack of rural community-based services for dementia care; care partners reluctant to seek help and had limited energy; and lack of integration of dementia-related services and supports. Facilitators

  18. Immunization Information Systems: A Decade of Progress in Law and Policy

    PubMed Central

    Martin, Daniel W.; Lowery, N. Elaine; Brand, Bill; Gold, Rebecca; Horlick, Gail

    2015-01-01

    This article reports on a study of laws, regulations, and policies governing Immunization Information Systems (IIS, also known as “immunization registries”) in states and selected urban areas of the United States. The study included a search of relevant statutes, administrative codes and published attorney general opinions/findings, an online questionnaire completed by immunization program managers and/or their staff, and follow-up telephone interviews. The legal/regulatory framework for IIS has changed considerably since 2000, largely in ways that improve IIS’ ability to perform their public health functions while continuing to maintain strict confidentiality and privacy controls. Nevertheless, the exchange of immunization data and other health information between care providers and public health and between entities in different jurisdictions remains difficult due in part to ongoing regulatory diversity. To continue to be leaders in health information exchange and facilitate immunization of children and adults, IIS will need to address the challenges presented by the interplay of federal and state legislation, regulations, and policies and continue to move toward standardized data collection and sharing necessary for interoperable systems. PMID:24402434

  19. Investigating onychophoran gas exchange and water balance as a means to inform current controversies in arthropod physiology.

    PubMed

    Clusella-Trullas, Susana; Chown, Steven L

    2008-10-01

    Several controversies currently dominate the fields of arthropod metabolic rate, gas exchange and water balance, including the extent to which modulation of gas exchange reduces water loss, the origins of discontinuous gas exchange, the relationship between metabolic rate and life-history strategies, and the causes of Palaeozoic gigantism. In all of these areas, repeated calls have been made for the investigation of groups that might most inform the debates, especially of taxa in key phylogenetic positions. Here we respond to this call by investigating metabolic rate, respiratory water loss and critical oxygen partial pressure (Pc) in the onychophoran Peripatopsis capensis, a member of a group basal to the arthropods, and by synthesizing the available data on the Onychophora. The rate of carbon dioxide release (VCO2) at 20 degrees C in P. capensis is 0.043 ml CO2 h(-1), in keeping with other onychophoran species; suggesting that low metabolic rates in some arthropod groups are derived. Continuous gas exchange suggests that more complex gas exchange patterns are also derived. Total water loss in P. capensis is 57 mg H2O h(-1) at 20 degrees C, similar to modern estimates for another onychophoran species. High relative respiratory water loss rates ( approximately 34%; estimated using a regression technique) suggest that the basal condition in arthropods may be a high respiratory water loss rate. Relatively high Pc values (5-10% O2) suggest that substantial safety margins in insects are also a derived condition. Curling behaviour in P. capensis appears to be a strategy to lower energetic costs when resting, and the concomitant depression of water loss is a proximate consequence of this behaviour.

  20. ATLAS Live: Collaborative Information Streams

    NASA Astrophysics Data System (ADS)

    Goldfarb, Steven; ATLAS Collaboration

    2011-12-01

    I report on a pilot project launched in 2010 focusing on facilitating communication and information exchange within the ATLAS Collaboration, through the combination of digital signage software and webcasting. The project, called ATLAS Live, implements video streams of information, ranging from detailed detector and data status to educational and outreach material. The content, including text, images, video and audio, is collected, visualised and scheduled using digital signage software. The system is robust and flexible, utilizing scripts to input data from remote sources, such as the CERN Document Server, Indico, or any available URL, and to integrate these sources into professional-quality streams, including text scrolling, transition effects, inter and intra-screen divisibility. Information is published via the encoding and webcasting of standard video streams, viewable on all common platforms, using a web browser or other common video tool. Authorisation is enforced at the level of the streaming and at the web portals, using the CERN SSO system.

  1. Information technology equipment cooling system

    DOEpatents

    Schultz, Mark D.

    2014-06-10

    According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools warm air generated by the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat from the rack of information technology equipment.

  2. Current Efforts in European Projects to Facilitate the Sharing of Scientific Observation Data

    NASA Astrophysics Data System (ADS)

    Bredel, Henning; Rieke, Matthes; Maso, Joan; Jirka, Simon; Stasch, Christoph

    2017-04-01

    This presentation is intended to provide an overview of currently ongoing efforts in European projects to facilitate and promote the interoperable sharing of scientific observation data. This will be illustrated through two examples: a prototypical portal developed in the ConnectinGEO project for matching available (in-situ) data sources to the needs of users and a joint activity of several research projects to harmonise the usage of the OGC Sensor Web Enablement standards for providing access to marine observation data. ENEON is an activity initiated by the European ConnectinGEO project to coordinate in-situ Earth observation networks with the aim to harmonise the access to observations, improve discoverability, and identify/close gaps in European earth observation data resources. In this context, ENEON commons has been developed as a supporting Web portal for facilitating discovery, access, re-use and creation of knowledge about observations, networks, and related activities (e.g. projects). The portal is based on developments resulting from the European WaterInnEU project and has been extended to cover the requirements for handling knowledge about in-situ earth observation networks. A first prototype of the portal was completed in January 2017 which offers functionality for interactive discussion, information exchange and querying information about data delivered by different observation networks. Within this presentation, we will introduce the presented prototype and initiate a discussion about potential future work directions. The second example concerns the harmonisation of data exchange in the marine domain. There are many organisation who operate ocean observatories or data archives. In recent years, the application of the OGC Sensor Web Enablement (SWE) technology has become more and more popular to increase the interoperability between marine observation networks. However, as the SWE standards were intentionally designed in a domain independent manner

  3. Building and strengthening infrastructure for data exchange: lessons from the beacon communities.

    PubMed

    Torres, Gretchen W; Swietek, Karen; Ubri, Petry S; Singer, Rachel F; Lowell, Kristina H; Miller, Wilhelmine

    2014-01-01

    The Beacon Community Cooperative Agreement Program supports interventions, including care-delivery innovations, provider performance measurement and feedback initiatives, and tools for providers and consumers to enhance care. Using a learning health system framework, we examine the Beacon Communities' processes in building and strengthening health IT (HIT) infrastructures, specifically successes and challenges in sharing patient information to improve clinical care. In 2010, the Office of the National Coordinator for Health Information Technology (ONC) launched the three-year program, which provided $250 million to 17 Beacon Communities to invest in HIT and health information exchange (HIE) infrastructure. Beacon Communities used this funding to develop and disseminate HIT-enabled quality improvement practices found effective in particular community and practice environments. NORC conducted 7 site visits, November 2012-March 2013, selecting Communities to represent diverse program features. From August-October 2013, NORC held discussions with the remaining 10 Communities. Following each visit or discussion, NORC summarized the information gathered, including transcripts, team observations, and other documents the Community provided, to facilitate a within-Community analysis of context and stakeholders, intervention strategies, enabling factors, and challenges. Although each Community designed and implemented data-sharing strategies in a unique environment, similar challenges and enabling factors emerged across the Beacons. From a learning health system perspective, their strategies to build and strengthen data-sharing infrastructures address the following crosscutting priorities: promoting technical advances and innovations by helping providers adapt EHRs for data exchange and performance measurement with customizable IT and offering technical support to smaller, independent providers; engaging key stakeholders; and fostering transparent governance and stewardship

  4. Building and Strengthening Infrastructure for Data Exchange: Lessons from the Beacon Communities

    PubMed Central

    Torres, Gretchen W.; Swietek, Karen; Ubri, Petry S.; Singer, Rachel F.; Lowell, Kristina H.; Miller, Wilhelmine

    2014-01-01

    Introduction: The Beacon Community Cooperative Agreement Program supports interventions, including care-delivery innovations, provider performance measurement and feedback initiatives, and tools for providers and consumers to enhance care. Using a learning health system framework, we examine the Beacon Communities’ processes in building and strengthening health IT (HIT) infrastructures, specifically successes and challenges in sharing patient information to improve clinical care. Background: In 2010, the Office of the National Coordinator for Health Information Technology (ONC) launched the three-year program, which provided $250 million to 17 Beacon Communities to invest in HIT and health information exchange (HIE) infrastructure. Beacon Communities used this funding to develop and disseminate HIT-enabled quality improvement practices found effective in particular community and practice environments. Methods: NORC conducted 7 site visits, November 2012–March 2013, selecting Communities to represent diverse program features. From August–October 2013, NORC held discussions with the remaining 10 Communities. Following each visit or discussion, NORC summarized the information gathered, including transcripts, team observations, and other documents the Community provided, to facilitate a within-Community analysis of context and stakeholders, intervention strategies, enabling factors, and challenges. Results: Although each Community designed and implemented data-sharing strategies in a unique environment, similar challenges and enabling factors emerged across the Beacons. From a learning health system perspective, their strategies to build and strengthen data-sharing infrastructures address the following crosscutting priorities: promoting technical advances and innovations by helping providers adapt EHRs for data exchange and performance measurement with customizable IT and offering technical support to smaller, independent providers; engaging key stakeholders; and

  5. Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework.

    PubMed

    Lavallée, Jacqueline F; Gray, Trish A; Dumville, Jo; Cullum, Nicky

    2018-06-01

    Pressure ulcers are areas of localised damage to the skin and underlying tissue; and can cause pain, immobility, and delay recovery, impacting on health-related quality of life. The individuals who are most at risk of developing a pressure ulcer are those who are seriously ill, elderly, have impaired mobility and/or poor nutrition; thus, many nursing home residents are at risk. To understand the context of pressure ulcer prevention in nursing homes and to explore the potential barriers and facilitators to evidence-informed practices. Semi-structured interviews were conducted with nursing home nurses, healthcare assistants and managers, National Health Service community-based wound specialist nurses (known in the UK as tissue viability nurses) and a nurse manager in the North West of England. The interview guide was developed using the Theoretical Domains Framework to explore the barriers and facilitators to pressure ulcer prevention in nursing home residents. Data were analysed using a framework analysis and domains were identified as salient based on their frequency and the potential strength of their impact. 25 participants (nursing home: 2 managers, 7 healthcare assistants, 11 qualified nurses; National Health Service community services: 4 tissue viability nurses, 1 manager) were interviewed. Depending upon the behaviours reported and the context, the same domain could be classified as both a barrier and a facilitator. We identified seven domains as relevant in the prevention of pressure ulcers in nursing home residents mapping to four "barrier" domains and six "facilitator" domains. The four "barrier" domains were knowledge, physical skills, social influences and environmental context and resources and the six "facilitator" domains were interpersonal skills, environmental context and resources, social influences, beliefs about capabilities, beliefs about consequences and social/professional role and identity). Knowledge and insight into these barriers and

  6. Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records.

    PubMed

    Cochran, Gary L; Lander, Lina; Morien, Marsha; Lomelin, Daniel E; Brittin, Jeri; Reker, Celeste; Klepser, Donald G

    2015-01-01

    Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10-12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the possibility of an unintended negative impact on the

  7. Consumer Opinions of Health Information Exchange, e-Prescribing, and Personal Health Records

    PubMed Central

    Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.

    2015-01-01

    Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the

  8. Facilitating admissions of diverse students: A six-point, evidence-informed framework for pipeline and program development.

    PubMed

    Young, Meredith E; Thomas, Aliki; Varpio, Lara; Razack, Saleem I; Hanson, Mark D; Slade, Steve; Dayem, Katharine L; McKnight, David J

    2017-04-01

    Several national level calls have encouraged reconsideration of diversity issues in medical education. Particular interest has been placed on admissions, as decisions made here shape the nature of the future physician workforce. Critical analysis of current practices paired with evidence-informed policies may counter some of the barriers impeding access for underrepresented groups. We present a framework for diversity-related program development and evaluation grounded within a knowledge translation framework, and supported by the initiation of longitudinal collection of diversity-related data. We provide an illustrative case study for each component of the framework. Descriptive analyses are presented of pre/post intervention diversity metrics if applicable and available. The framework's focal points are: 1) data-driven identification of underrepresented groups, 2) pipeline development and targeted recruitment, 3) ensuring an inclusive process, 4) ensuring inclusive assessment, 5) ensuring inclusive selection, and 6) iterative use of diversity-related data. Case studies ranged from wording changes on admissions websites to the establishment of educational and administrative offices addressing needs of underrepresented populations. We propose that diversity-related data must be collected on a variety of markers, developed in partnership with stakeholders who are most likely to facilitate implementation of best practices and new policies. These data can facilitate the design, implementation, and evaluation of evidence-informed diversity initiatives and provide a structure for continued investigation into 'interventions' supporting diversity-related initiatives.

  9. The impact of health information technology on collaborative chronic care management.

    PubMed

    Marchibroda, Janet M

    2008-03-01

    information exchange initiatives particularly at the local levels. Community-based initiatives have built social capital and trust across multiple stakeholders; enabled access to clinical data derived from the care delivery process that only resides locally; and in many cases aligned incentives around the mobilization of clinical information across care settings. All of these elements are critical to the long-term success of chronic care management. While there is good research regarding interdisciplinary care models, more research is still needed to identify policies, practices, and strategies for facilitating and building cooperation among those engaged in chronic care management, and those engaged in multi-stakeholder efforts involved in the exchange of clinical health information electronically.

  10. Investing in Post-Acute Care Transitions: Electronic Information Exchange Between Hospitals and Long-Term Care Facilities.

    PubMed

    Cross, Dori A; Adler-Milstein, Julia

    2017-01-01

    Electronic health information exchange (HIE) is expected to help improve care transitions from hospitals to long-term care (LTC) facilities. We know little about the prevalence of hospital LTC HIE in the United States and what contextual factors may motivate or constrain this activity. Cross-sectional analysis of U.S. acute-care hospitals responding to the 2014 AHA IT Supplement survey and with available readmissions data (n = 1,991). We conducted multivariate logistic regression to explore the relationship between hospital LTC HIE and selected IT and policy characteristics. Over half of the hospitals in our study (57.2%) reported engaging in some form of HIE with LTC providers: 33.9% send-only, 0.5% receive-only, and 22.8% send and receive. Hospitals that engaged in some form of LTC HIE were more likely than those that did not engage to have attested to meaningful use (odds ratio [OR], 1.87; P = .01 for stage 1 and OR, 2.05; P < .01 for stage 2), participate in a regional HIE effort (OR, 1.34; P = .021), and exchange information electronically with other hospitals or ambulatory providers (OR, 4.54; P < .01). Organizational affiliation with a skilled nursing facility (OR, 1.29; P = .041) and higher 30-day readmission rates (OR, 1.19; P = .016) were also associated with LTC HIE, but not accountable care organization nor bundled payment participation. As payment to LTC providers and hospitals increasingly emphasizes total patient care and paying for value, those leading these organizations have new incentives to pursue collaborative relationships. Hospitals appear to be investing in electronic information exchange with LTCs as part of a general strategy to adopt EHRs and engage in HIE, but also potentially to strengthen ties to LTC providers and to reduce readmissions. To achieve widespread connectivity, continued focus on adoption of related health IT infrastructure and greater emphasis on aligning incentives for hospital-LTC care transitions would

  11. Facilitation of information processing in the primary somatosensory area in the ball rotation task.

    PubMed

    Wasaka, Toshiaki; Kida, Tetsuo; Kakigi, Ryusuke

    2017-11-14

    Somatosensory input to the brain is known to be modulated during voluntary movement. It has been demonstrated that the response in the primary somatosensory cortex (SI) is generally gated during simple movement of the corresponding body part. This study investigated sensorimotor integration in the SI during manual movement using a motor task combining movement complexity and object manipulation. While the amplitude of M20 and M30 generated in the SI showed a significant reduction during manual movement, the subsequent component (M38) was significantly higher in the motor task than in the stationary condition. Especially, that in the ball rotation task showed a significant enhancement compared with those in the ball grasping and stone and paper tasks. Although sensorimotor integration in the SI generally has an inhibitory effect on information processing, here we found facilitation. Since the ball rotation task seems to be increasing the demand for somatosensory information to control the complex movements and operate two balls in the palm, it may have resulted in an enhancement of M38 generated in the SI.

  12. Exchange field and Hc dependence on the ferromagnetic material in exchange couples with CoO (abstract)

    NASA Astrophysics Data System (ADS)

    Takano, Kentaro; Berkowitz, A. E.

    1997-04-01

    As recording density increases, magnetoresistive (MR) sensors are becoming increasingly important in read heads. NixCo(1-x)O is receiving technological attention for biasing magnetoresistive sensors as a robust alternative to FeMn. The interfacial exchange coupling between a ferromagnetic (FM) layer and an antiferromagnetic (AFM) is observed as an exchange field and an enhanced coercive field of the FM layer. The AFM/FM coupling is sensitive to the interfacial structure and the AFM and FM magnetic parameters. In this work, we deposited various FM layers on similar 300 Å CoO base layers to study the dependence of the FM exchange integral parameter J on the exchange HE and coercive HC fields. CoO was selected as the AFM material because (i) its simple spin and crystal structures facilitate the structural characterization and modeling of its magnetic properties, and (ii) it's modest Néel temperature of 300 K facilitates the use of a superconducting quantum interference device for the magnetic measurements at temperatures ranging from 5 to 400 K. The 300 Å CoO films were reactively sputtered on silicon substrates and capped with various 300 Å FM films, Ni, Co, Fe, and permalloy (Ni81Fe19). The 300 Å CoO base layer films were polycrystalline with columnar grains. The CoO deposition conditions were reproduced to ensure similar structural and magnetic interfacial AF environments. The observed HE temperature dependence cannot be explained by current theoretical models. The temperature dependence of the exchange fields have the common features (i) a blocking temperature Tb=300 K, which corresponds to the bulk Néel temperature of CoO, (ii) a rise in the exchange field with decreasing temperature, (iii) an intermediate temperature region of constant HE (plateau value), and (iv) a second region of linearly increasing HE with decreasing temperatures down to 0 K. The plateau value of the HE decreased inversely with increasing FM magnetization as predicted by theory. The

  13. Learned face-voice pairings facilitate visual search.

    PubMed

    Zweig, L Jacob; Suzuki, Satoru; Grabowecky, Marcia

    2015-04-01

    Voices provide a rich source of information that is important for identifying individuals and for social interaction. During search for a face in a crowd, voices often accompany visual information, and they facilitate localization of the sought-after individual. However, it is unclear whether this facilitation occurs primarily because the voice cues the location of the face or because it also increases the salience of the associated face. Here we demonstrate that a voice that provides no location information nonetheless facilitates visual search for an associated face. We trained novel face-voice associations and verified learning using a two-alternative forced choice task in which participants had to correctly match a presented voice to the associated face. Following training, participants searched for a previously learned target face among other faces while hearing one of the following sounds (localized at the center of the display): a congruent learned voice, an incongruent but familiar voice, an unlearned and unfamiliar voice, or a time-reversed voice. Only the congruent learned voice speeded visual search for the associated face. This result suggests that voices facilitate the visual detection of associated faces, potentially by increasing their visual salience, and that the underlying crossmodal associations can be established through brief training.

  14. Caring and Sharing: Becoming a Peer Facilitator.

    ERIC Educational Resources Information Center

    Myrick, Robert D.; Erney, Tom

    This book contains information and skill-building activities designed to train adolescents as peer facilitators. The first chapter describes peer facilitation and provides an overview of the book. The second chapter discusses principles, concepts, and ideas to help better understand how people learn, make decisions, change, and develop their own…

  15. The NASA Scientific and Technical Information (STI) Program's Implementation of Open Archives Initiation (OAI) for Data Interoperability and Data Exchange

    NASA Technical Reports Server (NTRS)

    Rocker, JoAnne; Roncaglia, George J.; Heimerl, Lynn N.; Nelson, Michael L.

    2002-01-01

    Interoperability and data-exchange are critical for the survival of government information management programs. E-government initiatives are transforming the way the government interacts with the public. More information is to be made available through web-enabled technologies. Programs such as the NASA's Scientific and Technical Information (STI) Program Office are tasked to find more effective ways to disseminate information to the public. The NASA STI Program is an agency-wide program charged with gathering, organizing, storing, and disseminating NASA-produced information for research and public use. The program is investigating the use of a new protocol called the Open Archives Initiative (OAI) as a means to improve data interoperability and data collection. OAI promotes the use of the OAI harvesting protocol as a simple way for data sharing among repositories. In two separate initiatives, the STI Program is implementing OAI In collaboration with the Air Force, Department of Energy, and Old Dominion University, the NASA STI Program has funded research on implementing the OAI to exchange data between the three organizations. The second initiative is the deployment of OAI for the NASA technical report server (TRS) environment. The NASA TRS environment is comprised of distributed technical report servers with a centralized search interface. This paper focuses on the implementation of OAI to promote interoperability among diverse data repositories.

  16. Facilitating interpersonal interaction and learning online: linking theory and practice.

    PubMed

    Sargeant, Joan; Curran, Vernon; Allen, Michael; Jarvis-Selinger, Sandra; Ho, Kendall

    2006-01-01

    An earlier study of physicians' perceptions of interactive online learning showed that these were shaped both by program design and quality and the quality and quantity of interpersonal interaction. We explore instructor roles in enhancing online learning through interpersonal interaction and the learning theories that inform these. This was a qualitative study using focus groups and interviews. Using purposive sampling, 50 physicians were recruited based on their experience with interactive online CME and face-to-face CME. Qualitative thematic and interpretive analysis was used. Two facilitation roles appeared key: creating a comfortable learning environment and enhancing the educational value of electronic discussions. Comfort developed gradually, and specific interventions like facilitating introductions and sharing experiences in a friendly, informative manner were helpful. As in facilitating effective small-group learning, instructors' thoughtful use of techniques that facilitated constructive interaction based on learner's needs and practice demands contributed to the educational value of interpersonal interactions. Facilitators require enhanced skills to engage learners in meaningful interaction and to overcome the transactional distance of online learning. The use of learning theories, including behavioral, cognitive, social, humanistic, and constructivist, can strengthen the educational design and facilitation of online programs. Preparation for online facilitation should include instruction in the roles and techniques required and the theories that inform them.

  17. Health information technology to facilitate communication involving health care providers, caregivers, and pediatric patients: a scoping review.

    PubMed

    Gentles, Stephen James; Lokker, Cynthia; McKibbon, K Ann

    2010-06-18

    Pediatric patients with health conditions requiring follow-up typically depend on a caregiver to mediate at least part of the necessary two-way communication with health care providers on their behalf. Health information technology (HIT) and its subset, information communication technology (ICT), are increasingly being applied to facilitate communication between health care provider and caregiver in these situations. Awareness of the extent and nature of published research involving HIT interventions used in this way is currently lacking. This scoping review was designed to map the health literature about HIT used to facilitate communication involving health care providers and caregivers (who are usually family members) of pediatric patients with health conditions requiring follow-up. Terms relating to care delivery, information technology, and pediatrics were combined to search MEDLINE, EMBASE, and CINAHL for the years 1996 to 2008. Eligible studies were selected after three rounds of duplicate screening in which all authors participated. Data regarding patient, caregiver, health care provider, HIT intervention, outcomes studied, and study design were extracted and maintained in a Microsoft Access database. Stage of research was categorized using the UK's Medical Research Council (MRC) framework for developing and evaluating complex interventions. Quantitative and qualitative descriptive summaries are presented. We included 104 eligible studies (112 articles) conducted in 17 different countries and representing 30 different health conditions. The most common conditions were asthma, type 1 diabetes, special needs, and psychiatric disorder. Most studies (88, 85%) included children 2 to 12 years of age, and 73 (71%) involved home care settings. Health care providers operated in hospital settings in 96 (92%) of the studies. Interventions featured 12 modes of communication (eg, Internet, intranets, telephone, video conferencing, email, short message service [SMS], and

  18. On the additional information content of hyperspectral remote sensing data for estimating ecosystem carbon dioxde and energy exchange

    NASA Astrophysics Data System (ADS)

    Wohlfahrt, Georg; Hammerle, Albin; Tomelleri, Enrico

    2015-04-01

    Radiation reflected back from an ecosystem carries a spectral signature resulting from the interaction of radiation with the vegetation canopy and the underlying soil and thus allows drawing conclusions about the structure and functioning of an ecosystem. When this information is linked to a model of the leaf CO2 exchange, the ecosystem-scale CO2 exchange can be simulated. A well-known and very simplistic example for this approach is the light-use efficiency (LUE) model proposed by Monteith which links the flux of absorbed photosynthetically active radiation times a LUE parameter, both of which may be estimated based on remote sensing data, to predict the ecosystem gross photosynthesis. Here we explore the ability of a more elaborate approach by using near-surface remote sensing of hyperspectral reflected radiation, eddy covariance CO2 and energy flux measurements and a coupled radiative transfer and soil-vegetation-atmosphere-transfer (SVAT) model. Our main objective is to understand to what degree the joint assimilation of hyperspectral reflected radiation and eddy covariance flux measurements into the model helps to better constrain model parameters. To this end we use the SCOPE model, a combination of the well-known PROSAIL model and a SVAT model, and the Bayesian inversion algorithm DREAM. In order to explicitly link reflectance in the visible light and the leaf CO2 exchange, a novel parameterisation of the maximum carboxylation capacity parameter (Vcmax) on the leaf a+b chlorophyll content parameter of PROSAIL is introduced. Results are discussed with respect to the additional information content the hyperspectral data yield for simulating canopy photosynthesis.

  19. Roles of cation valance and exchange on the retention and colloid-facilitated transport of functionalized multi-walled carbon nanotubes in a natural soil.

    PubMed

    Zhang, Miaoyue; Bradford, Scott A; Šimůnek, Jirka; Vereecken, Harry; Klumpp, Erwin

    2017-02-01

    Saturated soil column experiments were conducted to investigate the transport, retention, and release behavior of a low concentration (1 mg L -1 ) of functionalized 14 C-labeled multi-walled carbon nanotubes (MWCNTs) in a natural soil under various solution chemistries. Breakthrough curves (BTCs) for MWCNTS exhibited greater amounts of retardation and retention with increasing solution ionic strength (IS) or in the presence of Ca 2+ in comparison to K + , and retention profiles (RPs) for MWCNTs were hyper-exponential in shape. These BTCs and RPs were well described using the advection-dispersion equation with a term for time- and depth-dependent retention. Fitted values of the retention rate coefficient and the maximum retained concentration of MWCNTs were higher with increasing IS and in the presence of Ca 2+ in comparison to K + . Significant amounts of MWCNT and soil colloid release was observed with a reduction of IS due to expansion of the electrical double layer, especially following cation exchange (when K + displaced Ca 2+ ) that reduced the zeta potential of MWCNTs and the soil. Analysis of MWCNT concentrations in different soil size fractions revealed that >23.6% of the retained MWCNT mass was associated with water-dispersible colloids (WDCs), even though this fraction was only a minor portion of the total soil mass (2.38%). More MWCNTs were retained on the WDC fraction in the presence of Ca 2+ than K + . These findings indicated that some of the released MWCNTs by IS reduction and cation exchange were associated with the released clay fraction, and suggests the potential for facilitated transport of MWCNT by WDCs. Published by Elsevier Ltd.

  20. Online interprofessional education facilitation: A scoping review.

    PubMed

    Evans, Sherryn Maree; Ward, Catherine; Reeves, Scott

    2018-04-22

    The use of online media to deliver interprofessional education (IPE) is becoming more prevalent across health professions education settings. Facilitation of IPE activities is known to be critical to the effective delivery of IPE, however, specifics about the nature of online IPE facilitation remains unclear. To explore the health professions education literature to understand the extent, range and nature of research on online IPE facilitation. Scoping review methodology was used to guide a search of four electronic databases for relevant papers. Of the 2095 abstracts initially identified, after screening of both abstracts and full-text papers, 10 studies were selected for inclusion in this review. Following abstraction of key information from each study, a thematic analysis was undertaken. Three key themes emerged to describe the nature of the IPE facilitation literature: (1) types of online IPE facilitation contributions, (2) the experience of online IPE facilitation and (3) personal outcomes of online IPE facilitation. These IPE facilitation themes were particularly focused on facilitation of interprofessional student teams on an asynchronous basis. While the included studies provide some insight into the nature of online IPE facilitation, future research is needed to better understand facilitator contributions, and the facilitation experience and associated outcomes, both relating to synchronous and asynchronous online environments.

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