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At least 523 records · Page 29Linked to original sources
PubMed2004

Comparative performance data for critical access hospitals.

CONTEXT: Among small rural hospitals, there is a growing recognition of the need to measure and report on the use of resources and the safety and quality of the services provided. Dashboards, clinical value compasses, and balanced scorecards are approaches to performance measurement that have been adopted by many health care organizations. However, there exists very little comparative performance data specific for critical access hospitals. PURPOSE: To identify how comparative performance data for critical access hospitals (CPD-CAH) might facilitate performance and quality improvement, to assess the potential benefits and drawbacks of such data, and to identify some of the critical issues in the development and implementation of CPD-CAH. METHODS: Assessment of discussions by participants at a rural hospital performance improvement summit and authors' analyses. FINDINGS: CPD-CAH potentially could improve quality of care and patient outcomes, provide comparative data and benchmarks, inform policy development, facilitate collaboration, and enhance community relations. However, CPD-CAH could also impose an unaffordable cost, produce poor information, require complex coordination, induce a negative public reaction, and result in perverse hospital behavior. Development and implementation of CPD-CAH would require including stakeholders' assessment of its desirability and feasibility, setting objectives, establishing guiding principles, developing a method, collecting and analyzing data, and disseminating results. CONCLUSIONS: CPD-CAH could significantly advance CAH performance and quality improvement. However, development and implementation would be a complicated exercise requiring academic expertise and practitioner consultation. The potential value of CPD-CAH should be carefully weighed against its potential cost.

Benchmarking↗
PubMed1999

Distributing digital imaging and communications in medicine data and optimizing access over satellite networks.

To improve radiology access to full uncompressed Digital Imaging and Communications in Medicine (DICOM) data sets, we evaluated satellite access to a DICOM server. Radiologists' home computers were connected by satellite to a Medweb DICOM server (Medweb, San Francisco, CA). A 10.2-kb data set containing a 19-image head computed tomography (CT) scan was transferred using DirecPC (Hughes Electronics Corp, Arlington, VA) at three different times of the day; 6 AM, 3 PM, and 8 PM. The average transfer time for all 19 images from the DICOM server was 4 minutes and 17 seconds (257 seconds). The slowest transfer rate of 670 seconds (121 kbps) was obtained at 8 PM. The best transfer rate of 2 minutes, 54 seconds (467 kbps) was obtained at 6 AM. The full 16-bit DICOM images were viewed with bone, brain, and soft tissue windows. The Medweb plug-in viewer loaded the first image within 30 seconds of selecting the case for satellite transfer. In conclusion, satellite internet transfer of radiology studies is suitable for timely review of full DICOM data sets and can expand the range of teleradiology consultation.

Brain↗
PubMed2026

Ethical Governance of Open Data Across Biomedical Research, Healthcare, and Public Health: Privacy, Equity, Trust, and Controlled Access.

Open data has become central to biomedical research and public health, but health information is uniquely sensitive and difficult to share responsibly. In this narrative review, open data is considered as a spectrum of health-data sharing arrangements, ranging from public aggregate datasets to controlled-access repositories, federated analysis, and synthetic data. This narrative review synthesizes the scientific and societal rationale for greater openness with the ethical, legal, and governance constraints that shape what "open" can realistically mean in healthcare. We examine how data sharing supports reproducibility, machine learning, and more efficient research, while also enabling public health surveillance and learning health systems. Against these benefits, we analyze privacy and re-identification risks, consent challenges in large-scale secondary use, inequities including data colonialism, and tensions introduced by commercialization. We integrate lessons from prominent case examples spanning pandemic data sharing, genomic initiatives, population registries, patient-led rare disease infrastructures, and regional data spaces. Across these domains, experience suggests that durable progress depends less on unrestricted openness than on calibrated access, privacy-preserving architectures, clear accountability, and sustained public engagement. We conclude by proposing a pragmatic ethical orientation for healthcare open data: treat openness as a spectrum of controlled sharing arrangements, embed equity and reciprocity into governance, and institutionalize trust-building measures that can persist beyond emergencies and political cycles.

Data colonialism↗
PubMed2005

SpA: web-accessible spectratype analysis: data management, statistical analysis and visualization.

SUMMARY: SpA is a web-accessible system for the management, visualization and statistical analysis of T-cell receptor spectratype data. Users upload data from their spectratype analyzers to SpA, which saves the raw data and user-defined supplementary covariates to a secure database. The statistical engine performs several data analyses and statistical summaries. The visualization engine displays spectratype histograms in a Java applet and in an image file suitable for download. All of these results are also saved to the database and remain accessible to the user. Additional statistical tools specific to the analysis of multiple spectratypes are also available through the SpA interface. AVAILABILITY: The service is freely accessible via the web at http://www.duke.edu/~kepler/spa.html. Additional technical support and specialized statistical analysis and consultation are available by arrangement with the authors and, depending on the service requested, may be subject to fee.

Animals↗
PubMed1997

Analysis of hospitalization rates by electoral ward: relationship to accessibility and deprivation data.

The objective of this paper is to investigate the relevance of access to hospital services in explaining utilization rates at a District Health Authority level in the UK. In order to test the hypothesis that access is important, it is necessary to develop a means of scoring access factors and then combining these scores with other more recognized influences on hospitalization rates e.g. deprivation measures. Acknowledging that hospitalization rates are not merely products of a population's socio-economic characteristics, the effect of accessibility to hospital services for the resident population is investigated through the derivation of an access score using both private and public transport from electoral ward of residence. Deprivation and accessibility to services were both found to be significant factors in determining hospitalization rates at electoral ward level. The chosen supply variable--number of GPs--was not found to be significant in any of the models developed using linear regression techniques. To conclude, it appears that access plays an important role in determining hospitalization rates within a given population. If high hospitalization rates are accepted as an indicator of effectively met demand then policy makers may have to consider increasing the accessibility of hospital services.

Catchment Area, Health↗
PubMed1997

Electronic access to tinnitus data: the Oregon Tinnitus Data Archive.

The recently published Oregon Tinnitus Data Archive can be viewed by anyone with Internet access and World Wide Web browser software. A dynamically changing document to be amplified and upgraded in future versions, at present the Archive summarizes records from 1630 patients with tinnitus seen between 1982 and 1992 at the Tinnitus Clinic of the Oregon Health Sciences University. The Archive has many features of standard journal publications but also has added advantages of extensive appendixes and other background information, as well as the ease of use and flexibility offered by hypertext documents. The data in the Archive can be used for a variety of clinical and research purposes such as development of prevalence estimates for medical conditions or etiologic circumstances associated with tinnitus, testing of clinical impressions and other hypotheses, and efforts to identify risk factors and possible causal agents for tinnitus.

Computer Communication Networks↗
PubMedDate not supplied

Community health assessment: driving the need for current, easily accessible population health data.

Community health assessment (CHA) is a core public health function. Community health assessment is a term that describes both a process and its tangible products, such as a community health profile or other types of reports on the status of the community's health and existing influences on its health, including the extent and nature of health-related resources. Assessment has enabled a better understanding of the community's health, and this has impacted public health decisions. The authors use the framework for community health improvement proposed in 1997 by the Institutes of Medicine to show how CHA is part of the community health improvement process. Community health assessment drives the need for current, easily accessible population health data. The importance of Web-based data query systems, the focus of the other articles in this special issue, can be best understood within the broader context of CHA. Selected case examples of how Web-based data query systems have impacted the CHA process in three states are highlighted.

Access to Information↗
PubMedDate not supplied

UMLS-based access to CPR data. Unified Medical Language Systems.

This paper describes the results of a project that explores the use the Unified Medical Language System (UMLS) for knowledge-driven tasks, such as browsing a computer-based patient record (CPR). The project consisted of a number of steps: the mapping between CPR terms and UMLS concepts, the development of an algorithm that explores the CPR data using this mapping and the implementation of a first prototype browser that visualizes 'found' data. A second task addressed in this project has been the direct access to online medical literature (MEDLINE) using the UMLS concepts found in the CPR data. In this project, we used a preliminary version of the Open Records for Patient Care (ORCA) CPR that consisted only of the history and physical examination data of patient suffering from heart failure.

Algorithms↗
PubMed1998

UMLS-based access to CPR data.

This paper describes the results of a project that explores the use the Unified Medical Language System (UMLS) for knowledge-driven tasks, such as browsing a computer-based patient record (CPR). The project consisted of a number of steps: the mapping between CPR terms and UMLS concepts, the development of an algorithm that explores the CPR data using this mapping, and the implementation of a first prototype browser that visualizes "found" data. A second task addressed in this project has been the direct access to online medical literature (MEDLINE) using the UMLS concepts found in the CPR data. In this project, we used a preliminary version of the Open Records for Patient Care (ORCA) CPR that consisted only of the history and physical examination data of patient suffering from heart failure.

Algorithms↗
PubMed1991

The practical use and evaluation of picture archiving and communication system in the Department of Orthopaedic Surgery.

A picture archiving and communication system (PACS) was started in June 1989 in the outpatient clinic of the Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan. The PACS system has several advantages: space savings for storage of images, safe custody and quick access to image data, simultaneous access to image data, the possibility of obtaining good quality data on utilization of images, and applications for medical education and resident training. However, this system has just begun, and several problems must still be solved. In this article, we describe our experiences with the PACS system in the outpatient clinic of the department of orthopaedic surgery.

Hospital Departments↗
PubMed2026

Scalable, open-access and multidisciplinary data integration pipeline for climate-sensitive diseases.

Climate-sensitive infectious diseases pose an important challenge for human, animal and environmental health and it has been estimated that over half of known human pathogenic diseases can be aggravated by climate change. While climatic and weather conditions are important drivers of transmission of vector-borne diseases, socio-economic, behavioural, and land-use factors as well as the interactions among them impact transmission dynamics. Analysis of drivers of climate-sensitive diseases require rapid integration of interdisciplinary data to be jointly analysed with epidemiological (including genomic and clinical) data. Current tools for the integration of multiple data sources are often limited to one data type or rely on proprietary data and software. To address this gap, we develop a scalable and open-access pipeline for the integration of multiple spatio-temporal datasets that requires only the declaration of the country and temporal range and resolution of the study. The tool is locally deployable and can easily be integrated into existing climate-disease-modelling applications. We demonstrate the utility of the tool for dengue modelling in Vietnam where epidemiological data are legally required to remain local. We include a pipeline for bias correction of climate data to enhance their quality for downstream modelling tasks. The Dengue Advanced Readiness Tools-Pipeline empowers users by simplifying complex download, correction, and aggregation steps, fostering data-driven discovery of relationships between infectious diseases and their drivers in space and time, and enhancing reproducibility in research. Additional modules and datasets can be added to the existing ones to make the pipeline extendable to use cases other than the ones presented here.

automated workflows↗
PubMed2004

Does health service utilisation vary by remoteness? South Australian population data and the Accessibility and Remoteness Index of Australia.

OBJECTIVE: To compare rates of self-reported use of health services between rural, remote and urban South Australians. METHODS: Secondary data analysis from a population-based survey to assess health and well-being, conducted in South Australia in 2000. In all, 2,454 adults were randomly selected and interviewed using the computer-assisted telephone interview (CATI) system. We analysed health service use by Accessibility and Remoteness Index of Australia (ARIA) category. RESULTS: There was no statistically significant difference in the median number of uses of the four types of health services studied across ARIA categories. Significantly fewer residents of highly accessible areas reported never using primary care services (14.4% vs. 22.2% in very remote areas), and significantly more reported high use (> or =6 visits, 29.3% vs. 21.5%). Fewer residents of remote areas reported never attending hospital (65.6% vs. 73.8% in highly accessible areas). Frequency of use of mental health services was not statistically significantly different across ARIA categories. Very remote residents were more likely to spend at least one night in a public hospital (15.8%) than were residents of other areas (e.g. 5.9% for highly accessible areas). CONCLUSION: The self-reported frequency of use of a range of health services in South Australia was broadly similar across ARIA categories. However, use of primary care services was higher among residents of highly accessible areas and public hospital use increased with increasing remoteness. There is no evidence for systematic rural disadvantage in terms of self-reported health service utilisation in this State.

Adolescent↗