Browsing by Subject "Reconciliation"

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    Consolidation of CDA-based documents from multiple sources : a modular approach
    (2016-09) Hosseini Asanjan, Seyed Masoud; Jones, Josette F.; Dixon, Brian E.; Vreeman, Daniel J.; Faiola, Anthony; Wu, Huanmei
    Physicians receive multiple CCDs for a single patient encompassing various encounters and medical history recorded in different information systems. It is cumbersome for providers to explore different pages of CCDs to find specific data which can be duplicated or even conflicted. This study describes the steps towards a system that integrates multiple CCDs into one consolidated document for viewing or processing patient-level data. Also, the impact of the system on healthcare providers’ perceived workload is evaluated. A modular system is developed to consolidate and de-duplicate CDA-based documents. The system is engineered to be scalable, extensible and open source. The system’s performance and output has evaluated first based on synthesized data and later based on real-world CCDs obtained from INPC database. The accuracy of the consolidation system along with the gaps in identification of the duplications were assessed. Finally, the impact of the system on healthcare providers’ workload is evaluated using NASA TLX tool. All of the synthesized CCDs were successfully consolidated, and no data were lost. The de-duplication accuracy was 100% based on synthesized data and the processing time for each document was 1.12 seconds. For real-world CCDs, our system de-duplicated 99.1% of the problems, 87.0% of allergies, and 91.7% of medications. Although the accuracy of the system is still very promising, however, there is a minor inaccuracy. Due to system improvements, the processing time for each document is reduced to average 0.38 seconds for each CCD. The result of NASA TLX evaluation shows that the system significantly decreases healthcare providers’ perceived workload. Also, it is observed that information reconciliation reduces the medical errors. The time for review of medical documents review time is significantly reduced after CCD consolidation. Given increasing adoption and use of Health Information Exchange (HIE) to share data and information across the care continuum, duplication of information is inevitable. A novel system designed to support automated consolidation and de-duplication of information across clinical documents as they are exchanged shows promise. Future work is needed to expand the capabilities of the system and further test it using heterogeneous vocabularies across multiple HIE scenarios.
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    The Lost Cause, Reconciliation, and White Supremacy in South Carolina's Education System, 1920 - 1940
    (2021-08) Bird, Jeffrey Allan, Jr.; Kaufman-McKivigan, John; Morgan, Anita; Guiliano, Jennifer
    Between 1920 and 1940, South Carolina saw major changes in its education system both in response to low literacy rates in the state and as part of a national trend in education reform. The period also saw the emergence of one history textbook as the dominant history text for middle school students across the state. William Gilmore Simms and his granddaughter, Mary C. Simms Oliphant, the authors of this history text, had influence over middle school-aged children’s history education for over a century with their books being used in South Carolina schools in some capacity from around 1840 until 1985. These books exhibit strong influence from the Lost Cause Movement, as well as reconciliationist and white supremacist ideology, to present a more pro-southern point of view of the Civil War. Through heroification—the remaking of historical figures into heroes despite their flaws—revision/omission, and both implicit and explicit racism, Simms and Simms-Oliphant weaved narratives that twisted the facts of the Civil War era. These narratives implanted in the seventh and eighth grade students’ minds who typically read the textbooks’ false ideas about the events and people involved in the war. While research on history textbooks generally is widespread, there have been no in-depth studies of the influence of Simms and Simms-Oliphant on South Carolina’s education system. In the 1920s and 1930s, when students across the country on average completed eight to nine years of school, Simms’ and Simms-Oliphant’s books would have been the last history book many of those students would have read before ending their schooling. This gave these two authors immense power to influence public opinion in South Carolina. Ultimately, it appears that education is the primary tool through which South Carolina, and other southern states, have institutionalized Lost Cause, reconciliationist, and white supremacist narratives of the Civil War era that continue to influence public opinion in South Carolina and across the South.