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Item Building Comprehensive and Sustainable Health Informatics Institutions in Developing Countries: Moi University Experience(IOS, 2015) Were, Martin C.; Siika, Abraham; Ayuo, Paul O.; Atwoli, Lukoye; Esamai, Fabian; Department of Medicine, IU School of MedicineCurrent approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving 3 million people. Moi University has formed strategic HI partnerships with Regenstrief Institute, Inc. (USA), University of Bergen (Norway), and Makerere University (Uganda), among others. The University has also created an Institute of Biomedical Informatics to serve as an HI Center of Excellence in the region. This Institute has divisions in Training, Research, Service and Administration. The HI capacity-building approach by Moi provides a model for adoption by other institutions in resource-limited settings.Item Can Salivary Innate Immune Molecules Provide Clue on Taste Dysfunction in COVID-19?(Frontiers, 2021-10) Ermel, Aaron; Thyvalikakath, Thankam Paul; Foroud, Tatiana; Khan, Babar; Srinivasan, Mythily; Medicine, School of MedicineEmerging concerns following the severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) pandemic are the long-term effects of coronavirus disease (COVID)-19. Dysgeusia in COVID-19 is supported by the abundant expression of the entry receptor, angiotensin-converting enzyme-2 (ACE2), in the oral mucosa. The invading virus perturbs the commensal biofilm and regulates the host responses that permit or suppress viral infection. We correlated the microbial recognition receptors and soluble ACE2 (sACE2) with the SARS-CoV2 measures in the saliva of COVID-19 patients. Data indicate that the toll-like receptor-4, peptidoglycan recognition protein, and sACE2 are elevated in COVID-19 saliva and correlate moderately with the viral load.Item Endorsement, Prior Action, and Language: Modeling Trusted Advice in Computerized Clinical Alerts(ACM, 2016-05) Chattopadhyay, Debaleena; Duke, Jon; Bolchini, Davide; Human-Centered Computing, School of Informatics and ComputingThe safe prescribing of medications via computerized physician order entry routinely relies on clinical alerts. Alert compliance, however, remains surprisingly low, with up to 95% often ignored. Prior approaches, such as improving presentational factors in alert design, had limited success, mainly due to physicians' lack of trust in computerized advice. While designing trustworthy alert is key, actionable design principles to embody elements of trust in alerts remain little explored. To mitigate this gap, we introduce a model to guide the design of trust-based clinical alerts-based on what physicians value when trusting advice from peers in clinical activities. We discuss three key dimensions to craft trusted alerts: using colleagues' endorsement, foregrounding physicians' prior actions, and adopting a suitable language. We exemplify our approach with emerging alert designs from our ongoing research with physicians and contribute to the current debate on how to design effective alerts to improve patient safety.Item Enhancing a Taxonomy for Health Information Technology: An Exploratory Study of User Input Towards Folksonomy(2010) Dixon, Brian E.; McGowan, Julie JThe U.S. Agency for Healthcare Research and Quality has created a public website to disseminate critical information regarding its health information technology initiative. The website is maintained by AHRQ's Natiomal Resource Center (NRC) for Health Information Technology. In the latest continuous quality improvement project, the NRC used the site's search logs to extract user-generated search phrases. The phrases were then compared to the site's controlled vocabulary with respect to language, grammar, and search precision. Results of the comparison demonstrate that search log data can be a cost-effective way to improve controlled vocabularies as well as information retrieval. User-entered search phrases were found to also share many similarities with folksonomy tags.Item Managing Pandemics with Health Informatics(IMIA Yearbook of Medical Informatics, 2021-09-03) Dixon, Brian E.; Holmes, John H.Objective: To summarize significant research contributions on managing pandemics with health informatics published in 2020. Methods: An extensive search using PubMed and Scopus was conducted to identify peer-reviewed articles published in 2020 that examined health informatics systems used during the global COVID-19 pandemic. The selection process comprised three steps: 1) 15 candidate best papers were first selected by the two section editors; 2) external reviewers from internationally renowned research teams reviewed each candidate best paper; and 3) the final selection of three best papers was conducted by the editorial committee of the International Medical Informatics Association (IMIA) Yearbook. Results: Selected best papers represent the important and diverse ways that health informatics supported clinical and public health responses to the global COVID-19 pandemic. Selected papers represent four groups of papers: 1) Use of analytics to screen, triage, and manage patients; 2) Use of telehealth and remote monitoring to manage patients and populations; 3) Use of EHR systems and administrative systems to manage internal operations of a hospital or health system; and 4) Use of informatics methods and systems by public health authorities to capture, store, manage, and visualize population-level data and information. Conclusion: Health informatics played a critical role in managing patients and populations during the COVID-19 pandemic. Health care and public health organizations both leveraged available information systems and standards to rapidly identify cases, triage infected individuals, and monitor population trends. The selected best papers represent a fraction of the body of knowledge stemming from COVID-19, most of which is focused on pandemic response. Future work will be needed to help the world recover from the pandemic and strengthen the health information infrastructure in preparation for the next pandemic.Item Ten year trends in hospital encounters for pediatric asthma: an Indiana experience(Taylor & Francis, 2021) Rogerson, Colin; He, Tian; Rowan, Courtney; Tu, Wanzhu; Mendonca, Eneida; Pediatrics, School of MedicineINTRODUCTION: Pediatric asthma is a common cause of emergency department visits, hospital admissions, and mortality. Population incidence studies have historically used large-scale survey data. We measured these epidemiologic trends using a health information exchange. METHODS: In this retrospective cohort study, we used electronic health record data from a regional health information exchange to study clinical trends in pediatric patients presenting to the hospital for asthma in the State of Indiana. Data was obtained from 2010 to 2019 and included all patients ages 2-18 years. Study participants were identified using international classification of disease codes. The measured outcomes were number of hospital encounters per year, percentage of admissions per year, and mortality rates. RESULTS: Data included 50,393 unique patients and 88,772 unique encounters, with 57% male patients. Over the ten-year period, hospital encounters ranged from 5000 to 8000 per year with no change in trajectory. Between 2010 and 2012, the percent of encounters admitted to the hospital was ∼30%. This decreased to ∼20-25% for 2015-2019. Patient mortality rates increased from 1 to 3 per 1000 patient encounters in 2010-2014 to between 5 and 7 per 1000 patient encounters from 2016 to 2019. White patients had a significantly higher admission percentage compared to other racial groups, but no difference in mortality rate. CONCLUSIONS: Asthma continues to be a common condition requiring hospital care for pediatric patients. Regional health information exchanges can enable public health researchers to follow asthma trends in near real time, and have potential for informing patient-level public health interventions.Item Understanding Advice Sharing among Physicians: Towards Trust-Based Clinical Alerts(Oxford, 2016-06) Chattopadhyay, Debaleena; Ghahari, Romisa Rohani; Duke, Jon; Bolchini, Davide; Department of Human-Centered Computing, School of Informatics and ComputingSafe prescribing of medications relies on drug safety alerts, but up to 96% of such warnings are ignored by physicians. Prior research has proposed improvements to the design of alerts, but with limited increase in adherence. We propose a different perspective: before re-designing alerts, we focus on improving the trust between physicians and computerized advice by examining why physicians trust their medical colleagues. To understand trusted advice among physicians, we conducted three contextual inquiries in a hospital setting (22 participants), and corroborated our findings with a survey (37 participants). Drivers that guide physicians in trusting peer advice include: timeliness of the advice, collaborative language, empathy, level of specialization and medical hierarchy. Based on these findings, we introduce seven design directions for trust-based alerts: endorsement, transparency, team sensing, collaborative, empathic, conflict mitigating and agency laden. Our work contributes to novel alert design strategies to improve the effectiveness of drug safety advice.