Academic literature on the topic 'Medical informatics Australia'
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Journal articles on the topic "Medical informatics Australia"
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Crowe, B. L., and I. G. Mcdonald. "Telemedicine in Australia. Recent developments." Journal of Telemedicine and Telecare 3, no. 4 (December 1, 1997): 188–93. http://dx.doi.org/10.1258/1357633971931147.
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There have been a number of important developments in Australia in the area of telemedicine. At the national level, the House of Representatives' Standing Committee on Family and Community Affairs has been conducting the Inquiry into Health Information Management and Telemedicine. The Australian Health Ministers' Advisory Council has supported the establishment of a working party convened by the South Australian Health Commission to prepare a detailed report on issues relating to telemedicine. State governments have begun a number of telemedicine projects, including major initiatives in New South Wales and Victoria and the extensive development of telepsychiatry services in Queensland. Research activities in high-speed image transmission have been undertaken by the Australian Computing and Communications Institute and Telstra, and by the Australian Navy. The matter of the funding of both capital and recurrent costs of telemedicine services has not been resolved, and issues of security and privacy of medical information are subject to discussion. The use of the Internet as a universal communications medium may provide opportunities for the expansion of telemedicine services, particularly in the area of continuing medical education. A need has been recognized for the coordinated evaluation of telemedicine services as cost-benefit considerations are seen to be very important.
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Edirippulige, Sisira, Peter Brooks, Colin Carati, Victoria A. Wade, Anthony C. Smith, Sumudu Wickramasinghe, and Nigel R. Armfield. "It’s important, but not important enough: eHealth as a curriculum priority in medical education in Australia." Journal of Telemedicine and Telecare 24, no. 10 (October 22, 2018): 697–702. http://dx.doi.org/10.1177/1357633x18793282.
Full textAbstract:
Information and communications technology has become central to the way in which health services are provided. Technology-enabled services in healthcare are often described as eHealth, or more recently, digital health. Practitioners may require new knowledge, skills and competencies to make best use of eHealth, and while universities may be a logical place to provide such education and training, a study in 2012 found that the workforce was not being adequately educated to achieve competence to work with eHealth. We revisited eHealth education and training in Australian universities with a focus on medical schools; we aimed to explore the progress of eHealth in the Australian medical curriculum. We conducted a national interview study and interpretative phenomenological analysis with participants from all 19 medical schools in Australia; two themes emerged: (i) consensus on the importance of eHealth to current and future clinical practice; (ii) there are other priorities, and no strong drivers for change. Systemic problems inhibit the inclusion of eHealth in medical education: the curriculum is described as ‘crowded’ and with competing demands, and because accrediting bodies do not expect eHealth competence in medical graduates, there is no external pressure for its inclusion. Unless and until accrediting bodies recognise and expect competence in eHealth, it is unlikely that it will enter the curriculum; consequently the future workforce will remain unprepared.
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Yogesan, K., C. Henderson, C. J. Barry, and I. J. Constable. "Online eye care in prisons in Western Australia." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 63–64. http://dx.doi.org/10.1258/1357633011937173.
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In prisons, prison medical officers provide general medical care. However, if specialist care is needed then the prisoner is transported to a specialist medical centre. This is a costly procedure and prison escapes occur during transportation. We have tested our Internet-based eye care system in prisons in Western Australia. Medical and ophthalmic history, visual acuity and intraocular pressure were stored in a browser-based multimedia database. Digital images of the retina and the external eye were recorded and transmitted to a central server. Based on the medical data and the digital images, the specialist ophthalmologist could provide a diagnosis within 24 h. Eleven patients (mean age 48, range 30–82 years) were reviewed during two separate visits to a maximum-security prison in Western Australia. Our main aim was to train prison medical officers and nurses to operate the portable ophthalmic imaging instruments and to use the Internet-based eye care system. The outcome of the pilot study indicated that considerable savings could be made in transport costs and the security risk could be reduced. The Ministry of Justice in Western Australia has decided to implement telemedicine services to provide regular ophthalmic consultation to its prisons.
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Hardie, Rae-Anne, Donna Moore, Derek Holzhauser, Michael Legg, Andrew Georgiou, and Tony Badrick. "Informatics External Quality Assurance (IEQA) Down Under: evaluation of a pilot implementation." LaboratoriumsMedizin 42, no. 6 (December 19, 2018): 297–304. http://dx.doi.org/10.1515/labmed-2018-0050.
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AbstractExternal quality assurance (EQA) provides ongoing evaluation to verify that laboratory medicine results conform to quality standards expected for patient care. While attention has focused predominantly on test accuracy, the diagnostic phases, consisting of pre- and post-laboratory phases of testing, have thus far lagged in the development of an appropriate diagnostic-phase EQA program. One of the challenges faced by Australian EQA has been a lack of standardisation or “harmonisation” resulting from variations in reporting between different laboratory medicine providers. This may introduce interpretation errors and misunderstanding of results by clinicians, resulting in a threat to patient safety. While initiatives such as the Australian Pathology Information, Terminology and Units Standardisation (PITUS) program have produced Standards for Pathology Informatics in Australia (SPIA), conformity to these requires regular monitoring to maintain integrity of data between sending (laboratory medicine providers) and receiving (physicians, MyHealth Record, registries) organisations’ systems. The PITUS 16 Informatics EQA (IEQA) Project together with the Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) has created a system to perform quality assurance on the electronic laboratory message when the laboratory sends a result back to the EQA provider. The purpose of this study was to perform a small scale pilot implementation of an IEQA protocol, which was performed to test the suitability of the system to check compliance of existing Health Level-7 (HL7 v2.4) reporting standards localised and constrained by the RCPA SPIA. Here, we present key milestones from the implementation, including: (1) software development, (2) installation, and verification of the system and communication services, (3) implementation of the IEQA program and compliance testing of the received HL7 v2.4 report messages, (4) compilation of a draft Informatics Program Survey Report for each laboratory and (5) review consisting of presentation of a report showing the compliance checking tool to each participating laboratory.
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Alexander, M. "Telemedicine in Australia. 2: The Health Communication Network." Journal of Telemedicine and Telecare 2, no. 1 (March 1, 1996): 1–6. http://dx.doi.org/10.1258/1357633961929079.
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The Health Communication Network HCN in Australia is reviewed. Early interest from both the government and the medical community led to the establishment of a number of pilot services. Because of the community interest in privacy issues, determined efforts to understand and build structures to cope with privacy have been made. The first HCN services began to be tested in 1995, and progressive expansion is planned. The HCN, while supported by the government, is a separate, commercial entity, and much early work has thus focused on corporate governance, so that it will be able to do what it was designed for.
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Lim, Adrian C., Adrian C. See, and Stephen P. Shumack. "Progress in Australian teledermatology." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 55–58. http://dx.doi.org/10.1258/1357633011937146.
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Because of their remoteness, the majority of rural towns in Australia are disadvantaged in terms of access to dermatological services. Telemedicine offers one solution. Since the mid-1990s, Australian dermatologists have experimented with tele-medicine as an adjunct to clinical practice. The technical viability of teledermatology was first demonstrated in 1997. In 1999, the accuracy and reliability of teledermatology were demonstrated in a real-life urban setting. In 2001, Broken Hill (in western New South Wales), a location remote from dermatology services, served as a trial site for the institution of tele-dermatology as the primary method of accessing dermatological services. High patient and general practitioner acceptability and positive medical outcomes were demonstrated, but the study also revealed unexpected barriers and pitfalls in the effective operation of rural teledermatology.
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Lasserre, Kaye E., Nicola Foxlee, Lisa Kruesi, and Julie Walters. "Health Sciences Librarians' Research on Medical Students' Use of Information for Their Studies at The Medical School, University of Queensland, Australia." Medical Reference Services Quarterly 30, no. 2 (April 25, 2011): 141–57. http://dx.doi.org/10.1080/02763869.2011.562794.
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Marceau, Jane. "Managing medical technology: hospitals and innovation in the biomedical industry in Australia." International Journal of Healthcare Technology and Management 2, no. 1/2/3/4 (2000): 281. http://dx.doi.org/10.1504/ijhtm.2000.001081.
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Rosengren, D., N. Blackwell, G. Kelly, L. Lenton, and J. Glastonbury. "The use of telemedicine to treat ophthalmological emergencies in rural Australia." Journal of Telemedicine and Telecare 4, no. 1_suppl (March 1998): 97–99. http://dx.doi.org/10.1258/1357633981931650.
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A retrospective analysis was made of a cohort of patients who presented sequentially with acute ophthalmological conditions which were managed by telemedicine consultation. Twenty-four patients presented with acute problems requiring specialist ophthalmological advice to the emergency department of a remote hospital in Mt Isa, Queensland, between December 1996 and February 1997. Tele-ophthalmology consultations were carried out with three ophthalmologists working in a specialist eye clinic in Townsville, 900 km away. Patients and doctors were extremely positive about the telemedicine facility. Tele-ophthalmology was an effective means of providing acute specialist consultation in a remote emergency department. By reducing the need for acute transfers to the tertiary hospital in Townsville, significant benefits can be anticipated—both financial and in terms of convenience for the patient. Benefits for medical staff in skills acquisition and education were also evident.
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Croll, P., B. Li, C. P. Wong, S. Gogia, A. Faud, Y. S. Kwak, S. Chu, et al. "Survey on Medical Records and EHR in Asia-Pacific Region." Methods of Information in Medicine 50, no. 04 (2011): 386–91. http://dx.doi.org/10.3414/me11-02-0002.
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SummaryObjectives: To clarify health record background information in the Asia-Pacific region, for planning and evaluation of medical information systems.Methods: The survey was carried out in the summer of 2009. Of the 14 APAMI (Asia-Pacific Association for Medical Informatics) delegates 12 responded which were Australia, China, Hong Kong, India, Indonesia, Japan, Korea, New Zealand, the Philippines, Singapore, Thailand, and Taiwan.Results: English is used for records and education in Australia, Hong Kong, India, New Zealand, the Philippines, Singapore and Taiwan. Most of the countries/regions are British Commonwealth. Nine out of 12 delegates responded that the second purpose of medical records was for the billing of medical services. Seven out of nine responders to this question answered that the second purpose of EHR (Electronic Health Records) was healthcare cost cutting. In Singapore, a versatile resident ID is used which can be applied to a variety of uses. Seven other regions have resident IDs which are used for a varying range of purposes. Regarding healthcare ID, resident ID is simply used as healthcare ID in Hong Kong, Singapore and Thailand. In most cases, disclosure of medical data with patient’s name identified is allowed only for the purpose of disease control within a legal framework and for disclosure to the patient and referred doctors. Secondary use of medical information with the patient’s identification anonymized is usually allowed in particular cases for specific purposes.Conclusion: This survey on the health record background information has yielded the above mentioned results. This information contributes to the planning and evaluation of medical information systems in the Asia-Pacific region.
Dissertations / Theses on the topic "Medical informatics Australia"
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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D'Arrietta, Louisa, and n/a. "An investigation of the information needs and information-seeking behaviour of general practitioners in their delivery of patient care to the elderly on the Gold Coast." University of Canberra. Information, Language & Culture, 1994. http://erl.canberra.edu.au./public/adt-AUC20060426.164122.
Full textAbstract:
The study investigated the self-reported information needs and
information-seeking behaviour of 143 general practitioners in their delivery
of patient care to the elderly on the Gold Coast.
The study sought to obtain an information profile in order to begin
discussion on the need for possible infrastructures that may need to be
considered in any planning strategies concerned with access to and
provision of relevant, accurate and timely information to general
practitioners which affects their delivery of patient care to the growing
number of elderly patients.
A ten-page questionnaire utilising both structured and unstructured
questions was returned by 61.9 percent of the survey population.
Demographic characteristics indicated that respondents were representative
of general practitioners in Australia.
Respondents frequently needed information with 40 percent requiring it '1 -
4 times a week' and 78 percent 'once a month or more often'. Information
on medical fact was required most frequently, 29 percent, medical opinion
27 percent, and non-medical information 23 percent.
The study found support for the proposition that computerised information
systems need to be enhanced and made widely known and available to
general practitioners to assist them in obtaining information that they need
in delivery of patient care to the elderly. There is a great need by these
general practitioners for non-medical information as well as medical
information. Therefore, the development of a database of non-medical
information containing information on local agencies and services is of high
priority.
Library information delivery services should also be de-institutionalised in
terms of lifting restrictions to services provided to enable general
practitioners greater access to information. Library services should aim to
provide remote access to information via telephone, fax and modem with
emphasis on value added services aimed at solving a particular specific
information need as well as straight-out bibliographic search services and
document delivery services.
Continuing medical education in the form of CME courses, conferences and
meetings should focus on specific information needs of general practitioners
in this area of patient care to the elderly. The need for information on
cardiology, orthopaedics, dermatology, physiotherapy, podiatry,
pharmaceutical benefits, home help, Meals-on-Wheels and nursing home
placement were areas of particular interest identified by respondents in this
study.
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Htat, Kyaw Kyaw. "A framework for development of android mobile electronic prescription transfer applications in compliance with security requirements mandated by the Australian healthcare industry." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2096.
Full textAbstract:
This thesis investigates mobile electronic transfer of prescription (ETP) in compliance with the security requirements mandated by the Australian healthcare industry and proposes a framework for the development of an Android mobile electronic prescription transfer application. Furthermore, and based upon the findings and knowledge from constructing this framework, another framework is also derived for assessing Android mobile ETP applications for their security compliance.
The centralised exchange model-based ETP solution currently used in the Australian healthcare industry is an expensive solution for on-going use. With challenges such as an aging population and the rising burden of chronic disease, the cost of the current ETP solution’s operational infrastructure is certain to rise in the future. In an environment where it is increasingly beneficial for patients to engage in and manage their own information and subsequent care, this current solution fails to offer the patient direct access to their electronic prescription information. The current system also fails to incorporate certain features that would dramatically improve the quality of the patient’s care and safety, i.e. alerts for the patient’s drug allergies, harmful dosage and script expiration. Over a decade old, the current ETP solution was essentially designed and built to meet legislation and regulatory requirements, with change-averting its highest priority. With little, if any, provision for future growth and innovation, it was not designed to cater to the needs of the ETP process. This research identifies the gap within the current ETP implementation (i.e. dependency on infrastructure, significant on-going cost and limited availability of the patient’s medication history) and proposes a framework for building a secure mobile ETP solution on the Android mobile operating system platform which will address the identified gap.
The literature review part of this thesis examined the significance of ETP for the nation’s larger initiative to provide an improved and better maintainable healthcare system. The literature review also revealed the stance of each jurisdiction, from legislative and regulatory perspectives, in transitioning to the use of a fully electronic ETP solution. It identified the regulatory mandates of each jurisdiction for ETP as well as the security standards by which the current ETP implementation is iii governed so as to conform to those regulatory mandates. The literature review part of the thesis essentially identified and established how the Australian healthcare industry’s various prescription-related legislations and regulations are constructed, and the complexity of this construction for eTP.
The jurisdictional regulatory mandates identified in the literature review translate into a set of security requirements. These requirements establish the basis of the guiding framework for the development of a security-compliant Android mobile ETP application. A number of experimentations were conducted focusing on the native security features of the Android operating system, as well as wireless communication technologies such as NFC and Bluetooth, in order to propose an alternative mobile ETP solution with security assurance comparable to the current ETP implementation. The employment of a proof-of-concept prototype such as this alongside / coupled with a series of iterative experimentations strengthens the validity and practicality of the proposed framework.
The first experiment successfully proved that the Android operating system has sufficient encryption capabilities, in compliance with the security mandates, to secure the electronic prescription information from the data at rest perspective. The second experiment indicated that the use of NFC technology to implement the alternative transfer mechanism for exchanging electronic prescription information between ETP participating devices is not practical. The next iteration of the experimentation using Bluetooth technology proved that it can be utilised as an alternative electronic prescription transfer mechanism to the current approach using the Internet. These experiment outcomes concluded the partial but sufficient proofof- concept prototype for this research.
Extensive document analysis and iterative experimentations showed that the framework constructed by this research can guide the development of an alternative mobile ETP solution with both comparable security assurance to and better access to the patient’s medication history than the current solution. This alternative solution would present no operational dependence upon infrastructure and its associated, ongoing cost to the nation’s healthcare expenditure. In addition, use of this mobile ETP alternative has the potential to change the public’s perception (i.e. acceptance from regulatory and security perspectives) of mobile healthcare solutions, thereby paving the way for further innovation and future enhancements in eHealth.
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Dare, Julie. "The role of information and communication technologies in managing transition and sustaining women's health during their midlife years." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2009. https://ro.ecu.edu.au/theses/1977.
Full textAbstract:
This research has been motivated primarily by a desire to extend and enrich existing research on women’s uses of information and communication technologies (ICTs) to manage relationships, and access and construct social support during their transitional midlife years. In doing so, this research addresses a gap in the literature on women’s consumption of such technologies. Since the late 1980s, when several landmark studies investigated women’s use of the telephone, there has been little systematic evaluation of the degree to which newer communication technologies have become integrated into women’s communication practices.
Another key feature of this research is an examination of how ‘midlife’, as a stage of life characterised by several common transitions, is experienced by a group of women. These life experiences are modified by the availability of social support and, significantly for this research, by the communication conduits through which this support circulates. Given that midlife involves physical and emotional changes that may impact on a woman’s sense of self, this period of transition can be a source of stress. Numerous studies have identified the critical role social support plays in helping individuals cope with stress. For women, social support is commonly manifested through female networks, maintained through faceto- face encounters, and increasingly through mediated communication channels. In a region as geographically isolated as Western Australia, where over 27% of the population were born overseas, the importance of communication technologies in facilitating access to dispersed social support networks is arguably even more critical.
The research procedure, drawing on a qualitative, interpretive methodological approach, involved 40 in-depth, one-on-one ethnographic interviews with women aged between 45 and 55. Initial findings indicated that while women are actively appropriating a range of online communication channels, there was a risk in limiting the research focus to women’s use of the Internet, in isolation from their broader communication practices. In particular, this research makes clear that one significant aspect of women’s uses of ICTs lies in how different communication channels meet the needs of women and their families at particular moments in their lives. At the midway mark in the lifecycle, many of the women interviewed are either consciously, or in some cases intuitively, employing particular communication channels to manage difficult or sensitive relationships; their choices often constrained by the communication needs and/or preferences of their aging parents and/or their own children.
Despite such constraints, this research provides strong evidence to suggest that midlife women are as adept at strategically appropriating multiple communication technologies to satisfy their own needs, as are many younger people. This is manifested in a variety of ways, from women’s use of email as a safe conduit through which to maintain tenuous links with difficult siblings; to their strategic employment of email, instant messaging and webcam to foster a richer sense of connection with young adult children living thousands of kilometres away; through to their appropriation of a mix of ‘old’ and new channels such as face-to-face communication, the landline telephone, text messaging and email, as tools to help them manage their hectic lifestyles and sustain relationships with family and friends. Women’s active appropriation of multiple communication channels is therefore critical to the ongoing maintenance of relationships and, by extension, the health and emotional wellbeing not only of the women themselves, but also their loved ones and friends
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Clark, R. A. "Chronic Heart Failure Beyond City Limits: An Analysis of the Distribution, Management and Information Technology Solutions for People with Chronic Heart Failure in Rural and Remote Australia." Thesis, University of South Australia, 2007.
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Mount, Christopher. "An Australian integrated health record and information system (IHRIS)." Phd thesis, 2000. http://hdl.handle.net/1885/148140.
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Vatjanapukka, Verawoot. "Consumer attitudes towards medical information: an exploratory study of direct-to-consumer prescription drug advertising in Australia." Thesis, 2004. https://vuir.vu.edu.au/15721/.
Full textAbstract:
The present exploratory study examined consumer attitudes towards medical information, particularly, from Direct-To-Consumer Prescription Drug Advertising (DTCA) in Australia. Nowadays, consumers require more information about prescription medicines that they may be interested in.
Further, a modern information technology, such as the Internet, provides a great opportunity to access such information easily. Also, little is known about the issues regarding prescription drug advertising in Australia. As a result, there is an increased demand for exploratory studies in the area of DTCA in Australia. Even though this type of drug advertising is not allowed in many countries
including Australia, the investigation of consumer attitudes towards medical information from healthcare providers and DTCA would provide a better understanding of what the general public want and create a valuable guidance
for the future research.
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Vimalachandran, Pasupathy. "Privacy and Security of Storing Patients’ Data in the Cloud." Thesis, 2019. https://vuir.vu.edu.au/40598/.
Full textAbstract:
A better health care service must ensure patients receive the right care, in the right place, at the right time. In enabling better health care, the impact of technology is immense. Technological breakthroughs are revolutionising the way health care is being delivered. To deliver better health care, sharing health information amongst health care providers who are involved with the care is critical. An Electronic Health Record (EHR) platform is used to share the health information among those health care providers faster, as a result of technological advancement including the Internet and the Cloud.
However, when integrating such technologies to support the provision of health care, they lead to major concerns over privacy and security of health sensitive information. The privacy and security concerns include a wide range of ethical and legal issues associated with the system. These concerns need to be considered and addressed for the implementation of EHR systems. In a shared environment like EHRs, these concerns become more significant. In this thesis, the author explores and discusses the situations where these concerns do arise in a health care environment. This thesis also covers different attacks that have targeted health care information in the past, with potential solutions for every attack identified. From these findings, the proposed system is designed and developed to provide considerable security assurance for a health care organisation when using the EHR systems. Furthermore, the My Health Record (MyHR) system is introduced in Australia to allow an individual’s doctors and other health care providers to access the individual’s health information. Privacy and security in using MyHR is a major challenge that impacts its usage.
Taking all these concerns into account, the author will also focus on discussing and analysing major existing access control methods, various threats for data privacy and security concerns over EHR use and the importance of data integrity while using MyHR or any other EHR systems. To preserve data privacy and security and prevent unauthorised access to the system, the author proposes a three-tier security model. In this three-tier security model, the first tier covers an access control mechanism, an Intermediate State of Databases (ISD) is included in the second tier and the third layer involves cryptography/data encryption and decryption. These three tiers, collectively, cover different forms of attacks from different sources including unauthorised access from inside a health care organisation. In every tier, a specific technique has been utilised. In tier one, an Improved Access Control Mechanism (IACM) known as log-in pair, pseudonymisation technique is proposed in tier two and a special new encryption and decryption algorithm has been developed and used for tier three in the proposed system.
In addition, the design, development, and implementation of the proposed model have been described to enable and evaluate the operational protocol.
Problem 1. Non-clinical staff including reception, admin staff access sensitive health clinical information (insiders).
Solution 1. An improved access control mechanism named log-in pair is introduced and occupied in tier one.
Problem 2. Researchers and research institutes access health data sets for research activities (outsiders).
Solution 2. Pseudonymisation technique, in tier two, provides de-identified required data with relationships, not the sensitive data.
Problem 3. The massive amount of sensitive health data stored with the EHR system in the Cloud becomes more vulnerable to data attacks.
Solution 3. A new encryption and decryption algorithm is achieved and used in tier three to provide high security while storing the data in the Cloud.
Books on the topic "Medical informatics Australia"
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International Conferenceon Nursing Use of Computers and Information Science ((4th 1991 Melbourne, Vic.). Nursing Informatics '91: Proceedings of the Fourth International Conference on Nursing Use of Computers and Information Science, Melbourne, Australia,April 14-17, 1991. Berlin: Springer-Verlag, 1991.
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Takeda, Hiroshi. E-Health: First IMIA/IFIP Joint Symposium, E-Health 2010, Held as Part of WCC 2010, Brisbane, Australia, September 20-23, 2010. Proceedings. Berlin, Heidelberg: IFIP International Federation for Information Processing, 2010.
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Melbourne, Vic ). National Health Informatics Conference (10th 2002. Improving quality by lowering barriers: HIC 2002 handbook of abstracts : Tenth National Health Informatics Conference, Melbourne, Victoria, Australia, 4-6 August 2002. Victoria, Australia: Health Informatics Society of Australia Ltd., 2002.
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Berkovsky, Shlomo. Persuasive Technology: 8th International Conference, PERSUASIVE 2013, Sydney, NSW, Australia, April 3-5, 2013. Proceedings. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013.
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Anthony, Maeder, and Martin-Sanchez Fernando J, eds. Health Informatics: Building a healthcare future through trusted information ; selected papers from the 20th Australian National Health Informatics Conference (HIC 2012). Amsterdam: IOS Press Inc., 2012.
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P, Hansen David, Maeder Anthony, and Schaper Louise K, eds. Health informatics: The transformative power of innovation, selected papers from the 19th Australian National Health Informatics Conference (HIC 2011). Amsterdam: IOS Press, 2011.
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Henderson, Helen. Sources of health information relevant to the Western Australian population: An overview. [Perth, WA]: Epidemiology & Analytical Services Branch, Health Information Centre, Health Department of Western Australia, 1997.
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Grain, Heather, editor of compilation and Schaper, Louise K., editor of compilation, eds. Health informatics: Digital health service delivery, the future is now! : selected papers from the 21st Australian National Health Informatics Conference (HIC 2013). Amsterdam: IOS Press, 2013.
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Hone, Jim. Applied population and community ecology: A case study of terrestrial vertebrates. Hoboken, NJ: Wiley, 2012.
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Zhou, Rui, Daniel Zeng, Xiaoxia Yin, Kendall Ho, and Uwe Aickelin. Health Information Science: 4th International Conference, HIS 2015, Melbourne, Australia, May 28-30, 2015, Proceedings. Springer, 2015.
Find full textBook chapters on the topic "Medical informatics Australia"
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Woods, Nic, and Monica Trujillo. "Health Information Technology and Its Evolution in Australian Hospitals." In Textbook of Medical Administration and Leadership, 255–80. Singapore: Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-10-5454-9_15.
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Aggeli, Aggeliki, and Mette Mechlenborg. "Mediatised Practices: Renovating Homes with Media and ICTs in Australia." In Digitisation and Low-Carbon Energy Transitions, 153–74. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-16708-9_9.
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AbstractThe extensive use of media and information and communication technologies (ICTs) in the household is building a new normality, where the use of technology is imperceptible to its users. Within this context, home renovation can be examined as a mediatised practice, which suggests the interactive transformation of practices which takes place with and through media. Our chapter is based on an interdisciplinary Australian study of 13 home renovations and their media practices. In this chapter, we argue that home renovation activities have moved into the digital realm. Furthermore, we emphasise that these mediatised home renovation practices contribute to the development of new mediatised domains that could assist in the transition and domestication of low-carbon practices and technologies.
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Anderson, Cheryl L., Jane Rovins, David M. Johnston, Will Lang, Brian Golding, Brian Mills, Rainer Kaltenberger, et al. "Connecting Forecast and Warning: A Partnership Between Communicators and Scientists." In Towards the “Perfect” Weather Warning, 87–113. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-98989-7_4.
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AbstractIn this chapter, we examine the ways that warning providers connect and collaborate with knowledge sources to produce effective warnings. We first look at the range of actors who produce warnings in the public and private sectors, the sources of information they draw on to comprehend the nature of the hazard, its impacts and the implications for those exposed and the process of drawing that information together to produce a warning. We consider the wide range of experts who connect hazard data with impact data to create tools for assessing the impacts of predicted hazards on people, buildings, infrastructure and business. Then we look at the diverse ways in which these tools need to take account of the way their outputs will feed into warnings and of the nature of partnerships that can facilitate this. The chapter includes examples of impact prediction in sport, health impacts of wildfires in Australia, a framework for impact prediction in New Zealand, and communication of impacts through social media in the UK.
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Fade, Premila. "Women's Health Informatics." In Medical Informatics in Obstetrics and Gynecology, 13–36. IGI Global, 2009. http://dx.doi.org/10.4018/978-1-60566-078-3.ch002.
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Principlism (derived from common sense morality) is the most common theory used within the healthcare sphere. The elements of this theory are explored and discussed in context. A theoretical woman presenting in pregnancy is used to identify issues which can arise and explore the potential conflicts. In the second half of the chapter, health informatics and the law are discussed. Issues such as consent, confidentiality, privacy, and human rights are discussed in general. Legislation in the United Kingdom, United States, Canada, Australia, and New Zealand are discussed in detail.
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Tissera, Shaluni, Rebecca Jedwab, Rafael Calvo, Naomi Dobroff, Nicholas Glozier, Alison Hutchinson, Michael Leiter, et al. "Older Nurses’ Perceptions of an Electronic Medical Record Implementation." In Studies in Health Technology and Informatics. IOS Press, 2021. http://dx.doi.org/10.3233/shti210786.
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In Australia, almost 40% of nurses are aged 50 years and older. These nurses may be vulnerable to leaving the workforce due to challenges experienced during electronic medical record (EMR) implementations. This research explored older nurses’ perceptions of factors expected to influence their adoption of an EMR, to inform recommendations to support implementation. The objectives were to: 1) measure psychological factors expected to influence older nurses’ adoption of the EMR; and 2) explore older nurses’ perceptions of facilitators and barriers to EMR adoption. An explanatory sequential mixed methods design was used to collect survey and focus group data from older nurses, prior to introducing an EMR system. These nurses were highly engaged with their work; 79.3% reported high wellbeing scores. However, their motivation appeared to be predominantly governed by external rather than internal influences. Themes reflecting barriers to EMR and resistance to adoption emerged in the qualitative data.
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Wickramasinghe, Nilmini, Helen Almond, Amir Eslami Androgoli, and Jonathan Schaffer. "You Want Me to Use This EMR?" In Studies in Health Technology and Informatics. IOS Press, 2021. http://dx.doi.org/10.3233/shti210794.
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Globally, implementation of electronic medical records (EMRs) has accelerated. Australia is starting on this necessary but arduous path. Anecdotes suggest many nurses enquire “You Want Me to Use This EMR? Opinions on the use and usefulness of EMRs are not positive. This research proffers the use of a rich theoretical lens, taken from the information system’s domain, to understand the root concerns and create solutions; providing insight into nursing acceptance and adoption of the EMR.
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Pham, Anthony, Rebecca Jedwab, Janette Gogler, and Naomi Dobroff. "Development of Nursing Workflows and Device Requirement Principles with the Implementation of an Electronic Medical Record System." In Studies in Health Technology and Informatics. IOS Press, 2021. http://dx.doi.org/10.3233/shti210681.
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The past decade has seen the implementation of electronic medical record (EMR) systems being implemented across large-scale healthcare organisations throughout Australia. A first-time implementation of an organisational-wide EMR system required a multi-modal approach to the development of new nursing workflows and appropriate selection of hardware devices to ensure acceptance and adoption of the EMR. The aim of this work was to develop new nursing workflows and associated device requirement principles to allow for continuation of safe, high quality nursing care with an EMR implementation. The incorporation of multi-disciplinary consultations, an audit, observational study and clinical and governance stakeholder engagement was used to develop device requirement principles. This ensured development of standardised nursing workflows were successfully adopted throughout the organisation with the EMR implementation.
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Foster, Melissa Robin Bowman. "Australia's Medicare System." In Advances in Healthcare Information Systems and Administration, 168–79. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-6684-4060-5.ch010.
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The current United States health care system is continuously falling short of the promises made by numerous political health care leaders. Although some efforts have been made to improve the system, such as the Patient Protection and Affordable Care Act, the current system still leaves a large percentage of the population uninsured or underinsured. Additionally, patients delay seeking care because of the high out-of-pocket costs, which allows conditions to become more severe, therefore leading to more costly treatment and adding to the large amount of money that must be written off by health care organizations. In this chapter, a review is provided of Australia's effort to improve these conditions for Australians through Australia's Medicare program. The chapter will also suggest how some components of the Australian Medicare System could help improve the quality of the United States health care system.
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Taylor, Andrew. "ICT and the Tourism Information Marketplace in Australia." In Information Communication Technologies, 2022–31. IGI Global, 2008. http://dx.doi.org/10.4018/978-1-59904-949-6.ch147.
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n November 2003, the Australian Government released the Tourism White Paper, a medium- to long-term strategy for the Australian tourism industry. The Paper provides for funding to improve the availability of high-quality information for the development of tourism in regional areas of Australia. More than $21 million, a historically large amount, has been identified for “…extending the provision of quality research and statistics” (Prime Minister John Howard, Media Release, November 20, 2003).
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Taylor, Andrew. "ICT and the Tourism Information Marketplace in Australia." In Encyclopedia of Developing Regional Communities with Information and Communication Technology, 360–66. IGI Global, 2005. http://dx.doi.org/10.4018/978-1-59140-575-7.ch063.
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n November 2003, the Australian Government released the Tourism White Paper, a medium- to long-term strategy for the Australian tourism industry. The Paper provides for funding to improve the availability of high-quality information for the development of tourism in regional areas of Australia. More than $21 million, a historically large amount, has been identified for “…extending the provision of quality research and statistics” (Prime Minister John Howard, Media Release, November 20, 2003).
Conference papers on the topic "Medical informatics Australia"
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Grzegorz Broda, Lukasz, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Jodie Robinson, and Mark Yates. "The Design of a Smartbrush Oral Health Installation for Aged Care Centres in Australia." In ICMHI 2021: 2021 5th International Conference on Medical and Health Informatics. New York, NY, USA: ACM, 2021. http://dx.doi.org/10.1145/3472813.3473186.
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Graham, Myfanwy, Elianne Renaud, Catherine Lucas, Jennifer Schneider, and Jennifer Martin. "Medicinal cannabis prescribing guidance documents: An evidence-based, best-practice framework based on the New South Wales experience." In 2022 Annual Scientific Meeting of the Research Society on Marijuana. Research Society on Marijuana, 2022. http://dx.doi.org/10.26828/cannabis.2022.02.000.51.
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Introduction: In 2018, the Australian Centre for Cannabinoid Clinical and Research Excellence (ACRE), a National Health and Medical Research Council (NHMRC) Centre of Research Excellence was funded to develop a suite of state-wide medicinal cannabis prescribing guidance documents. At this time, regulatory changes in Australia were enabling broader access to medicinal cannabis in a medical model. The initiative funded through the New South Wales (NSW) Government’s Clinical Cannabis Medicines Program enabled the development of practical resources to support NSW medical practitioners in prescribing medicinal cannabis to patients for conditions where cannabinoids are perceived to have some benefit. Aim: To provide interim guidance to support medical practitioners in the prescription of medicinal cannabis where they are perceived to have potential benefit. Methods: A team of clinical pharmacologists, pharmacists and clinicians collaborated in the development of the first tranche of prescribing guidance documents. The suite of six medicinal cannabis prescribing guidance documents covered the most common indications for which prescriptions for medicinal cannabis were being sought by NSW patients: dementia; anorexia and cachexia; nausea; chemotherapy-induced nausea and vomiting; spasticity; and chronic non-cancer pain. In 2019, the draft guidance documents underwent a comprehensive review and consultation process involving fifty key stakeholders before publication. Results: The ACRE medicinal cannabis prescribing guidance documents have been widely adopted, both in NSW and around the world. The prescribing guidance documents are now recommended as a health professional educational resource by the Australian national medicines regulator the Therapeutic Goods Administration and state health departments. The prescribing guidance on epilepsy from the second tranche of guidance documents has recently been published in the British Journal of Clinical Pharmacology. National medicinal cannabis prescribing pattern data and enquiries to the first-of-kind, state-government funded medicinal cannabis advisory service for medical practitioners informed the themes of the second tranche of six medicinal cannabis prescribing guidance documents being developed in 2022. Conclusions: ACRE medicinal cannabis prescribing guidance documents delivered interim guidance to Australian medical practitioners on the evidence-based and best-practice prescription of medicinal cannabis. Prescribing guidance document themes align with Australian medicinal cannabis prescribing patterns and areas where medical practitioners are seeking further information and advice. It is anticipated that the prescribing guidance documents will be updated periodically as further evidence becomes available. Acknowledgements: NSW Government through the NSW Clinical Cannabis Medicines Program supported development of the NSW Cannabis Medicines Prescribing Guidance. ACRE was established and is funded through the National Health and Medical Research Council Centres of Research Excellence scheme.
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Soņeca, Viktorija. "Tehnoloģiju milžu ietekme uz suverēnu." In The 8th International Scientific Conference of the Faculty of Law of the University of Latvia. University of Latvia Press, 2022. http://dx.doi.org/10.22364/iscflul.8.1.18.
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In the last two decades, we have seen the rise of companies providing digital services. Big Tech firms have become all-pervasive, playing critical roles in our social interactions, in the way we access information, and in the way we consume. These firms not only strive to be dominant players in one market, but with their giant monopoly power and domination of online ecosystems, they want to become the market itself. They are gaining not just economic, but also political power. This can be illustrated by Donald Trump’s campaigns, in which he attempted to influence the sovereign will, as the sovereign power is vested in the people. The Trump campaigns' use of Facebook's advertising tools contributed to Trump's win at the 2016 presidential election. After criticism of that election, Facebook stated that it would implement a series of measures to prevent future abuse. For example, no political ads will be accepted in the week before an election. Another example of how Big Tech firms can effect the sovereign is by national legislator. For example, Australia had a dispute with digital platforms such as Facebook and Google. That was because Australia began to develop a News Media and Digital Platforms Mandatory Code. To persuade the Australian legislature to abandon the idea of this code, Facebook prevented Australian press publishers, news media and users from sharing/viewing Australian as well as international news content, including blocking information from government agencies. Such action demonstrated how large digital platforms can affect the flow of information to encourage the state and its legislature to change their position. Because of such pressure, Australia eventually made adjustments to the code in order to find a compromise with the digital platform. Also, when we are referring to political power, it should include lobbying and the European Union legislator. Tech giants are lobbying their interests to influence the European Union’s digital policy, which has the most direct effect on member states, given that the member states are bound by European Union law.
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Sansurooah, Krishnun. "Security Risks Of Medical Devices In Wireless Environments." In Australian eHealth Informatics and Security Conference. Security Research Institute, Edith Cowan University, 2015. http://dx.doi.org/10.14221/aeis.2015.1.
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Moura, Ludmila Sandy Alves, André Taumaturgo Cavalcanti Arruda, and Mário Luciano de Melo Silva Júnior. "Parallels between neurologist training in Brazil and in other countries." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.534.
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Introduction: Neurology training involves practice in infirmaries and outpatient clinics in several subspecialties, as well as training in procedures and examinations. The analysis of Medical Residency Programs (MRPs) in Neurology in other countries is important to identify points of contrast and similarities as a way to keep the national training equivalent to other countries. Objectives: To analyze the duration and characteristics of the training of neurology physicians in Brazil and other countries. Methods: Cross-sectional study by active search on official web pages of governments and organizations/entities representing neurologists from 12 countries: Australia, Portugal, Italy, Greece, India, USA, Canada, Puerto Rico, Argentina, Chile, Uruguay, and Colombia. Information was obtained on the duration of medical school and residency, as well as the characteristics of this. Results: The duration of medical school was 4 to 7 years (median: 6; IIQ: 0.5). Duration in neurology was 3 to 6 years (median: 4; IIQ:1). Developed countries have a median duration of residency of 4.83 years ± 0.68 years, whereas in developing countries it was 3.66 ±0.47 years. Regarding access, 25% of the countries require a prerequisite. Regarding rotations, those present in most of the programs studied were: neurology outpatient clinic (100%), neuroradiology (83%), neuropediatrics (75%) clinical medicine (58%), psychiatry (58%). Conclusion: We identified differences in the standardization of PRM in Neurology among the countries studied. The duration of Brazilian residency is below the average of the other countries studied, but it includes the required rotations in developed countries.
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Alan Hodgett, R. "A Role for Information Systems Education Programs." In 2002 Informing Science + IT Education Conference. Informing Science Institute, 2002. http://dx.doi.org/10.28945/2503.
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The international media continually reports a worldwide shortage of skilled information technology literate people. An intermediary role or disciplinary area between business requirements and computer science has been identified in the past. A number of institutions have developed information systems education programs to fill this role. A survey of pasl graduates and employers evaluates the performance of several information systems education programs at the University of South Australia.
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Chaudhry, Junaid, Craig Valli, Michael Crowley, Jon Haass, and Peter Roberts. "POStCODE Middleware for Post-Market Surveillance of Medical Devices for Cyber Security in Medical and Healthcare Sector in Australia." In 2018 12th International Symposium on Medical Information and Communication Technology (ISMICT). IEEE, 2018. http://dx.doi.org/10.1109/ismict.2018.8573695.
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Damhus, Christina, Gabriela Petersen, Alexandra Jønsson, and John Brodersen. "35 Do we understand benefits and harms of medical screening? Information material focusing on informed choice, when invited to cervical cancer screening." In Preventing Overdiagnosis Abstracts, December 2019, Sydney, Australia. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/bmjebm-2019-pod.49.
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Brown, I., A. Smale, M. Wong, and C. L. Yeo. "The management of medical technology." In ANZIIS 2001. Proceedings of the Seventh Australian and New Zealand Intelligent Information Systems Conference. IEEE, 2001. http://dx.doi.org/10.1109/anziis.2001.974106.
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Gloria, Chrismatovanie. "Compliance with Complete Filling of Patient's Medical Record at Hospital: A Systematic Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.29.
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ABSTRACT Background: The health information system, especially medical records in hospitals must be carried out accurately and completely. Medical records are important as evidence for the courts, education, research, and policy makers. This study aimed to investigate the factors affecting the compliance with completeness of filling patient’s medical records at hospitals. Subjects and Methods: A systematic review was conducted by searching from ProQuest, Scopus, and National journals using keywords medical records, filling of medical records, and non- compliance filling medical records. The abstracts and full-text articles published between 2014 to 2019 were selected for this review. A total of 62,355 articles were conducted screening of eligibility criteria. The data were reported using PRISMA flow chart. Results: Eleven articles consisting of eight articles using observational studies and three articles using experimental studies met the eligible criteria. There were two articles analyzed systematically from the United States and India, two articles reviewed literature from the United States and England, and seven articles were analyzed statistically from Indonesia, America, Australia, and Europe. Six articles showed the significant results of the factors affecting non-compliance on the medical records filling at the Hospitals. Conclusion: Non-compliance with medical record filling was found in the hospitals under study. Health professionals are suggested to fill out the medical record completely. The hospital should enforce compliance with complete medical record filling by health professionals. Keywords: medical record, compliance, hospital Correspondence: Chrismatovanie Gloria. Hospital Administration Department, Faculty Of Public Health, Universitas Indonesia, Depok, West Java. Email: chrismatovaniegloria@gmail.com. Mobile: +6281321161896 DOI: https://doi.org/10.26911/the7thicph.04.29
Reports on the topic "Medical informatics Australia"
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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McEntee, Alice, Sonia Hines, Joshua Trigg, Kate Fairweather, Ashleigh Guillaumier, Jane Fischer, Billie Bonevski, James A. Smith, Carlene Wilson, and Jacqueline Bowden. Tobacco cessation in CALD communities. The Sax Institute, June 2022. http://dx.doi.org/10.57022/sneg4189.
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Background Australia is a multi-cultural society with increasing rates of people from culturally and linguistically diverse (CALD) backgrounds. On average, CALD groups have higher rates of tobacco use, lower participation in cancer screening programs, and poorer health outcomes than the general Australian population. Lower cancer screening and smoking cessation rates are due to differing cultural norms, health-related attitudes, and beliefs, and language barriers. Interventions can help address these potential barriers and increase tobacco cessation and cancer screening rates among CALD groups. Cancer Council NSW (CCNSW) aims to reduce the impact of cancer and improve cancer outcomes for priority populations including CALD communities. In line with this objective, CCNSW commissioned this rapid review of interventions implemented in Australia and comparable countries. Review questions This review aimed to address the following specific questions: Question 1 (Q1): What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Question 2 (Q2): What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? This review focused on Chinese-, Vietnamese- and Arabic-speaking people as they are the largest CALD groups in Australia and have high rates of tobacco use and poor screening adherence in NSW. Summary of methods An extensive search of peer-reviewed and grey literature published between January 2013-March 2022 identified 19 eligible studies for inclusion in the Q1 review and 49 studies for the Q2 review. The National Health and Medical Research Council (NHMRC) Levels of Evidence and Joanna Briggs Institute’s (JBI) Critical Appraisal Tools were used to assess the robustness and quality of the included studies, respectively. Key findings Findings are reported by components of an intervention overall and for each CALD group. By understanding the effectiveness of individual components, results will demonstrate key building blocks of an effective intervention. Question 1: What smoking cessation interventions have been proven effective in reducing or preventing smoking among culturally and linguistically diverse communities? Thirteen of the 19 studies were Level IV (L4) evidence, four were Level III (L3), one was Level II (L2), none were L1 (highest level of evidence) and one study’s evidence level was unable to be determined. The quality of included studies varied. Fifteen tobacco cessation intervention components were included, with most interventions involving at least three components (range 2-6). Written information (14 studies), and education sessions (10 studies) were the most common components included in an intervention. Eight of the 15 intervention components explored had promising evidence for use with Chinese-speaking participants (written information, education sessions, visual information, counselling, involving a family member or friend, nicotine replacement therapy, branded merchandise, and mobile messaging). Another two components (media campaign and telephone follow-up) had evidence aggregated across CALD groups (i.e., results for Chinese-speaking participants were combined with other CALD group(s)). No intervention component was deemed of sufficient evidence for use with Vietnamese-speaking participants and four intervention components had aggregated evidence (written information, education sessions, counselling, nicotine replacement therapy). Counselling was the only intervention component to have promising evidence for use with Arabic-speaking participants and one had mixed evidence (written information). Question 2: What screening interventions have proven effective in increasing participation in population cancer screening programs among culturally and linguistically diverse populations? Two of the 49 studies were Level I (L1) evidence, 13 L2, seven L3, 25 L4 and two studies’ level of evidence was unable to be determined. Eighteen intervention components were assessed with most interventions involving 3-4 components (range 1-6). Education sessions (32 studies), written information (23 studies) and patient navigation (10 studies) were the most common components. Seven of the 18 cancer screening intervention components had promising evidence to support their use with Vietnamese-speaking participants (education sessions, written information, patient navigation, visual information, peer/community health worker, counselling, and peer experience). The component, opportunity to be screened (e.g. mailed or handed a bowel screening test), had aggregated evidence regarding its use with Vietnamese-speaking participants. Seven intervention components (education session, written information, visual information, peer/community health worker, opportunity to be screened, counselling, and branded merchandise) also had promising evidence to support their use with Chinese-speaking participants whilst two components had mixed (patient navigation) or aggregated (media campaign) evidence. One intervention component for use with Arabic-speaking participants had promising evidence to support its use (opportunity to be screened) and eight intervention components had mixed or aggregated support (education sessions, written information, patient navigation, visual information, peer/community health worker, peer experience, media campaign, and anatomical models). Gaps in the evidence There were four noteworthy gaps in the evidence: 1. No systematic review was captured for Q1, and only two studies were randomised controlled trials. Much of the evidence is therefore based on lower level study designs, with risk of bias. 2. Many studies provided inadequate detail regarding their intervention design which impacts both the quality appraisal and how mixed finding results can be interpreted. 3. Several intervention components were found to have supportive evidence available only at the aggregate level. Further research is warranted to determine the interventions effectiveness with the individual CALD participant group only. 4. The evidence regarding the effectiveness of certain intervention components were either unknown (no studies) or insufficient (only one study) across CALD groups. This was the predominately the case for Arabic-speaking participants for both Q1 and Q2, and for Vietnamese-speaking participants for Q1. Further research is therefore warranted. Applicability Most of the intervention components included in this review are applicable for use in the Australian context, and NSW specifically. However, intervention components assessed as having insufficient, mixed, or no evidence require further research. Cancer screening and tobacco cessation interventions targeting Chinese-speaking participants were more common and therefore showed more evidence of effectiveness for the intervention components explored. There was support for cancer screening intervention components targeting Vietnamese-speaking participants but not for tobacco cessation interventions. There were few interventions implemented for Arabic-speaking participants that addressed tobacco cessation and screening adherence. Much of the evidence for Vietnamese and Arabic-speaking participants was further limited by studies co-recruiting multiple CALD groups and reporting aggregate results. Conclusion There is sound evidence for use of a range of intervention components to address tobacco cessation and cancer screening adherence among Chinese-speaking populations, and cancer screening adherence among Vietnamese-speaking populations. Evidence is lacking regarding the effectiveness of tobacco cessation interventions with Vietnamese- and Arabic-speaking participants, and cancer screening interventions for Arabic-speaking participants. More research is required to determine whether components considered effective for use in one CALD group are applicable to other CALD populations.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Boyle, Maxwell, and Elizabeth Rico. Terrestrial vegetation monitoring at Cape Hatteras National Seashore: 2019 data summary. National Park Service, January 2022. http://dx.doi.org/10.36967/nrr-2290019.
Full textAbstract:
The Southeast Coast Network (SECN) conducts long-term terrestrial vegetation monitoring as part of the nationwide Inventory and Monitoring Program of the National Park Service (NPS). The vegetation community vital sign is one of the primary-tier resources identified by SECN park managers, and monitoring is currently conducted at 15 network parks (DeVivo et al. 2008). Monitoring plants and their associated communities over time allows for targeted understanding of ecosystems within the SECN geography, which provides managers information about the degree of change within their parks’ natural vegetation. The first year of conducting this monitoring effort at four SECN parks, including 52 plots on Cape Hatteras National Seashore (CAHA), was 2019. Twelve vegetation plots were established at Cape Hatteras NS in July and August. Data collected in each plot included species richness across multiple spatial scales, species-specific cover and constancy, species-specific woody stem seedling/sapling counts and adult tree (greater than 10 centimeters [3.9 inches {in}]) diameter at breast height (DBH), overall tree health, landform, soil, observed disturbance, and woody biomass (i.e., fuel load) estimates. This report summarizes the baseline (year 1) terrestrial vegetation data collected at Cape Hatteras National Seashore in 2019. Data were stratified across four dominant broadly defined habitats within the park (Maritime Tidal Wetlands, Maritime Nontidal Wetlands, Maritime Open Uplands, and Maritime Upland Forests and Shrublands) and four land parcels (Bodie Island, Buxton, Hatteras Island, and Ocracoke Island). Noteworthy findings include: A total of 265 vascular plant taxa (species or lower) were observed across 52 vegetation plots, including 13 species not previously documented within the park. The most frequently encountered species in each broadly defined habitat included: Maritime Tidal Wetlands: saltmeadow cordgrass Spartina patens), swallow-wort (Pattalias palustre), and marsh fimbry (Fimbristylis castanea) Maritime Nontidal Wetlands: common wax-myrtle (Morella cerifera), saltmeadow cordgrass, eastern poison ivy (Toxicodendron radicans var. radicans), and saw greenbriar (Smilax bona-nox) Maritime Open Uplands: sea oats (Uniola paniculata), dune camphorweed (Heterotheca subaxillaris), and seabeach evening-primrose (Oenothera humifusa) Maritime Upland Forests and Shrublands: : loblolly pine (Pinus taeda), southern/eastern red cedar (Juniperus silicicola + virginiana), common wax-myrtle, and live oak (Quercus virginiana). Five invasive species identified as either a Severe Threat (Rank 1) or Significant Threat (Rank 2) to native plants by the North Carolina Native Plant Society (Buchanan 2010) were found during this monitoring effort. These species (and their overall frequency of occurrence within all plots) included: alligatorweed (Alternanthera philoxeroides; 2%), Japanese honeysuckle (Lonicera japonica; 10%), Japanese stilt-grass (Microstegium vimineum; 2%), European common reed (Phragmites australis; 8%), and common chickweed (Stellaria media; 2%). Eighteen rare species tracked by the North Carolina Natural Heritage Program (Robinson 2018) were found during this monitoring effort, including two species—cypress panicgrass (Dichanthelium caerulescens) and Gulf Coast spikerush (Eleocharis cellulosa)—listed as State Endangered by the Plant Conservation Program of the North Carolina Department of Agriculture and Consumer Services (NCPCP 2010). Southern/eastern red cedar was a dominant species within the tree stratum of both Maritime Nontidal Wetland and Maritime Upland Forest and Shrubland habitat types. Other dominant tree species within CAHA forests included loblolly pine, live oak, and Darlington oak (Quercus hemisphaerica). One hundred percent of the live swamp bay (Persea palustris) trees measured in these plots were experiencing declining vigor and observed with symptoms like those caused by laurel wilt......less