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.
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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.
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Fernando, Juanita, and Jennifer Lindley. "Lessons learned from piloting mHealth informatics practice curriculum into a medical elective." Journal of the American Medical Informatics Association 25, no. 4 (August 23, 2017): 380–84. http://dx.doi.org/10.1093/jamia/ocx076.
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Abstract Introduction This case study reports the development and delivery of an mHealth elective piloted for first-year undergraduate medical students at Monash University (Australia) and the lessons learned by designers. Results The students were not as adept at using mHealth devices as the literature had predicted. Expert speakers using mHealth for practice perceptibly engaged students. Force-field analysis was a useful basis for devising end-user evaluative research tools for practice. Combining small- and large-group discussions with eLearning discussions promoted student engagement with new concepts and associated jargon. Assessment by mHealth informatics champions supported the students’ independent learning. Lessons learned Promotion of mHealth curriculum must be transparent and clear. Our elective delivery was hampered by a lack of suitable mobile device ownership and limited availability of useful, free apps. Technological jargon required clarification. Educators require particular mHealth informatics and educational expertise to support mHealth pedagogies. This learning helps to prepare medical curriculum designers for addressing evolving mHealth practice horizons.
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Isautier, Jennifer MJ, Tessa Copp, Julie Ayre, Erin Cvejic, Gideon Meyerowitz-Katz, Carys Batcup, Carissa Bonner, et al. "People’s Experiences and Satisfaction With Telehealth During the COVID-19 Pandemic in Australia: Cross-Sectional Survey Study." Journal of Medical Internet Research 22, no. 12 (December 10, 2020): e24531. http://dx.doi.org/10.2196/24531.
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Background In response to the COVID-19 pandemic, telehealth has rapidly been adopted to deliver health care services around the world. To date, studies have not compared people’s experiences with telehealth services during the pandemic in Australia to their experiences with traditional in-person visits. Objective This study aimed to compare participants’ perceptions of telehealth consults to their perceptions of traditional in-person visits and investigate whether people believe that telehealth services would be useful after the pandemic. Methods A national, cross-sectional, community survey was conducted between June 5 and June 12, 2020 in Australia. In total, 1369 participants who were aged ≥18 years and lived in Australia were recruited via targeted advertisements on social media (ie, Facebook and Instagram). Participants responded to survey questions about their telehealth experience, which included a free-text response option. A generalized linear model was used to estimate the adjusted relative risks of having a poorer telehealth experience than a traditional in-person visit experience. Content analysis was performed to determine the reasons why telehealth experiences were worse than traditional in-person visit experiences. Results Of the 596 telehealth users, the majority of respondents (n=369, 61.9%) stated that their telehealth experience was “just as good as” or “better than” their traditional in-person medical appointment experience. On average, respondents perceived that telehealth would be moderately useful to very useful for medical appointments after the COVID-19 pandemic ends (mean 3.67, SD 1.1). Being male (P=.007), having a history of both depression and anxiety (P=.016), and lower patient activation scores (ie, individuals’ willingness to take on the role of managing their health/health care) (P=.036) were significantly associated with a poor telehealth experience. In total, 6 overarching themes were identified from free-text responses for why participants’ telehealth experiences were poorer than their traditional in-person medical appointment experiences, as follows: communication is not as effective, limitations with technology, issues with obtaining prescriptions and pathology results, reduced confidence in their doctor, additional burden for complex care, and inability to be physically examined. Conclusions Based on our sample’s responses, telehealth appointment experiences were comparable to traditional in-person medical appointment experiences. Telehealth may be worthwhile as a mode of health care delivery while the pandemic continues, and it may continue to be worthwhile after the pandemic.
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Labiris, G., I. Coertzen, A. Katsikas, A. Karydis, and A. Petounis. "An eight-year study of Internet-based remote medical counselling." Journal of Telemedicine and Telecare 8, no. 4 (August 1, 2002): 222–25. http://dx.doi.org/10.1258/135763302320272194.
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We carried out a prospective study of an Internet-based remote counselling service. A total of 15,456 Internet users visited the Website over eight years. From these, 1500 users were randomly selected for analysis. Medical counselling had been granted to 901 of the people requesting it (60%). One hundred and sixty-four physicians formed project groups to process the requests and responded using email. The distribution of patients using the service was similar to the availability of the Internet: 78% were from the European Union, North America and Australia. Sixty-seven per cent of the patients lived in urban areas and the remainder were residents of remote rural areas with limited local medical coverage. Sixty-five per cent of the requests were about problems of internal medicine and 30% of the requests concerned surgical issues. The remaining 5% of the patients sought information about recent developments, such molecular medicine or aviation medicine. During the project, our portal became inaccessible five times, and counselling was not possible on 44 days. There was no hacking of the Website. Internet-based medical counselling is a helpful addition to conventional practice.
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Jabbour, Joe, Haryana M. Dhillon, Heather L. Shepherd, Puma Sundaresan, Chris Milross, and Jonathan R. Clark. "A web-based comprehensive head and neck cancer patient education and support needs program: Usability testing." Health Informatics Journal 28, no. 1 (January 2022): 146045822210871. http://dx.doi.org/10.1177/14604582221087128.
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Background: With increasing accessibility of the World Wide Web, patients are using it to obtain patient education materials (PEM). With this in mind, our group (surgeons, radiation oncologists, medical oncologists, nursing, allied health professionals and academic researchers) developed a comprehensive information resource for patients with head and neck cancer (HNC), the Head and Neck Cancer Australia, formerly Beyond Five website. The aim of this study was to determine patient usability of the Head and Neck Cancer Australia website. Methods: Usability testing (Cognitive walkthrough & Think-Aloud) in 18 patients treated for HNC was undertaken at a Cancer centre (anonymous for reviewers). Results: The tasks rated easiest by patients were finding information on psychological well-being (mean time spent: 66 s, range: 10–565), health and well-being effecting quality of life (mean time spent: 36 s, range 9–117) and carer information (mean time spent: 10 s, range 3–35). Patients indicated the website contained a lot of information, covers most topics, was a trusted source of information and a springboard to other information. Conclusions: The Head and Neck Cancer Australia website provides a wide range of information and support in multiple formats available to HNC patients. Further refinements in design, navigation and website instructions are needed to allow effective patient interaction.
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Braunack-Mayer, Annette, Belinda Fabrianesi, Jackie Street, Pauline O'Shaughnessy, Stacy M. Carter, Lina Engelen, Lucy Carolan, Rebecca Bosward, David Roder, and Kylie Sproston. "Sharing Government Health Data With the Private Sector: Community Attitudes Survey." Journal of Medical Internet Research 23, no. 10 (October 1, 2021): e24200. http://dx.doi.org/10.2196/24200.
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Background The use of government health data for secondary purposes, such as monitoring the quality of hospital services, researching the health needs of populations, and testing how well new treatments work, is increasing. This increase in the secondary uses of health data has led to increased interest in what the public thinks about data sharing, in particular, the possibilities of sharing with the private sector for research and development. Although international evidence demonstrates broad public support for the secondary use of health data, this support does not extend to sharing health data with the private sector. If governments intend to share health data with the private sector, knowing what the public thinks will be important. This paper reports a national survey to explore public attitudes in Australia toward sharing health data with private companies for research on and development of therapeutic drugs and medical devices. Objective This study aims to explore public attitudes in Australia toward sharing government health data with the private sector. Methods A web-based survey tool was developed to assess attitudes about sharing government health data with the private sector. A market research company was employed to administer the web-based survey in June 2019. Results The survey was completed by 2537 individuals residing in Australia. Between 51.8% and 57.98% of all participants were willing to share their data, with slightly fewer in favor of sharing to improve health services (51.99%) and a slightly higher proportion in favor of sharing for research and development (57.98%). There was a preference for opt-in consent (53.44%) and broad support for placing conditions on sharing health information with private companies (62% to 91.99%). Wide variability was also observed in participants’ views about the extent to which the private sector could be trusted and how well they would behave if entrusted with people’s health information. In their qualitative responses, the participants noted concerns about private sector corporate interests, corruption, and profit making and expressed doubt about the Australian government’s capacity to manage data sharing safely. The percentages presented are adjusted against the Australian population. Conclusions This nationally representative survey provides preliminary evidence that Australians are uncertain about sharing their health data with the private sector. Although just over half of all the respondents supported sharing health data with the private sector, there was also strong support for strict conditions on sharing data and for opt-in consent and significant concerns about how well the private sector would manage government health data. Addressing public concern about sharing government health data with the private sector will require more and better engagement to build community understanding about how agencies can collect, share, protect, and use their personal data.
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Mazza, Danielle, Christopher Pearce, Lyle Robert Turner, Maria De Leon-Santiago, Adam McLeod, Jason Ferriggi, and Marianne Shearer. "The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research." Journal of Innovation in Health Informatics 23, no. 2 (July 4, 2016): 523. http://dx.doi.org/10.14236/jhi.v23i2.181.
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The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia. MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients. The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices. While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia
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Grando, Adela, Jessica S. Ancker, Donghua Tao, Rachael Howe, Clare Coonan, Merida Johns, and Wendy Chapman. "Design and evaluation of a Women in American Medical Informatics Association (AMIA) leadership program." Journal of the American Medical Informatics Association 29, no. 1 (October 22, 2021): 163–70. http://dx.doi.org/10.1093/jamia/ocab232.
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Abstract The objective is to report on the design and evaluation of the inaugural Women in AMIA Leadership Program. A year-long leadership curriculum was developed. Survey responses were summarized with descriptive statistics and quotes selected. Twenty-four scholars participated in the program. There was a significant increase in perceived achievement of learning objectives after the program (P < .0001). The largest improvement was in leadership confidence and presence in work interactions (modal answer Neutral in presurvey from 21 responses rose to Agree in postsurvey from 24 responses). Most (92% of 13) scholars clarified leadership vision and goals and (83% of 18) would be Very Likely to recommend the program to others. The goals of the program—developing women’s leader identity, increasing networks, and accumulating experience for future programs—were achieved. The second leadership program is on its way in the United States and Australia. This study may benefit organizations seeking to develop leadership programs for women in informatics and digital health.
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Jedwab, Rebecca M., Elizabeth Manias, Alison M. Hutchinson, Naomi Dobroff, and Bernice Redley. "Understanding nurses’ perceptions of barriers and enablers to use of a new electronic medical record system in Australia: A qualitative study." International Journal of Medical Informatics 158 (February 2022): 104654. http://dx.doi.org/10.1016/j.ijmedinf.2021.104654.
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Neuhaus, Maike, Danette Langbecker, Liam J. Caffery, Monica Taylor, Lisa Garner, Gayle Williams, Anthony C. Smith, and Graeme A. Macdonald. "Telementoring for hepatitis C treatment in correctional facilities." Journal of Telemedicine and Telecare 24, no. 10 (October 22, 2018): 690–96. http://dx.doi.org/10.1177/1357633x18795361.
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Introduction Prevalence of hepatitis C virus (HCV) is substantially higher among prisoners than the general population. In Australia until recently, only a small proportion of prisoners with HCV received antiviral therapy. The direct-acting antivirals (DAAs) for HCV are highly effective, with a low burden of side effects. Since 2016, DAAs are available to all Australians with HCV. However, currently in Australia, they can only be prescribed by or in consultation with experienced prescribers. This study evaluated a telementoring service to upskill doctors and nurse practitioners working in correctional facilities. Methods The telementoring service was implemented in five correctional facilities. Qualitative interviews were used to examine the perceived clinical effectiveness and organisational impacts of the service. Content analysis of the interviews was used to identify key themes. Results In the first ten months of the service, there were 16 telementoring sessions with 173 patients discussed. Sixteen staff participated in qualitative interviews. From these, three key themes were identified: access to antiviral therapy; organisational impacts (cost, increased staff knowledge and confidence, staff time, and workload); and, adaptations of the care model and future opportunities. Conclusion Telementoring is an effective method to facilitate eligible prescriber status to medical doctors and upskill other clinicians in correctional facilities to increase capacity to treat HCV.
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Lloyd, Sheree, Karrie Long, Abraham Oshni Alvandi, Josie Di Donato, Yasmine Probst, Jeremy Roach, and Christopher Bain. "A National Survey of EMR Usability: Comparisons between medical and nursing professions in the hospital and primary care sectors in Australia and Finland." International Journal of Medical Informatics 154 (October 2021): 104535. http://dx.doi.org/10.1016/j.ijmedinf.2021.104535.
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Wang, K., K. K. W. Yau, and A. H. Lee. "Factors Influencing Hospitalisation of Infants for Recurrent Gastroenteritis in Western Australia." Methods of Information in Medicine 42, no. 03 (2003): 251–54. http://dx.doi.org/10.1055/s-0038-1634357.
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Summary Objective: To determine factors affecting length of hospitalisation of infants for recurrent gastroenteritis using linked data records from the Western Australia heath information system. Methods: A seven-year retrospective cohort study was undertaken on all infants born in Western Australia in 1995 who were admitted for gastroenteritis during their first year of life (n = 519). Linked hospitalisation records were retrieved to derive the outcome measure and other demographic variables for the cohort. Unlike previous studies that focused mainly on a single episode of gastroenteritis, the durations of successive hospitalisations were analysed using a proportional hazards model with correlated frailty to determine the prognostic factors influencing recurrent gastroenteritis. Results: Older children experienced a shorter stay with an increased discharge rate of 1.9% for each month increase in admission age. An additional comorbidity recorded in the hospital discharge summary slowed the adjusted discharge rate by 46.5%. Aboriginal infants were readmitted to hospital more frequently, and had an adjusted hazard ratio of 0.253, implying a much higher risk of prolonged hospitalisation compared to non-Aborigines. Conclusions: The use of linked hospitalisation records has the advantage of providing access to hospital-based population information in the context of medical informatics. The analysis of linked data has enabled the assessment of prognostic factors influencing length of hospitalisations for recurrent gastroenteritis with high statistical power.
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Baysari, Melissa T., Bethany A. Van Dort, Wu Yi Zheng, Ling Li, Sarah Hilmer, Johanna Westbrook, and Richard Day. "Prescribers’ reported acceptance and use of drug-drug interaction alerts: An Australian survey." Health Informatics Journal 28, no. 2 (January 2022): 146045822211006. http://dx.doi.org/10.1177/14604582221100678.
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Drug-drug interaction (DDI) alerts are frequently included in electronic medical record (eMR) systems to provide users with relevant information and guidance at the point of care. In this study, we aimed to examine views of DDI alerts among prescribers, including junior doctors, registrars and senior doctors, across Australia. A validated survey for assessing prescribers’ reported acceptance and use of DDI alerts was distributed among researcher networks and in newsletters. Fifty useable responses were received, more than half ( n = 28) from senior doctors. Prescribers at all levels expected DDI alerts to improve performance but junior doctors reported that this was at a high cost, with respect to time and effort. Senior doctors and registrars reported rarely reading alerts and rarely changing prescribing decisions based on alerts. Respondents identified a number of problems with current alerts including limited relevance, repetition, and poor design, highlighting some clear areas for alert improvement.
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Rathore, Vatsna, Amy E. Mitchell, Alina Morawska, and Santosh Kumar Tadakamadla. "Online Parenting Intervention for Children’s Eating and Mealtime Behaviors: Protocol of a Randomized Controlled Trial." Healthcare 10, no. 5 (May 17, 2022): 924. http://dx.doi.org/10.3390/healthcare10050924.
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Introduction: Obesity and overweight are significant health problems among Australian children. Parents play a vital role in establishing healthy eating behaviors in their children. However, parents often experience difficulties in implementing effective parenting practices and lack confidence in their ability to help children adopt these behaviors. This trial will evaluate the efficacy of an online program, Healthy Habits Triple P, in improving children’s snacking and mealtime behaviors and related parenting practices. Methods and analysis: This is a single-blinded, randomized controlled trial for parents of young Australian children aged 2–6 years. Participants will be recruited through childcare centers, social media, online parent forums and existing networks. The participants in the intervention arm will receive access to a web-based parenting intervention in addition to nutrition-related information for parents published by the National Health and Medical Research Council of Australia; those in the control arm will receive nutrition-related information only. After the completion of the study, the parenting intervention will be offered to the control arm. The primary outcome will be improvement in children’s eating habits. The secondary outcomes include parents’ self-efficacy, confidence, children’s mealtime behaviors and mealtime parenting strategies. Both primary and secondary outcomes will be evaluated through online-administered, validated parent-reported questionnaires. We will also undertake a quantitative and qualitative evaluation of the practicality and acceptability of the intervention.
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Tually, Peter, John Walker, and Simon Cowell. "The effect of nuclear medicine telediagnosis on diagnostic pathways and management in rural and remote regions of Western Australia." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 50–53. http://dx.doi.org/10.1258/1357633011937119.
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Limited accessibility to certain medical imaging services in regional and rural centres has led to the use of alternative modalities, which may not be best practice or which require patients to travel considerable distances for diagnosis. Data collected over three years were examined to determine the clinical effect of nuclear medicine teleradiology (NMT) and its effect on diagnostic patterns for the investigation of cardiovascular disease, radio-occult musculoskeletal injury and oncology. In comparison with two other rural, non-NMT areas of similar demographic profile, there was a significant shift in the delivery of care in terms of diagnostic work-up. NMT input led to the detection of disease and a change to therapeutic management in 122 cases and eliminated the need to transfer patients to another facility for unnecessary and expensive examinations in 38 cases. While NMT is more costly than conventional nuclear medicine services, it permits faster access to specialist consultation, provides for better management and is likely to reduce overall health costs by reducing the volume of inappropriate tests and treatment practice.
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Mac, Olivia A., Amy Thayre, Shumei Tan, and Rachael H. Dodd. "Web-Based Health Information Following the Renewal of the Cervical Screening Program in Australia: Evaluation of Readability, Understandability, and Credibility." Journal of Medical Internet Research 22, no. 6 (June 26, 2020): e16701. http://dx.doi.org/10.2196/16701.
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Background Three main changes were implemented in the Australian National Cervical Screening Program (NCSP) in December 2017: an increase in the recommended age to start screening, extended screening intervals, and change from the Papanicolaou (Pap) test to primary human papillomavirus screening (cervical screening test). The internet is a readily accessible source of information to explain the reasons for these changes to the public. It is important that web-based health information about changes to national screening programs is accessible and understandable for the general population. Objective This study aimed to evaluate Australian web-based resources that provide information about the changes to the cervical screening program. Methods The term cervical screening was searched in 3 search engines. The first 10 relevant results across the first 3 pages of each search engine were selected. Overall, 2 authors independently evaluated each website for readability (Flesch Reading Ease [FRE], Flesch-Kincaid Grade Level, and Simple Measure of Gobbledygook [SMOG] index), quality of information (Patient Education Materials Assessment Tool [PEMAT] for printable materials), credibility (Journal of the American Medical Association [JAMA] benchmark criteria and presence of Health on the Net Foundation code of conduct [HONcode] certification), website design, and usability with 5 simulation questions to assess the relevance of information. A descriptive analysis was conducted for the readability measures, PEMAT, and the JAMA benchmark criteria. Results Of the 49 websites identified in the search, 15 were eligible for inclusion. The consumer-focused websites were classed as fairly difficult to read (mean FRE score 51.8, SD 13.3). The highest FRE score (easiest to read) was 70.4 (Cancer Council Australia Cervical Screening Consumer Site), and the lowest FRE score (most difficult to read) was 33.0 (NCSP Clinical Guidelines). A total of 9 consumer-focused websites and 4 health care provider–focused websites met the recommended threshold (sixth to eighth grade; SMOG index) for readability. The mean PEMAT understandability scores were 87.7% (SD 6.0%) for consumer-focused websites and 64.9% (SD 13.8%) for health care provider–focused websites. The mean actionability scores were 58.1% (SD 19.1%) for consumer-focused websites and 36.7% (SD 11.0%) for health care provider–focused websites. Moreover, 9 consumer-focused and 3 health care provider–focused websites scored above 70% for understandability, and 2 consumer-focused websites had an actionability score above 70%. A total of 3 websites met all 4 of the JAMA benchmark criteria, and 2 websites displayed the HONcode. Conclusions It is important for women to have access to information that is at an appropriate reading level to better understand the implications of the changes to the cervical screening program. These findings can help health care providers direct their patients toward websites that provide information on cervical screening that is written at accessible reading levels and has high understandability.
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Mitchell, J. G., and A. P. S. Disney. "Clinical applications of renal telemedicine." Journal of Telemedicine and Telecare 3, no. 3 (September 1, 1997): 158–62. http://dx.doi.org/10.1258/1357633971931075.
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In 1994, a telemedicine network was established linking the renal unit at The Queen Elizabeth Hospital to three satellite dialysis centres in South Australia. In the first two and a half years of operation, the telemedicine equipment was used on over 6000 occasions. Interviews were conducted with 18 medical, nursing and allied health staff and dialysis patients. The main finding was that the full range of staff, from surgeons and nephrologists to allied health staff and nurses, were able use the technology successfully for clinical purposes. A second finding was that the technology enabled staff to perform a wide range of clinical procedures, from routine outpatient consultations and monitoring infections to making decisions about retrieval or confirming decisions to operate. A third finding was that telemedicine enabled the renal unit to provide improved services in which teams of staff at the different sites cooperated in ways that were not possible before the telemedicine links became available.
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Geissbuhler, A., R. Haux, and S. Y. Kwankam. "Towards Health for All: WHO and IMIA Intensify Collaboration." Methods of Information in Medicine 46, no. 05 (2007): 503–5. http://dx.doi.org/10.1160/me5006.
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Summary Objective: To intensify the collaboration between WHO, the World Health Organization, and IMIA, the International Medical Informatics Association. Methods: Identifying key areas of collaboration and publishing a joint communiqué during Medinfo 2007 in Brisbane, Australia. Results and Conclusions: WHO and IMIA have identified three keyareas of joint work for the next three years: the Global Observatory for eHealth, the use of I CT for the development of the health and health care workforce, and sharing eHealth products and services related to intellectual property for development.
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Sutarsa, I. Nyoman, Rosny Kasim, Ben Steward, Suzanne Bain-Donohue, Claudia Slimings, Sally Hall Dykgraaf, and Amanda Barnard. "Do General Practitioners in a Visiting Medical Officer Arrangement Improve the Perceived Quality of Care of Rural and Remote Patients? A Qualitative Study in Australia." Healthcare 10, no. 6 (June 4, 2022): 1045. http://dx.doi.org/10.3390/healthcare10061045.
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Background: In rural and remote Australia, general practitioners (GPs) provide care across the continuum from primary to secondary care, often in Visiting Medical Officer (VMO) arrangements with a local hospital. However, little is known about the role of GP-VMOs in improving the perceived quality of care and health outcomes for rural and remote communities. Methods: We collected qualitative data from three GP-VMOs (all aged >55 years) and 10 patients (all aged over 65 years) in three local health districts of New South Wales, Australia. Thirteen in-depth interviews were conducted between October 2020 and February 2021. We employed thematic analysis to identify key roles of GP-VMOs in improving the perceived quality of care and health outcomes of rural and remote patients. Results: Our study advances the current understanding regarding the role of GP-VMOs in improving the perceived quality of services and health outcomes of rural and remote patients. Key roles of GP-VMOs in improving the perceived quality of care include promoting the continuity of care and integrated health services, cultivating trust from local communities, and enhancing the satisfaction of patients. Conclusions: GP-VMOs work across primary and secondary care creating better linkages and promoting the continuity of care for rural and remote communities. Employing GP-VMOs in rural hospitals enables the knowledge and sensitivity gained from their ongoing interactions with patients in primary care to be effectively utilised in the delivery of hospital care.
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Ouyang, Zenhwa, Jan Sargeant, Alison Thomas, Kate Wycherley, Rebecca Ma, Rosa Esmaeilbeigi, Ali Versluis, et al. "A scoping review of ‘big data’, ‘informatics’, and ‘bioinformatics’ in the animal health and veterinary medical literature." Animal Health Research Reviews 20, no. 1 (June 2019): 1–18. http://dx.doi.org/10.1017/s1466252319000136.
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AbstractResearch in big data, informatics, and bioinformatics has grown dramatically (Andreu-Perez J, et al., 2015, IEEE Journal of Biomedical and Health Informatics 19, 1193–1208). Advances in gene sequencing technologies, surveillance systems, and electronic medical records have increased the amount of health data available. Unconventional data sources such as social media, wearable sensors, and internet search engine activity have also contributed to the influx of health data. The purpose of this study was to describe how ‘big data’, ‘informatics’, and ‘bioinformatics’ have been used in the animal health and veterinary medical literature and to map and chart publications using these terms through time. A scoping review methodology was used. A literature search of the terms ‘big data’, ‘informatics’, and ‘bioinformatics’ was conducted in the context of animal health and veterinary medicine. Relevance screening on abstract and full-text was conducted sequentially. In order for articles to be relevant, they must have used the words ‘big data’, ‘informatics’, or ‘bioinformatics’ in the title or abstract and full-text and have dealt with one of the major animal species encountered in veterinary medicine. Data items collected for all relevant articles included species, geographic region, first author affiliation, and journal of publication. The study level, study type, and data sources were collected for primary studies. After relevance screening, 1093 were classified. While there was a steady increase in ‘bioinformatics’ articles between 1995 and the end of the study period, ‘informatics’ articles reached their peak in 2012, then declined. The first ‘big data’ publication in animal health and veterinary medicine was in 2012. While few articles used the term ‘big data’ (n = 14), recent growth in ‘big data’ articles was observed. All geographic regions produced publications in ‘informatics’ and ‘bioinformatics’ while only North America, Europe, Asia, and Australia/Oceania produced publications about ‘big data’. ‘Bioinformatics’ primary studies tended to use genetic data and tended to be conducted at the genetic level. In contrast, ‘informatics’ primary studies tended to use non-genetic data sources and conducted at an organismal level. The rapidly evolving definition of ‘big data’ may lead to avoidance of the term.
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Hyde, Lisa Lynne, Allison W. Boyes, Lisa J. Mackenzie, Lucy Leigh, Christopher Oldmeadow, Carlos Riveros, and Rob Sanson-Fisher. "Electronic Health Literacy Among Magnetic Resonance Imaging and Computed Tomography Medical Imaging Outpatients: Cluster Analysis." Journal of Medical Internet Research 21, no. 8 (August 28, 2019): e13423. http://dx.doi.org/10.2196/13423.
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Background Variations in an individual’s electronic health (eHealth) literacy may influence the degree to which health consumers can benefit from eHealth. The eHealth Literacy Scale (eHEALS) is a common measure of eHealth literacy. However, the lack of guidelines for the standardized interpretation of eHEALS scores limits its research and clinical utility. Cut points are often arbitrarily applied at the eHEALS item or global level, which assumes a dichotomy of high and low eHealth literacy. This approach disregards scale constructs and results in inaccurate and inconsistent conclusions. Cluster analysis is an exploratory technique, which can be used to overcome these issues, by identifying classes of patients reporting similar eHealth literacy without imposing data cut points. Objective The aim of this cross-sectional study was to identify classes of patients reporting similar eHealth literacy and assess characteristics associated with class membership. Methods Medical imaging outpatients were recruited consecutively in the waiting room of one major public hospital in New South Wales, Australia. Participants completed a self-report questionnaire assessing their sociodemographic characteristics and eHealth literacy, using the eHEALS. Latent class analysis was used to explore eHealth literacy clusters identified by a distance-based cluster analysis, and to identify characteristics associated with class membership. Results Of the 268 eligible and consenting participants, 256 (95.5%) completed the eHEALS. Consistent with distance-based findings, 4 latent classes were identified, which were labeled as low (21.1%, 54/256), moderate (26.2%, 67/256), high (32.8%, 84/256), and very high (19.9%, 51/256) eHealth literacy. Compared with the low class, participants who preferred to receive a lot of health information reported significantly higher odds of moderate eHealth literacy (odds ratio 16.67, 95% CI 1.67-100.00; P=.02), and those who used the internet at least daily reported significantly higher odds of high eHealth literacy (odds ratio 4.76, 95% CI 1.59-14.29; P=.007). Conclusions The identification of multiple classes of eHealth literacy, using both distance-based and latent class analyses, highlights the limitations of using the eHEALS global score as a dichotomous measurement tool. The findings suggest that eHealth literacy support needs vary in this population. The identification of low and moderate eHealth literacy classes indicate that the design of eHealth resources should be tailored to patients’ varying levels of eHealth literacy. eHealth literacy improvement interventions are needed, and these should be targeted based on individuals’ internet use frequency and health information amount preferences.
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Priede, Andre, Phyllis Lau, Ivan Darby, Mike Morgan, and Rodrigo Mariño. "Referral Compliance Following a Diabetes Screening in a Dental Setting: A Scoping Review." Healthcare 10, no. 10 (October 13, 2022): 2020. http://dx.doi.org/10.3390/healthcare10102020.
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With type 2 diabetes prevalence increasing in Australia, and the condition associated with significant morbidity and mortality, screening for dysglycaemia in the dental setting has been proposed to identify asymptomatic individuals. Screening commences with a risk assessment, and individuals identified at elevated risk for having diabetes are then referred to their medical practitioner for confirmation of their glycemic status. Therefore, for screening to be effective, individuals need to adhere to their oral health professionals’ (OHP) advice and attend their medical follow-ups. This review aims to investigate the literature on referral compliance following a risk assessment in the dental setting and identify barriers and facilitators to screened individuals’ referral compliance. A scoping review of the literature was undertaken, selecting studies of diabetes screening in a dental setting that recorded compliance to referral to follow-up, and explored any barriers and facilitators to adherence. Fourteen studies were selected. The referral compliance varied from 25 % to 90%. Six studies reported barriers and facilitators to attending medical follow-ups. Barriers identified included accessibility, cost, knowledge of the condition, and OHP characteristics.
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Krahe, Michelle A., Julie Toohey, Malcolm Wolski, Paul A. Scuffham, and Sheena Reilly. "Research data management in practice: Results from a cross-sectional survey of health and medical researchers from an academic institution in Australia." Health Information Management Journal 49, no. 2-3 (March 11, 2019): 108–16. http://dx.doi.org/10.1177/1833358319831318.
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Background: Building or acquiring research data management (RDM) capacity is a major challenge for health and medical researchers and academic institutes alike. Considering that RDM practices influence the integrity and longevity of data, targeting RDM services and support in recognition of needs is especially valuable in health and medical research. Objective: This project sought to examine the current RDM practices of health and medical researchers from an academic institution in Australia. Method: A cross-sectional survey was used to collect information from a convenience sample of 81 members of a research institute (68 academic staff and 13 postgraduate students). A survey was constructed to assess selected data management tasks associated with the earlier stages of the research data life cycle. Results: Our study indicates that RDM tasks associated with creating, processing and analysis of data vary greatly among researchers and are likely influenced by their level of research experience and RDM practices within their immediate teams. Conclusion: Evaluating the data management practices of health and medical researchers, contextualised by tasks associated with the research data life cycle, is an effective way of shaping RDM services and support in this group. Implications: This study recognises that institutional strategies targeted at tasks associated with the creation, processing and analysis of data will strengthen researcher capacity, instil good research practice and, over time, improve health informatics and research data quality.
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Gane, Elise M., Veronika Schoeb, Petrea Cornwell, Cassandra Ranatunga Cooray, Brooke Cowie, and Tracy A. Comans. "Discharge Planning of Older Persons from Hospital: Comparison of Observed Practice to Recommended Best Practice." Healthcare 10, no. 2 (January 20, 2022): 202. http://dx.doi.org/10.3390/healthcare10020202.
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Older people are particularly vulnerable to hospital re-presentation following discharge. Ideal discharge planning processes facilitate the transition from hospital to home and prevent subsequent re-presentations to hospital. The objective of this study was to examine discharge planning processes in two Australian hospitals, compare them between sites and to best-practice recommendations. An ethnographic observational study of discharge planning processes was conducted at two general medical inpatient wards at a large tertiary hospital and a smaller regional hospital in Brisbane, Australia. Participants were patients and ward staff involved in discharge planning during a hospital admission. A literature review was conducted to elicit best-practice recommendations for discharge planning. Data for this study (duration: 112 h) were collected directly using field notes by a research assistant embedded in the ward. A directed qualitative content analysis approach was used for data analysis. Results were compared to best-practice recommendations. Findings indicate that both hospitals implemented various best-practice interventions to enhance communication, collaboration, coordination and patient/family engagement for optimal discharge planning. Strategies used were context specific and effective to varying degrees. Clear responsibilities and goals within the multidisciplinary team helped to create cohesive, well-functioning teams. More work is needed to engage patients and families in discharge planning, and to encourage health professionals to consider patients and family as active team members in the discharge planning process.
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Coombs, Geoffrey, Denise Daley, Jan Bell, and on behalf of the Australian Group on Antimicrobial Resistance. "The Australian Group on Antimicrobial Resistance (AGAR)." Microbiology Australia 40, no. 2 (2019): 69. http://dx.doi.org/10.1071/ma19020.
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The Australian Group on Antimicrobial Resistance (AGAR) is a collaboration of clinicians and scientists working in diagnostic medical microbiology laboratories located across Australia. The group gathers information on the level of antimicrobial resistance (AMR) in bacteria causing important and life threatening infections and is a key component of Australia's response to the problem of increasing AMR. It defines where Australia stands with regard to antimicrobial resistance in human health.
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Perron, Janaya Elizabeth, Michael Jonathon Coffey, Andrew Lovell-Simons, Luis Dominguez, Mark E. King, and Chee Y. Ooi. "Resuscitating Cardiopulmonary Resuscitation Training in a Virtual Reality: Prospective Interventional Study." Journal of Medical Internet Research 23, no. 7 (July 29, 2021): e22920. http://dx.doi.org/10.2196/22920.
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Background Simulation-based technologies are emerging to enhance medical education in the digital era. However, there is limited data for the use of virtual reality simulation in pediatric medical education. We developed Virtual Doc as a highly immersive virtual reality simulation to teach pediatric cardiopulmonary resuscitation skills to medical students. Objective The primary objectives of this study were to evaluate participant satisfaction and perceived educational efficacy of Virtual Doc. The secondary aim of this study was to assess the game play features of Virtual Doc. Methods We conducted a prospective closed beta-testing study at the University of New South Wales (Sydney, Australia) in 2018. All medical students from the 6-year undergraduate program were eligible to participate and were recruited through voluntary convenience sampling. Participants attended a 1-hour testing session and attempted at least one full resuscitation case using the virtual reality simulator. Following this, participants were asked to complete an anonymous postsession questionnaire. Responses were analyzed using descriptive statistics. Results A total of 26 participants were recruited, consented to participate in this study, and attended a 1-hour in-person closed beta-testing session, and 88% (23/26) of participants completed the anonymous questionnaire and were included in this study. Regarding participant satisfaction, Virtual Doc was enjoyed by 91% (21/23) of participants, with 74% (17/23) intending to recommend the simulation to a colleague and 66% (15/23) intending to recommend the simulation to a friend. In assessment of the perceived educational value of Virtual Doc, 70% (16/23) of participants agreed they had an improved understanding of cardiopulmonary resuscitation, and 78% (18/23) agreed that Virtual Doc will help prepare for and deal with real-life clinical scenarios. Furthermore, 91% (21/23) of participants agreed with the development of additional Virtual Doc cases as beneficial for learning. An evaluation of the game play features as our secondary objective revealed that 70% (16/23) of participants agreed with ease in understanding how to use Virtual Doc, and 74% (17/23) found the game play elements useful in understanding cardiopulmonary resuscitation. One-third (7/23, 30%) found it easy to work with the interactive elements. In addition, 74% (17/23) were interested in interacting with other students within the simulation. Conclusions Our study demonstrates a positive response regarding trainee satisfaction and perceived educational efficacy of Virtual Doc. The simulation was widely accepted by the majority of users and may have the potential to improve educational learning objectives.
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Marshall, Skye, Graeme G Rich, Felicity Cohen, Asha Soni, and Elizabeth Isenring. "Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study." JMIR Formative Research 6, no. 11 (November 24, 2022): e29713. http://dx.doi.org/10.2196/29713.
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Background Bariatric weight-loss surgery rates are increasing internationally. Endoscopic sleeve gastroplasty (ESG) is a novel, minimally invasive endoscopic procedure thought to mimic some of the effects of a more common surgery, laparoscopic sleeve gastrectomy (LSG). Patient factors affecting procedural choice are unexplored. Objective This formative study aimed to determine the preoperative and early postoperative characteristics of adults matched for age, sex, and BMI who chose ESG versus LSG. Methods This prospective cohort study recruited ESG and matched LSG adults in Australia. Preoperative outcomes were medical history, glycemic biomarkers, blood lipids, liver function enzymes, albumin, blood pressure, hepatic steatosis index, the Gastrointestinal Symptom Rating Scale, the Impact of Weight on Quality of Life–Lite questionnaire, and body composition via dual-energy x-ray absorptiometry. Adverse events were recorded preoperatively and up to 2 weeks postoperatively. SPSS was used to test if there were differences between cohorts by comparing means or mean ranks, and binary regression was used to understand how characteristics might predict procedure choice. Results A total of 50 (including 25 ESG and 25 LSG) patients were recruited, who were primarily White (45/50, 90%) and female (41/50, 82%) with a mean age of 41.7 (SD 9.4) years. Participants had a mean of 4.0 (SD 2.2) active comorbid conditions, with the most common being nonalcoholic fatty liver disease (38/50, 76%), back pain (32/50, 64%), anxiety or depression (24/50, 48%), and joint pain (23/50, 46%). The LSG cohort had higher hemoglobin A1c (5.3%, SD 0.2%) than the ESG cohort (5%, SD 0.2%; P=.008). There was a 2.4 kg/m2 difference in median BMI (P=.03) between the groups, but fat and fat-free mass had no meaningful differences. Comparing the LSG and ESG groups showed that the LSG group had lower total quality of life (49.5%, SD 10.6% vs 56.6%, SD 12.7%; P=.045), lower weight-related self-esteem (10.7%, IQR 3.6%-25% vs 25%, IQR 17.9%-39.3%; P=.02), and worse abdominal pain (38.9%, IQR 33.3%-50% vs 53.9%, SD 14.2%, P=.01). For every percent improvement in weight-related self-esteem, the odds for selecting ESG increased by 4.4% (95% CI 1.004-1.085; P=.03). For every percent worsening in hunger pain, the odds for selecting ESG decreased by 3.3% (95% CI 0.944-0.990; P=.004). Conclusions There was very little evidence that Australian adults who chose an endoscopic versus surgical sleeve had different rates of comorbidities, body fat percentage, or weight-related quality of life. There was evidence against the test hypothesis, that is, there was evidence suggesting that lower self-esteem predicted choosing a more invasive sleeve (ie, LSG rather than ESG) Trial Registration Australia New Zealand Clinical Trials Registry ACTRN12618000337279; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374595
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Canfell, Oliver J., Yasaman Meshkat, Zack Kodiyattu, Teyl Engstrom, Wilkin Chan, Jayden Mifsud, Jason D. Pole, Martin Byrne, Ella Van Raders, and Clair Sullivan. "Understanding the Digital Disruption of Health Care: An Ethnographic Study of Real-Time Multidisciplinary Clinical Behavior in a New Digital Hospital." Applied Clinical Informatics 13, no. 05 (October 2022): 1079–91. http://dx.doi.org/10.1055/s-0042-1758482.
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Abstract Background Understanding electronic medical record (EMR) implementation in digital hospitals has focused on retrospective “work as imagined” experiences of multidisciplinary clinicians, rather than “work as done” behaviors. Our research question was “what is the behavior of multidisciplinary clinicians during the transition to a new digital hospital?” Objectives The aim of the study is to: (1) Observe clinical behavior of multidisciplinary clinicians in a new digital hospital using ethnography. (2) Develop a thematic framework of clinical behavior in a new digital hospital. Methods The setting was the go-live of a greenfield 182-bed digital specialist public hospital in Queensland, Australia. Participants were multidisciplinary clinicians (allied health, nursing, medical, and pharmacy). Clinical ethnographic observations were conducted between March and April 2021 (approximately 1 month post-EMR implementation). Observers shadowed clinicians in real-time performing a diverse range of routine clinical activities and recorded any clinical behavior related to interaction with the digital hospital. Data were analyzed in two phases: (1) content analysis using machine learning (Leximancer v4.5); (2) researcher-led interpretation of the text analytics to generate contextual meaning and finalize themes. Results A total of 55 multidisciplinary clinicians (41.8% allied health, 23.6% nursing, 20% medical, 14.6% pharmacy) were observed across 58 hours and 99 individual patient encounters. Five themes were derived: (1) Workflows for clinical documentation; (2) Navigating a digital hospital; (3) Digital efficiencies; (4) Digital challenges; (5) Patient experience. There was no observed harm attributable to the digital transition. Clinicians primarily used blended digital and paper workflows to achieve clinical goals. The EMR was generally used seamlessly. New digital workflows affected clinical productivity and caused frustration. Digitization enabled multitasking, clinical opportunism, and benefits to patient safety; however, clinicians were hesitant to trust digital information. Conclusion This study improves our real-time understanding of the digital disruption of health care and can guide clinicians, managers, and health services toward digital transformation strategies based upon “work as done.”
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Badell-Grau, Rafael A., Jordan Patrick Cuff, Brendan P. Kelly, Helen Waller-Evans, and Emyr Lloyd-Evans. "Investigating the Prevalence of Reactive Online Searching in the COVID-19 Pandemic: Infoveillance Study." Journal of Medical Internet Research 22, no. 10 (October 27, 2020): e19791. http://dx.doi.org/10.2196/19791.
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Background The ongoing pandemic has placed an unprecedented strain on global society, health care, governments, and mass media. Public dissemination of government policies, medical interventions, and misinformation has been remarkably rapid and largely unregulated during the COVID-19 pandemic, resulting in increased misinterpretations, miscommunication, and public panic. Being the first full-scale global pandemic of the digital age, COVID-19 has presented novel challenges pertinent to government advice, the spread of news and misinformation, and the trade-off between the accessibility of science and the premature public use of unproven medical interventions. Objective This study aims to assess the use of internet search terms relating to COVID-19 information and misinformation during the global pandemic, identify which were most used in six affected countries, investigate any temporal trends and the likely propagators of key search terms, and determine any correlation between the per capita cases and deaths with the adoption of these search terms in each of the six countries. Methods This study uses relative search volume data extracted from Google Trends for search terms linked to the COVID-19 pandemic alongside per capita case and mortality data extracted from the European Open Data Portal to identify the temporal dynamics of the spread of news and misinformation during the global pandemic in six affected countries (Australia, Germany, Italy, Spain, the United Kingdom, and the United States). A correlation analysis was carried out to ascertain any correlation between the temporal trends of search term use and the rise of per capita mortality and disease cases. Results Of the selected search terms, most were searched immediately following promotion by governments, public figures, or viral circulation of information, but also in relation to the publication of scientific resources, which were sometimes misinterpreted before further dissemination. Strong correlations were identified between the volume of these COVID-19–related search terms (overall mean Spearman rho 0.753, SD 0.158), and per capita mortality (mean per capita deaths Spearman rho 0.690, SD 0.168) and cases (mean per capita cases Spearman rho 0.800, SD 0.112). Conclusions These findings illustrate the increased rate and volume of the public consumption of novel information during a global health care crisis. The positive correlation between mortality and online searching, particularly in countries with lower COVID-19 testing rates, may demonstrate the imperative to safeguard official communications and dispel misinformation in these countries. Online news, government briefings, and social media provide a powerful tool for the dissemination of important information to the public during pandemics, but their misuse and the presentation of misrepresented medical information should be monitored, minimized, and addressed to safeguard public safety. Ultimately, governments, public health authorities, and scientists have a moral imperative to safeguard the truth and maintain an accessible discourse with the public to limit fear.
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Gray, Jodi, Andrew Partington, and Jonathan Karnon. "Access, Use, and Patient-Reported Experiences of Emergency Care During the COVID-19 Pandemic: Population-Based Survey." JMIR Human Factors 8, no. 3 (September 8, 2021): e30878. http://dx.doi.org/10.2196/30878.
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Background An increase in the number of people presenting to emergency departments (EDs) is contributing to ED overcrowding. In the early stages of the COVID-19 pandemic, there was a significant reduction in the number of ED presentations in Australia, creating an opportunity to learn from patients’ experiences of alternative management options. Objective The aim of this study is to report on the use and experience of health services by Australian adults experiencing a health issue during the COVID-19 pandemic for which they would have presented at an ED prior to the pandemic. Methods An online survey was conducted in May 2020. Reported health issues were categorized using an existing classification system. Data collected included demographics, care pathways, levels of concern at times of health issue and survey completion, and patient-reported experiences with care. Results A total of 1289 eligible respondents completed the survey. Almost 25% (309/1289) of respondents avoided an ED presentation, of which 58% (179/309) used an alternative form of health care and 42% (130/309) self-managed. Respondents making face-to-face or telehealth appointments with their general practitioner (GP) reported high levels of ED avoidance (135/286, 47%) and mostly positive experiences of care provided by GPs. A high proportion of those who self-managed reported high levels of concern at the time of completing the survey (42/130, 32%). Conclusions Telehealth consultations with GPs may be a more promotable alternative to the ED beyond the COVID-19 pandemic, providing easier access to a doctor with access to patients’ medical histories than an appointment for a face-to-face consultation. GP telehealth consultations may also address barriers to accessing health care for those with potentially the greatest need. The reported use and positive experiences with GP telehealth appointments should inform further research on their appropriateness as an alternative to the ED.
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Baysari, Melissa Therese, Wu Yi Zheng, Bethany Van Dort, Hannah Reid-Anderson, Mihaela Gronski, and Eliza Kenny. "A Late Attempt to Involve End Users in the Design of Medication-Related Alerts: Survey Study." Journal of Medical Internet Research 22, no. 3 (March 13, 2020): e14855. http://dx.doi.org/10.2196/14855.
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Background When users of electronic medical records (EMRs) are presented with large numbers of irrelevant computerized alerts, they experience alert fatigue, begin to ignore alert information, and override alerts without processing or heeding alert recommendations. Anecdotally, doctors at our study site were dissatisfied with the medication-related alerts being generated, both in terms of volume being experienced and clinical relevance. Objective This study aimed to involve end users in the redesign of medication-related alerts in a hospital EMR, 4 years post implementation. Methods This work was undertaken at a private not-for-profit teaching hospital in Sydney, Australia. Since EMR implementation in 2015, the organization elected to implement all medication-related alert types available in the system for prescribers: allergy and intolerance alerts, therapeutic duplication alerts, pregnancy alerts, and drug-drug interaction alerts. The EMR included no medication administration alerts for nurses. To obtain feedback on current alerts and suggestions for redesign, a Web-based survey was distributed to all doctors and nurses at the site via hospital mailing lists. Results Despite a general dissatisfaction with alerts, very few end users completed the survey. In total, only 3.37% (36/1066) of doctors and 14.5% (60/411) of nurses took part. Approximately 90% (30/33) of doctors who responded held the view that too many alerts were triggered in the EMR. Doctors suggested that most alerts be removed and that alerts be more specific and less sensitive. In contrast, 97% (58/60) of the nurse respondents indicated that they would like to receive medication administration alerts in the EMR. Most nurses indicated that they would like to receive all the alert types available at all severity levels. Conclusions Attempting to engage with end users several years post implementation was challenging. Involving users so late in the implementation process may lead to clinicians viewing the provision of feedback to be futile. Seeking user feedback on usefulness, volume, and design of alerts is extremely valuable; however, we suggest this is undertaken early, preferably before system implementation.
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Bomba, David, Kurt Svardsudd, and Per Kristiansson. "A comparison of patient attitudes towards the use of computerised medical records and unique identifiers in Australia and Sweden." Australian Journal of Primary Health 10, no. 2 (2004): 36. http://dx.doi.org/10.1071/py04024.
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This article compares the attitudes of Australian and Swedish patients towards the use of computerised medical records and unique identifiers in medical practices in Australia and Sweden. A Swedish translation of an Australian survey was conducted and results were compared. Surveys were distributed to patients at a medical practice in Sweden in 2003 and compared to the results of an Australian study by Bomba and Land (2003). Results: Based on the survey samples (Australia N=271 and Sweden N=55), 91% of Swedish respondents and 78% of Australian respondents gave a positive appraisal of the use of computers in health care. Of the Swedish respondents, 93% agreed that the computer-based patient record is an essential technology for health care in the future, while 86% of the Australian respondents agreed. Overwhelmingly, 95% of Swedish respondents and 91% of Australian respondents stated that the use of computers did not interfere with the doctor-patient consultation. Both groups preferred biometric identification as the method for uniquely identifying patients but differed in their preferred method to store medical information - a combination of central database and smart card for Australian respondents and central database for Swedish respondents. This analysis indicates that patient attitudes towards the use of computerised medical records and unique identifiers in Australia and Sweden are positive; however, there are concerns over information privacy and security. These concerns need to be taken into account in any future development of a national computer health network.
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Ospina-Pinillos, Laura, Tracey Davenport, Antonio Mendoza Diaz, Alvaro Navarro-Mancilla, Elizabeth M. Scott, and Ian B. Hickie. "Using Participatory Design Methodologies to Co-Design and Culturally Adapt the Spanish Version of the Mental Health eClinic: Qualitative Study." Journal of Medical Internet Research 21, no. 8 (August 2, 2019): e14127. http://dx.doi.org/10.2196/14127.
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Background The Mental Health eClinic (MHeC) aims to deliver best-practice clinical services to young people experiencing mental health problems by making clinical care accessible, affordable, and available to young people whenever and wherever they need it most. The original MHeC consists of home page with a visible triage system for those requiring urgent help; a online physical and mental health self-report assessment; a results dashboard; a booking and videoconferencing system; and the generation of a personalized well-being plan. Populations who do not speak English and reside in English-speaking countries are less likely to receive mental health care. In Australia, international students have been identified as disadvantaged compared with their peers; have weaker social support networks; and have higher rates of psychological distress. This scenario is acquiring significant relevance as Spanish-speaking migration is rapidly growing in Australia, and the mental health services for culturally and linguistically diverse populations are limited. Having a Spanish version (MHeC-S) of the Mental Health eClinic would greatly benefit these students. Objective We used participatory design methodologies with users (young people aged 16-30 years, supportive others, and health professionals) to (1) conduct workshops with users to co-design and culturally adapt the MHeC; (2) inform the development of the MHeC-S alpha prototype; (3) test the usability of the MHeC-S alpha prototype; (4) translate, culturally adapt, and face-validate the MHeC-S self-report assessment; and (5) collect information to inform its beta prototype. Methods A research and development cycle included several participatory design phases: co-design workshops; knowledge translation; language translation and cultural adaptation; and rapid prototyping and user testing of the MHeC-S alpha prototype. Results We held 2 co-design workshops with 17 users (10 young people, 7 health professionals). A total of 15 participated in the one-on-one user testing sessions (7 young people, 5 health professionals, 3 supportive others). We collected 225 source documents, and thematic analysis resulted in 5 main themes (help-seeking barriers, technology platform, functionality, content, and user interface). A random sample of 106 source documents analyzed by 2 independent raters revealed almost perfect agreement for functionality (kappa=.86; P<.001) and content (kappa=.92; P<.001) and substantial agreement for the user interface (kappa=.785; P<.001). In this random sample, no annotations were coded for help-seeking barriers or the technology platform. Language was identified as the main barrier to getting medical or psychological services, and smartphones were the most-used device to access the internet. Acceptability was adequate for the prototype’s 5 main elements: home page and triage system, self-report assessment, dashboard of results, booking and video visit system, and personalized well-being plan. The data also revealed gaps in the alpha prototype, such as the need for tailored assessment tools and a greater integration with Spanish-speaking services and communities. Spanish-language apps and e-tools, as well as online mental health information, were lacking. Conclusions Through a research and development process, we co-designed and culturally adapted, developed and user tested, and evaluated the MHeC-S. By translating and culturally adapting the MHeC to Spanish, we aimed to increase accessibility and availability of e-mental health care in the developing world, and assist vulnerable populations that have migrated to English-speaking countries.
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Yun, Andrew, Yuan Luo, Hanny Calache, Yan Wang, Ivan Darby, and Phyllis Lau. "Diabetes and Oral Health (DiabOH): The Perspectives of Primary Healthcare Providers in the Management of Diabetes and Periodontitis in China and Comparison with Those in Australia." Healthcare 10, no. 6 (June 2, 2022): 1032. http://dx.doi.org/10.3390/healthcare10061032.
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Diabetes and periodontal disease are highly prevalent conditions around the world with a bilateral causative relationship. Research suggests that interprofessional collaboration can improve care delivery and treatment outcomes. However, there continues to be little interprofessional management of these diseases. DiabOH research aims to develop an interprofessional diabetes and oral health care model for primary health care that would be globally applicable. Community medical practitioners (CMPs), community health nurses (CNs), and dentists in Shanghai were recruited to participate in online quantitative surveys. Response data of 76 CMPs, CNs, and dentists was analysed for descriptive statistics and compared with Australian data. Health professionals in China reported that, while screening for diabetes and periodontitis, increasing patient referral and improving interprofessional collaboration would be feasible, these were not within their scope of practice. Oral health screening was rarely conducted by CMPs or CNs, while dentists were not comfortable discussing diabetes with patients. Most participants believed that better collaboration would benefit patients. Chinese professionals concurred that interprofessional collaboration is vital for the improved management of diabetes and periodontitis. These views were similar in Melbourne, except that Shanghai health professionals held increased confidence in managing patients with diabetes and were more welcoming to increased oral health training.
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Cao, Jianfei, Yeongjoo Lim, Shintaro Sengoku, Xitong Guo, and Kota Kodama. "Exploring the Shift in International Trends in Mobile Health Research From 2000 to 2020: Bibliometric Analysis." JMIR mHealth and uHealth 9, no. 9 (September 8, 2021): e31097. http://dx.doi.org/10.2196/31097.
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Background Smartphones have become an integral part of our lives with unprecedented popularity and a diverse selection of apps. The continuous upgrading of information technology has also enabled smartphones to display great potential in the field of health care. Objective We aimed to determine the future research direction of mobile health (mHealth) by analyzing its research trends and latest research hotspots. Methods This study collected mHealth-related literature published between 2000 and 2020 from the Web of Science database. Descriptive statistics of publication trends of mHealth research were determined by analyzing the annual number of publications in the literature and annual number of publications by country. We constructed visualization network maps of country (or regional) collaborations and author-provided keyword co-occurrences, as well as overlay visualization maps of the average publication year of author-provided keywords to analyze the hotspots and research trends in mHealth research. Results In total, 12,593 mHealth-related research papers published between 2000 and 2020 were found. The results showed an exponential growth trend in the number of annual publications in mHealth literature. JMIR mHealth and uHealth, the Journal of Medical Internet Research, and JMIR Research Protocols were the 3 top journals with respect to number of publications. The United States remained the leading contributor to the literature in this area (5294/12,593, 42.0%), well ahead of other countries and regions. Other countries and regions also showed a clear trend of annual increases in the number of mHealth publications. The 4 countries with the largest number of publications—the United States, the United Kingdom, Canada, and Australia—were found to cooperate more closely. The rest of the countries and regions showed a clear geographic pattern of cooperation. The keyword co-occurrence analysis of the top 100 authors demonstrated 5 clusters, namely, development of mHealth medical technology and its application to various diseases, use of mHealth technology to improve basic public health and health policy, mHealth self-health testing and management in daily life, adolescent use of mHealth, and mHealth in mental health. The research trends revealed a gradual shift in mHealth research from health policy and improving public health care to the development and social application of mHealth technologies. Conclusions To the best of our knowledge, the most current bibliometric analysis dates back to 2016. However, the number of mHealth research published between 2017 and 2020 exceeds the previous total. The results of this study shed light on the latest hotspots and trends in mHealth research. These findings provide a useful overview of the development of the field; they may also serve as a valuable reference and provide guidance for researchers in the digital health field.
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Tracy, Marguerite Clare, Heather L. Shepherd, Pinika Patel, and Lyndal Jane Trevena. "Exploring the Vast Choice of Question Prompt Lists Available to Health Consumers via Google: Environmental Scan." Journal of Medical Internet Research 22, no. 5 (May 29, 2020): e17002. http://dx.doi.org/10.2196/17002.
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Background There is increasing interest in shared decision making (SDM) in Australia. Question prompt lists (QPLs) support question asking by patients, a key part of SDM. QPLs have been studied in a variety of settings, and increasingly the internet provides a source of suggested questions for patients. Environmental scans have been shown to be useful in assessing the availability and quality of online SDM tools. Objective This study aimed to assess the number and readability of QPLs available to users via Google.com.au. Methods Our environmental scan used search terms derived from literature and reputable websites to search for QPLs available via Google.com.au. Following removal of duplicates from the 4000 URLs and 22 reputable sites, inclusion and exclusion criteria were applied to create a list of unique QPLs. A sample of 20 QPLs was further assessed for list length, proxy measures of quality such as a date of review, and evidence of doctor endorsement. Readability of the sample QPL instructions and QPLs themselves was assessed using Flesch Reading Ease and Flesch-Kincaid Grade Level scores. Results Our environmental scan identified 173 unique QPLs available to users. Lists ranged in length from 1 question to >200 questions. Of our sample, 50% (10/20) had a listed date of creation or update, and 60% (12/20) had evidence of authorship or source. Flesch-Kincaid Grade Level scores for instructions were higher than for the QPLs (grades 10.3 and 7.7, respectively). There was over a 1 grade difference between QPLs from reputable sites compared with other sites (grades 4.2 and 5.4, respectively). Conclusions People seeking questions to ask their doctor using Google.com.au encounter a vast number of question lists that they can use to prepare for consultations with their doctors. Markers of the quality or usefulness of various types of online QPLs, either surrogate or direct, have not yet been established, which makes it difficult to assess the value of the abundance of lists. Doctor endorsement of question asking has previously been shown to be an important factor in the effectiveness of QPLs, but information regarding this is not readily available online. Whether these diverse QPLs are endorsed by medical practitioners warrants further investigation.
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Allan, Stephanie, Simon Bradstreet, Hamish Mcleod, John Farhall, Maria Lambrou, John Gleeson, Andrea Clark, and Andrew Gumley. "Developing a Hypothetical Implementation Framework of Expectations for Monitoring Early Signs of Psychosis Relapse Using a Mobile App: Qualitative Study." Journal of Medical Internet Research 21, no. 10 (October 24, 2019): e14366. http://dx.doi.org/10.2196/14366.
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Background Relapse is a common experience for people diagnosed with psychosis, which is associated with increased service costs and profound personal and familial distress. EMPOWER (Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery) is a peer worker–supported digital intervention that aims to enable service users to self-monitor their mental health with the aim of encouraging self-management and the shared use of personal data to promote relapse prevention. Digital interventions have not been widely used in relapse prevention and, therefore, little is currently known about their likely implementation—both within trials and beyond. Objective Seeking the perspectives of all relevant stakeholder groups is recommended in developing theories about implementation because this can reveal important group differences in understandings and assumptions about whether and for whom the intervention is expected to work. However, the majority of intervention implementation research has been retrospective. This study aimed to discover and theoretically frame implementation expectations in advance of testing and synthesize these data into a framework. Methods To develop a hypothetical implementation framework, 149 mental health professionals, carers, and people diagnosed with psychosis participated in 25 focus groups in both Australia and the United Kingdom. An interview schedule informed by the normalization process theory was used to explore stakeholders’ expectations about the implementation of the EMPOWER intervention. Data were analyzed using thematic analysis and then theoretically framed using the Medical Research Council guidelines for understanding the implementation of complex interventions. Results All groups expected that EMPOWER could be successfully implemented if the intervention generated data that were meaningful to mental health staff, carers, and service users within their unique roles. However, there were key differences between staff, carers, and service users about what facilitators and barriers that stakeholders believe exist for intervention implementation in both the cluster randomized controlled trial stage and beyond. For example, service user expectations mostly clustered around subjective user experiences, whereas staff and carers spoke more about the impact upon staff interactions with service users. Conclusions A hypothetical implementation framework synthesized from stakeholder implementation expectations provides an opportunity to compare actual implementation data gathered during an ongoing clinical trial, giving valuable insights into the accuracy of these stakeholders’ previous expectations. This is among the first studies to assess and record implementation expectations for a newly developed digital intervention for psychosis in advance of testing in a clinical trial. Trial Registration ISRCTN Registry ISRCTN99559262; http://www.isrctn.com/ISRCTN99559262
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Moshi, Magdalena Ruth, Jacqueline Parsons, Rebecca Tooher, and Tracy Merlin. "Evaluation of Mobile Health Applications: Is Regulatory Policy Up to the Challenge?" International Journal of Technology Assessment in Health Care 35, no. 4 (2019): 351–60. http://dx.doi.org/10.1017/s0266462319000461.
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AbstractObjectivesThe aim of this study is to determine whether the approach used in Australia to regulate mobile medical applications (MMA) is consistent with international standards and is suitable to address the unique challenges of these technologies.MethodsThe policies of members of the International Medical Device Regulator's Forum (IMDRF) were analyzed, to determine whether these regulatory bodies address IMDRF recommendations for the clinical evaluation of software as a medical device (SaMD). Case-studies of varying types of regulated MMAs in Australia and the United States were also reviewed to determine how well the guidance in the IMDRF's SaMD: Clinical Evaluation (2017) document was operationalized.ResultsAll included jurisdictions evaluated the effectiveness of MMAs and addressed the majority of the key sub-categories recommended in the IMDRF guidance document. However, safety principles concerning information security (cybersecurity) and potential dangers of misinformation (risk-classification) were generally not addressed in either the case-studies or in the policy documents of international regulatory bodies. Australia's approach was consistent with MMA regulation conducted internationally. None of the approaches used by global regulatory bodies adequately addressed the risk of misinformation from apps and the potential for adverse clinical consequences.ConclusionsThe risks posed by MMAs are mainly through the information they provide and how this is used in clinical decision-making. Policy in Australia and elsewhere should be adjusted to follow the IMDRF risk-classification criteria to address potential harms from misinformation. Australian regulatory information should also be updated so the harm posed by cybersecurity and connectivity can be comprehensively evaluated.
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Pandit, Tarsh, Robin A. Ray, and Sabe Sabesan. "Managing Emergencies in Rural North Queensland: The Feasibility of Teletraining." International Journal of Telemedicine and Applications 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/8421346.
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Introduction. Historically, the use of videoconference technologies in emergency medicine training has been limited. Whilst there are anecdotal reports of the use of teletraining for emergency medicine by rural doctors in Australia, minimal evidence exists in the literature. This paper aimed to explore the use of teletraining in the context of managing emergency presentations in rural hospitals. Methods. Using a qualitative approach, a mixture of junior and senior doctors were invited to participate in semistructured interviews. Data were transcribed and analysed line by line. Applying the grounded theory principles of open and axial coding, themes and subthemes were generated. Results. A total of 20 interviews were conducted with rural doctors, rural doctors who are medical educators, and emergency medicine specialists. Two major themes—(1) teletraining as education and (2) personal considerations—and ten subthemes were evident from the data. Most participants had some previous experience with teletraining. Access to peer teaching over videoconference was requested by rural generalist registrars. There was a preference for interactive training sessions, over didactic lectures with little mention of technical barriers to engagement. The ability of teletraining to reduce professional isolation was a major benefit for doctors practicing in remote locations. Discussion. For these rural doctors, teletraining is a feasible method of education delivery. Wider application of teletraining such as its use in peer teaching needs to be explored. The benefits of teletraining suggest that teletraining models need to be core business for health services and training providers, including specialist colleges.
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Hannan, T. "Medical informatics-an Australian perspective." Australian and New Zealand Journal of Medicine 21, no. 3 (June 1991): 363–78. http://dx.doi.org/10.1111/j.1445-5994.1991.tb04709.x.
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Millbank, Jenni. "What is the Responsibility of Australian Medical Professionals Whose Patients Travel Abroad for Assisted Reproduction?" Medical Law Review 27, no. 3 (2019): 365–89. http://dx.doi.org/10.1093/medlaw/fwy040.
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Abstract Australian medical professionals whose patients undertake assisted reproductive treatment abroad face a conflict: to try to provide optimal and on-going care for their patient at the same time as ensuring compliance with Australian legal, ethical, and professional rules which proscribe as unsafe or unethical key aspects of such treatment. A major suggestion from literature on medical travel is that risks to the patient can be mitigated through the involvement of the local professional. However, the force of legal regulation and ethical guidance in Australia strenuously directs clinicians away from involvement in overseas reproductive treatment. This article reports on 37 interviews with Australians travelling abroad for surrogacy, egg donation, and embryo donation, reflecting on patients’ experiences with Australian medical professionals both before and after they travelled. Patient reports demonstrate a fragmented and bewildering medical landscape in Australia, in which the ability to access domestic care and expertise varied markedly depending upon the kind of treatment patients were seeking abroad, and the mode of practice of the Australian doctor. Doctors practicing within licensed IVF clinics were notably more constrained than those outside such a setting. Patients seeking egg donation were offered information and received a wide range of diagnostic and preparatory treatments, while those seeking surrogacy were shunned, chided and offered limited (and sometimes covert) assistance. While recent changes to national ethical guidance improve clarity on information giving, the ethical and legal propriety of Australian medical professionals providing diagnostic or preparatory treatment for cross border reproduction remains uncertain.