利用儿童主索引解决预防接种管理信息共享问题的研究 与应用

将患者主索引的概念应用到儿童预防接种信息管理系统（CIIMS）中，创建儿童主索引，详细阐述其设计思想、在CIIMS中的应用模式以及区域平台之间的数据交换流程与实际应用场景，使儿童接种信息在全国范围实现共享。     

Brief communication: The Mid-South Clinical Data Research Network

The Mid-South Clinical Data Research Network (CDRN) encompasses three large health systems: (1) Vanderbilt Health System (VU) with electronic medical records for over 2 million patients, (2) the Vanderbilt Healthcare Affiliated Network (VHAN) which currently includes over 40 hospitals, hundreds of ambulatory practices, and over 3 million patients in the Mid-South, and (3) Greenway Medical Technologies, with access to 24 million patients nationally. Initial goals of the Mid-South CDRN include: (1) expansion of our VU data network to include the VHAN and Greenway systems, (2) developing data integration/interoperability across the three systems, (3) improving our current tools for extracting clinical data, (4) optimization of tools for collection of patient-reported data, and (5) expansion of clinical decision support. By 18 months, we anticipate our CDRN will robustly support projects in comparative effectiveness research, pragmatic clinical trials, and other key research areas and have the capacity to share data and health information technology tools nationally.     

Tumor Epigenetic Signature and Survival in Resected Gastric Cancer Patients

1. Download : Download high-res image (292KB)
2. Download : Download full-size image

     

卫生统计管理信息系统构建

简要阐述基于卫生综合管理信息平台的卫生统计管理系统建设目标和指导思想,具体介绍系统建设内容、原则与架构,并对卫生统计管理信息系统的使用效果进行总结。     

社区随访信息化管理对2型糖尿病患者的效果分析

目的探讨社区随访信息化管理对2型糖尿病患者自我管理能力与疾病控制的效果。方法对社区内212例2型糖尿病患者通过建立健康档案，同时建立电子健康档案，进行随访信息化管理。结果实施社区随访信息化管理1年后，患者的自我管理能力明显提高，患者的体重指数、空腹血糖、餐后2 h血糖、糖化血红蛋白、总胆固醇、甘油三酯与管理前比较，差异有显著意义（P〈0．01）。结论多样化、个性化、持续有效的社区随访信息化管理，能够提高2型糖尿病患者的自我管理能力和血糖控制水平，减缓并发症的发生，提高生存质量。     

Membrane-associated mucins of the ocular surface: New genes,new protein functions and new biological roles in human and mouse

The mucosal glycocalyx of the ocular surface constitutes the point of interaction between the tear film and the apical epithelial cells. Membrane-associated mucins (MAMs) are the defining molecules of the glycocalyx in all mucosal epithelia. Long recognized for their biophysical properties of hydration, lubrication, anti-adhesion and repulsion, MAMs maintain the wet ocular surface, lubricate the blink, stabilize the tear film and create a physical barrier to the outside world. However, it is increasingly appreciated that MAMs also function as cell surface receptors that transduce information from the outside to the inside of the cell. A number of excellent review articles have provided perspective on the field as it has progressed since 1987, when molecular cloning of the first MAM was reported. The current article provides an update for the ocular surface, placing it into the broad context of findings made in other organ systems, and including new genes, new protein functions and new biological roles. We discuss the epithelial tissue-equivalent with mucosal differentiation, the key model system making these advances possible. In addition, we make the first systematic comparison of MAMs in human and mouse, establishing the basis for using knockout mice for investigations with the complexity of an in vivo system. Lastly, we discuss findings from human genetics/genomics, which are providing clues to new MAM roles previously unimagined. Taken together, this information allows us to generate hypotheses for the next stage of investigation to expand our knowledge of MAM function in intracellular signaling and roles unique to the ocular surface.     

On measurements and their quality: Paper 3: Post hoc pooling and errors of discreteness

This is the third in a short series of papers on measurement theory and practice with particular relevance to research in nursing, midwifery, and healthcare. In this paper I demonstrate how the decisions we make regarding the post hoc treatment of our measurements impact the quality of our data and influence the validity of the inferences we draw from them. I address two variations of this practice, pooling data over response options found on self-report measures, and transforming measurements of continuous variables, such as age, into ranges or ordered categories. The problems inherent in this practice are examined using concepts from information theory. Pooling more precise measurements into less precise ones creates errors of discreteness that introduce unpredictable (positive or negative) bias in our results.     

Why common carrier and network neutrality principles apply to the Nationwide Health Information Network (NWHIN)

The Office of the National Coordinator will be defining the architecture of the Nationwide Health Information Network (NWHIN) together with the proposed HealtheWay public/private partnership as a development and funding strategy. There are a number of open questions—for example, what is the best way to realize the benefits of health information exchange? How valuable are regional health information organizations in comparison with a more direct approach? What is the role of the carriers in delivering this service? The NWHIN is to exist for the public good, and thus shares many traits of the common law notion of ‘common carriage’ or ‘public calling,’ the modern term for which is network neutrality. Recent policy debates in Congress and resulting potential regulation have implications for key stakeholders within healthcare that use or provide services, and for those who exchange information. To date, there has been little policy debate or discussion about the implications of a neutral NWHIN. This paper frames the discussion for future policy debate in healthcare by providing a brief education and summary of the modern version of common carriage, of the key stakeholder positions in healthcare, and of the potential implications of the network neutrality debate within healthcare.     

The application of technology acceptance and diffusion of innovation models in healthcare informatics

There have been many attempts to apply previously developed models of technology acceptance and the diffusion of innovations; however the models have weaknesses in predicting the behaviour of individuals and organisations, particularly within the complex health domain. The insights recent work on these models offer is relevant to health informatics development and innovation and need to be considered in the development of organisational strategies. This paper analyses the merits of several relevant models and explores their potential significance for the success or otherwise of health related Information Technology projects, highlighting their weaknesses in relation to the lack of differentiation between technological and human factors which limit their applicability in practice.