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Personally controlled health records (PCHRs) enable patients to store, manage, and share their own health data, and promise unprecedented consumer access to medical information. To deploy a PCHR in the pediatric population requires crafting of access and security policies, tailored to a record that is not only under patient control, but one that may also be accessed by parents, guardians, and third-party entities. Such hybrid control of health information requires [...]

OBJECTIVES This study sought to examine the differences between ignoring (naïve) and incorporating dependency (nonnaïve) among linkage variables on the outcome of a probabilistic record linkage study. DESIGN AND MEASUREMENTS We used the outcomes of a previously developed probabilistic linkage procedure for different registries in perinatal care assuming independence among linkage variables. We estimated the impact of ignoring dependency by re-estimating the linkage weights after constructing a variable that combines [...]

OBJECTIVE All electronic health (e-health) interventions require validation as health information technologies, ideally in randomized controlled trial settings. However, as with other types of complex interventions involving various active components and multiple targets, health informatics trials often experience problems of design, methodology, or analysis that can influence the results and acceptance of the research. Our objective was to review selected key methodologic issues in conducting and reporting randomized controlled trials [...]

The Pfizer Healthcare Informatics team conducted a series of guided interviews with 35 Pfizer senior leaders to elicit their understanding, desires, and expectations of how Electronic Health Records (EHR) might be used in the pharmaceutical industry today and/or in the future. The interviews yielded fourteen use case categories comprising 42 specific use cases. The highest priority use cases were "Drug Safety & Surveillance," "Clinical Trial Recruitment," and "Support Regulatory Approval." [...]

This article describes the motivation, development, and implementation of a software tool, www.vaccineselection.com, introduced to assist health care professionals and public health administrators in managing pediatric vaccine purchase decisions and making economically sound formulary choices. The tool integrates general operations research methodologies with specific local practice choices to solve for the lowest overall cost set of vaccines required to immunize a child according to the Recommended Childhood Immunization Schedule. A [...]

There is increasing pressure to share health information and even make it publicly available. However, such disclosures of personal health information raise serious privacy concerns. To alleviate such concerns, it is possible to anonymize the data before disclosure. One popular anonymization approach is k-anonymity. There have been no evaluations of the actual re-identification probability of k-anonymized data sets.

The use of doctor-computer interaction devices in the operation room (OR) requires new modalities that support medical imaging manipulation while allowing doctors' hands to remain sterile, supporting their focus of attention, and providing fast response times. This paper presents "Gestix," a vision-based hand gesture capture and recognition system that interprets in real-time the user's gestures for navigation and manipulation of images in an electronic medical record (EMR) database. Navigation and [...]

The aim of this study was to improve naïve Bayes prediction of Medical Subject Headings (MeSH) assignment to documents using optimal training sets found by an active learning inspired method.

All methods of identifying medication prescribing errors are fraught with inaccuracies and systematic bias. A systematic, efficient, and inexpensive way of measuring and quantifying prescribing errors would be a useful step for reducing them. We ask if rapid discontinuations of prescription-orders--where physicians stop their orders within 2 hours--would be an expedient proxy for prescribing errors? To study this we analyzed CPOE-system medication orders entered and then discontinued within 2 hours [...]

Shortcomings surrounding the care of patients with diabetes have been attributed largely to a fragmented, disorganized, and duplicative health care system that focuses more on acute conditions and complications than on managing chronic disease. To address these shortcomings, we developed a diabetes registry population management application to change the way our staff manages patients with diabetes. Use of this new application has helped us coordinate the responsibilities for intervening and [...]