Journal of Health & Medical Informatics

Background: Fertility is one of the major components of population dynamics, which determine the size and structure of a population. According to Ethiopian Demographic and Health Survey 2011 report, the total fertility rate is decreasing from 5.5 children in 2000 to 4.8 in 2011. However, the rate of decline has been very slow as compared to the developed world. Thus, the objective of this study was to determine the magnitude and factors associated with high fertility among ever married women aged 25-49 years in Northern Ethiopia. Methods: A community based cross-sectional study was conducted on randomly selected 531 subjects in Enderta district using an interviewer administered questionnaire. A multistage sampling technique was used to draw the study participants. Data were collected using a pretested and structured questionnaire from March 10-19/2013. The study participants’ fertility was categorized as high and low. The collected data were coded, entered, and cleaned. Bivariate and multivariable logistic regression was used to analyze the variables at p-value <0.05. Results: This study showed that 51% of the respondents had high fertility. Women who got married at the age of less than 18 years were 2.63 times (AOR=2.63, 95% CI: ([1.526, 4.528]) more likely to have higher fertility as compared to those who got married at 18 years or more. Similarly, women with history of under five child mortality were 3.57 times (AOR=3.57, 95% CI: [1.884, 6.779]) more likely to have higher fertility when compared to those who had no history of under-five child mortality. Conclusion: About half of the respondents had high fertility. Age at first marriage, under five child mortality, educational status of the women, current age of the women and age at first birth were found to be statistically significant. Thus, information, education and communication (IEC) should be strengthened to create awareness mainly among women and their husbands about the negative consequence of early marriage, early child birth and high fertility rate.

Background: Shortcomings of plain text renderings of pathology reports in the electronic medical records (EMRs) are widely known. As the pathology reports grow in complexity, Portable Document Format (PDF) renderings of pathology reports are seen as a flexible solution. Since 3/2014, our group has successfully implemented architecture for PDF functionality for pathology report integration into the EMR. Design: We outlined our architectural framework. Within our architectural framework, pathology reports are first generated as MS Word documents. They are then exported into both HL7 and PDF formats in the EMR. The clinicians may then choose to view either format. The HL7 interface message contains the file location path of the PDF, and the PDF reports are stored on the hospital servers for display retrieval within the EMR. As the HL7 feed is maintained, data can still be extracted into the institutional data warehouse (IDW). The retained HL7 rendering of the report allows copy/pasting of the pathology report into clinical documents. A reconciliation report is generated to match the transmissions sent with those received. Results: The number of PDF reports sent across the interface from 3/2014 to 5/2015 total 191,868. The monthly reports sent range from 11,449 to 14,422 per month, with a median & average of 12,419 and 12,791, respectively. Conclusions: PDF renderings of pathology reports have been successfully integrated into the EMR system. PDF reports bypass errors that may occur when HL7 strips the formatting from MS Word documents, such as blood counts or gene mutation lists. Use of visual analytics is also possible with PDF reports. Most commercially available EMRs have the capability of displaying PDF documents. We hope that our experience can serve as a framework for PDF functionality in EMRs.

Objective: To examine racial disparities in the in-hospital utilization of frequently performed prophylactic vaccinations and inoculations in the U.S. Methods: Using 2011 Nationwide Inpatient Sample (NIS) data, unadjusted Relative Risks (RRs) were calculated to compare the use of prophylactic vaccinations and inoculations between White and Black; White and Hispanic; White and Asian or Pacific Islander; and White and Native American for live birth; asthma; short gestation, low birth weight and fetal growth retardation; and other perinatal conditions. RRs were also calculated using patients’ insurance statuses to further verify procedure use among new-borns. Results: Whites were significantly less likely to receive prophylactic vaccinations and inoculations than all other races for live birth (p<0.0001), and asthma (p<0.05). Overall, White new-borns were also significantly less likely to receive prophylactic vaccinations than most of new-borns of other races when insurance status was compared. Conclusion: Whites were less likely than other races to receive prophylactic vaccinations and inoculations in the U.S. hospitals.