Journal of Health & Medical Informatics

The smartphone, bringing together the communication and information technologies, is a device that offers an easily and friendly access to the information. Mobile health applications (apps) are increasing popular and could become an integral part of our daily lives, no matter if we are students or health care professionals. Having the support and agreement of the leadership of the hospitals and health institutions, the nurse community is starting to use this technology in many different areas. The goal of this paper is to present the advantages and benefits of using the mobile health apps (mHealth apps) in nursing, to identify some mHealth apps for different specific nursing activities, to identify which competencies are needed to use those apps and to provide a way to evaluate the nursing apps.

Infertility is a worldwide problem affecting couples that have unprotected intercourse, so the current study investigated the possible ameliorative effect of intra testicular stem cell injection in rats subjected to Gentamycin gentamicin induced testicular degeneration. For this study 100 male rats were randomly allocated into 4 groups, namely, the control group (group I), gentamicin group (group II), stem cell group (group III) and gentamicin and stem cell group (group IV). Gentamicin was administered daily for 2 weeks (80 mg/kg) to groups (II and IV). Stem cells were injected intra testicular into rete testis once by the end of gentamicin administration in group (IV) or after I/P injection of saline in group III. Blood and testicular samples were collected by the end of weeks 2, 6 and 10 from group (I) and (II), and by the end of weeks 6 and 10 from group (III and IV). The obtained results showed a significant decreases in serum testosterone, testicular testosterone and estradiol, sperm counts, sperm viability and an increase in % of fragmented DNA (indicating degenerative and necrotic changes) in testicular tissue of group (II) compared to group I , III and IV. Mesenchymal stem cells administration significantly improved all altered testicular parameters, where values of group IV (except testicular estradiol) were not significantly different from those of control group (I). Conclusively, mesenchymal stem cells proved to be beneficial in rats subjected to gentamicin induced testicular dysfunctions.

Infant mortality constitutes an important indicator of health and social environment of a society. Mortality is an important issue in public health, most especially for developing countries like Nigeria. This paper has been able to look critically into the health sector of Ondo State, Akure by looking into the aspect of Infant mortality, still birth and possible causes of infant mortality. The summary of the Chi-square results show that there is no significant difference between the type of disease causing infant mortality and gender while the regression analysis identifies the diseases contributing more to infant mortality such as severe anaemia, pneumonia and still birth asphyxia.

Health record management is an important and challenging task. Utilization of technologies in health care, particularly the use of Electronic Health Records (EHR) offers a wide variety of benefits. Better healthcare is provided by EHR by improving all aspects of health care. This paper aims to do an extensive review of existing literature on the issues and expectations concerning consumers and physicians in the development of EHR. In this paper, based on the issues, recommendations are made, and future directions explored.

Although there have been tremendous advances in understanding various disease outcomes, there are significant gaps and the associated costs to investigate disease burden can be exorbitant. Clinical data repositories can be a valuable aid for analysing patient and disease characteristics in a faster and most cost-effective manner. We offer our own example, using mitral regurgitation as the illustration of a disease process that was identified through the use of a clinical data repository in a subset of patients, matched with a control population, and then analysed for clinical and financial factors. Increasing adoption of digital systems to store and analyse large volumes of data paired with incentives by the government and various health systems makes the current environment ripe for an explosion of big data to help guide clinical decision making.

Uniquely identifying patients in the health system has eluded the Nigerian health sector players. Digital health tools are being deployed to address different challenges in the Nigerian health system with little showing any sign of scale. Despite global interest in digital identity system and its potential to improve health outcome, little progress has been registered in Nigeria. Nigeria has a convoluted patient identity system at the time of writing with patient identity local to health facility and sometimes department. Functional Identification systems like civic registration of birth, election, and financial services, to mobile telephony identity schemes are variously in place in Nigeria. These functional identity systems were reviewed for size of enrolees, data quality, and possibility of use as health functional identity system. Health sector stakeholders have two options to address the identity crisis. Either to adopt one of the existing functional identity systems or a combination of them or to setup a Master Patient Index (MPI) based client registry for the health system. This work having reviewed the factors necessary to adopt a functional identity system, recommends deployment of State based client registries as a way of addressing this challenge. The recommended framework of action is to develop a policy and strategy to guide implementation, implement as appropriate at different levels and then monitor while improving as appropriate. A good functional identity system will take into consideration necessary behaviour changes, staff workload, State autonomy, political interest, patient privacy, technology and return on investment concerns including total cost of ownership even for open source technology solutions.

An increasing prevalence of cancer requires new ways of supporting outpatients and improving their compliance to treatment. Initial mostly surgical treatment is followed by long-term surveillance to detect and treat cancer recurrence timely. Depending on the tumor stage, the frequencies of follow-up appointments differ and the patient has to remember to make these appointments at the right time. Currently, the patient receives a paper-based schema indicating the follow-up schedule. Since this document is difficult to understand or may get lost, patients are missing the follow-up appointments. This paper illustrates our attempt at exploiting mHealth to support the empowerment and awareness in outpatients by a mobile, bilingual app that supports variable cancer follow-up schedules. Installed on a mobile device, the app reminds the patient to schedule his appointments timely and provides additional information about disease and treatment. Equipped with additional functionalities for monitoring vital parameters, the app can be used for continuous monitoring. The usability was studied with nine persons. We conclude that the app provides a good basis for a successful product after realizing some extensions and improvements of the usability.

Introduction: Now a day’s self-medication practice is increasing widely due to availability of variety of over the counter medications. Self-medication practice is expected to be higher in health science students due to their exposure to knowledge about different diseases and drugs. If self-medication is used properly it saves time and money spent. Improper self-medication practice or medication abuse may lead to serious adverse drug reactions and possibly fatal consequences and emergence of antibiotic resistant.

Objective: The aim of this study is to assess the knowledge, attitude and practice of self-medication among Pharmacy Students in Rift Valley University of the Abichu campus.

Methods: A cross sectional survey was conducted using self-administered questionnaires which comprise 7 parts among pharmacy students (year one to five) who were available during the study period (January 1st to February 1st, 2017). Descriptive statistics was used to describe the frequency of variables contained in the questionnaire.

Results: Six hundred forty students were included in the study, of these 443 students were participated. A total of 400 students filled properly and returned the questionnaire. Among the participants, 218 (54.5%) were females with the prevalent age group of 26-35 years 202 (50.2%). Nearly half of the respondents 189 (47.3%) didn’t know the medication classification of OTC and prescription only drugs. About 165 (41.3%) had information about the medication classification of OTC and prescription only drugs. The most frequently reported self-medication symptom was fever/ headache (69.3%) followed by gastric pain (67.5%). The three main reasons for self-medication were non-seriousness, quick relief and emergency use accounting for 81.3%, 70.3%, and 45.8% respectively. Among the respondents, 109 (27.3%) had not practiced self-medication. 262 (65.5%) had visited physicians for the illnesses encountered whereas 52 (13.0%) had taken no action and others 291 (72.8) used pure self-medication from pharmacy or drug vendor without prescription. Paracetamol (92.0%), antacids (71.8%) and antibiotic (66.8%) were the most frequently consumed medication among the participants. The main source of information during self-medication was reading material (56.3%) followed by advice from pharmacist (43.8%), and advice from physician/nurses without prescription (38.8%). More than half of the respondents agreed that the practice of self-medication is part of self-care in the study.

Conclusion and Recommendation: A significant number of students were identified to practice self-medication and nearly half of the respondents have no knowledge about OTC and prescriptions only drugs. Prevalence of selfmedication increases as year of study increases. This may be due to increased study exposure to diseases and medications. Students should be aware that improper use of medications can lead to drug resistance, toxicity, and increased side effects.

Frontline clinicians are often faced with the task of rapidly sifting through a high volume of information from a variety of electronic sources. Managing this information deluge can be overwhelming, yet paramount to the delivery of highvalue healthcare. Thus, today’s clinicians must become the ‘e-Doctors’, who can best leverage mobile technology to overcome the informational challenges at point-of-care. In this review, we provide a framework for clinicians to manage electronic information, and go through a day in the life of an e-Doctor to understand how clinicians may use mobile health apps to accomplish different tasks and enhance the care and learning.

Since September 2013 the Ministry of Public Health (MSP) in Ecuador has integrated a computerized solution for Integral Health Management called Sisalud. By 2014, the MSP and the National Institute for Standardization (INEN) adopted the ISO 13606 standard. In 2014 the Medical Informatics Research Program (PROMEINFO) was implemented at Universidad de Guayaquil. This article is the result of four years of research and development led by PROMEINFO at Universidad de Guayaquil in Ecuador.

Objectives: Several attempts have been made to develop a Standardized Ecuadorian Electronic Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Health Record (EHR), to meet the Ministry of Health standard. These prior attempts failed mainly due to interoperability issues. This document presents a proposal for the development of compatible archetypes to interoperate EHR in Ecuador.

Methods: The project is based on the conventional engineering cycle for software development.

Results: PROMEINFO has developed a proposal for the new implementation of the Sisalud System, using a semantic interoperable system that complies with all of the Ecuadorian standards. The proposal operates through the use of archetypes based on ISO 13606 and SNOMED CT terminology for semantic interoperability.

Conclusion: It is expected that the present article will contribute to promote the interoperability of the medical records implemented in Ecuador, which will result in a timely and comprehensive attention of the patients and to improve their quality of health care.

Healthy diet with balanced nutrition is key to the prevention of life-threatening diseases such as obesity, cardiovascular disease, and cancer. Recent advances in smartphone and wearable sensor technologies have led to a proliferation of food monitoring applications based on automated food image processing and eating episode detection, with the goal to conquer drawbacks of the traditional manual food journaling that is time consuming, inaccurate, underreporting, and low adherent. In order to provide users feedback with nutritional information accompanied by insightful dietary advice, various techniques in light of the key computational learning principles have been explored. This survey presents a variety of methodologies and resources on this topic, along with unsolved problems, and closes with a perspective and boarder implications of this field.

The authors present a proposal to develop intelligent assisted living environments for home based healthcare in the presence of multimorbidity chronic patients. These environments unite the chronicle patient clinical history sematic representation ICP (Individual Care Process) with the ability of monitoring the living conditions using IoT technologies and events recurring to a fully managed Semantic Web of Things (SWoT) and Machine Learning Algorithms in order to activate the LDC (Less Differentiated Caregiver) for a specific care need. With these capabilities at hand, home based healthcare providing becomes a viable possibility reducing the institutionalization needs. The resulting integrated healthcare framework will provide significant savings while improving the generality of health and satisfaction indicators.

Introduction: In Ethiopia a gap between knowledge and use of contraceptive method is observed from many studies. According to the 2005 Ethiopian Demographic Health survey report the knowledge about any modern method among women is 86%, Contraceptive Acceptance Rate is 50.1% whereas the Contraceptive Prevalence Rate is 13.9%.

Methods: In order to find and interpret patterns from data the KDD process model is employed. This has gone through the steps of the process model; data selection and understanding, pre-processing, transformation, data mining, interpretation and evaluation. Decision tree and Naïve Bayes are used for the purpose of classification. The dataset used in this study is the 2005 demographic health survey data collected by central statistics agency. The techniques are tested both on the balanced and unbalanced datasets.

Results: Experimental results show that J48 decision tree performs better than Naïve Bayes. From this model 253 rules are generated. Overall accuracy of 82.85% a true positive (classifying non-user of contraceptive method) 87.3% and a true negative (classification of contraceptive method user) of 74.7% and a precision of 86.3%. One important rule detected was; women who do not know any contraceptive method have no any chance of using contraceptive method. But having knowledge of contraceptive method could not be a guarantee in order to use contraception. Other factors such as Partner occupation, Current marital status, wealth index, type of place were found to be most determinant factors as well.

Conclusion: Data mining techniques have revealed an important socioeconomic, demographic, geographic, reproductive history and knowledge factors associated with contraceptive method use. All concerned parties to strengthen the promotion of contraceptive method knowledge.

Telemedicine also denoted as telehealth and e-health, is the remote diagnosis and delivery of healthcare using telecommunications technology. This article presents a synopsis of some of the features associated with telemedicine including the training courses, the technology involved, the medical implications, and the underlying ethics.

Blockchain technology and the associated crypto currencies have the ability to transform industries including healthcare. We suggest the decentralized and programmable nature of the blockchain applications can be used to change health information technology to gain greater efficiency in public and private health care systems. Current public health information technology systems such as eligibility, enrolment and electronic health records have documented issues with interoperability and are slow to adapt to changing program and technology demands. We suggest that blockchain can potentially solve these issues. We argue that a public program such as the U.S. Medicaid program with $553 Billion in total program costs and over $25 Billion spent on health information technology and administration last fiscal year could benefit from the use of blockchain based distributed ledger and smart contracts. We finally argue that a decentralized benefits administration system can provide greater efficiency to enrolment, eligibility, claims payment and adjudication processes thus driving efficiency and reducing systemic fraud.

In the background of stagnant home markets, health care firms from mature economies are looking for opportunities in developing markets such as Vietnam. Various studies on marketing of health care from developed economies show convenience, specialties, reputation, and word of mouth as major choice factors for hospitals. The limited number of consumer behaviour articles from developing economies has contradictory findings for private and public hospitals with no mention of international hospitals. In this paper, the authors investigate the choice criteria and consumer perceptions of international hospitals in Ho Chi Minh City. Findings imply that younger consumers prefer private care as they suffer from minor illnesses and prioritize convenience, customer service and comfortable facilities. Some older patients are more conservative, seeking government sites due to trust, familiarity and insurance coverage. Irrespective of age and income, all those who experienced international hospitals where left with a lasting positive impression of the caring consultation and staff, modern equipment, and ‘VIP feel’ of facilities, with price quoted as the main barrier.

Ergonomics is the scientific field of knowledge concerned with the understanding of interactions between humans and systems or machines and furthermore the profession that applies theory, principles data and methods to design in order to optimize human well-being and overall system performance. Therefore, to further optimize the ergonomic performance the environment need to be incorporated in the human system interaction definition to form a tripartite symbiotic interphase. The purpose of this article is to discuss the role of ergonomists in improving the human, system and environmental conditions using the pragmatic approach of defining human factors ergonomics.

Purpose: Different medical computer science standards, such as ISO\EN 13606, openEHR and HL7 CDA, use the dual model approach to support interoperability between medical information systems. However, use of these standards encounters some obstacles: (i) lack methodological tools to facilitate design of Electronic Health Record (EHR) systems in accordance to two conceptual levels, (ii) Lack of methodologies to perform semantic activities on EHR content in the semantic web environment, and (iii) Absence of models to adapt medical knowledge, modelled by means of archetypes, in different contexts of use. This paper presents a model-driven based methodology for the generation of context-aware medical interfaces. This methodology, entitled OpenEHR modelling Methodology: OpenEHR-MM includes concepts, models, rules, processes and tools aimed to assist EHR designer in the generation process of context-aware medical interfaces.

Methods: OpenEHR-MM is based on the use of the model driven architecture technological space, and it includes the following four steps:

1. Analysis and specification of requirements: This first step aims to guide EHR interface designer in the definition of users’ needs.

2. Conceptualization: This step aims to define tools, concepts and approaches that assist EHR designer in the two conceptual levels modelling process. At this step, we define an approach to provide the context information modelling.

3. Ontologization: This step aims to assist the designer to integrate the semantic dimension in the EHR systems modeled in accordance to the dual model approach.

4. Implementation: Finally, OpenEHR-MM provides an adaptive approach to enable medical interface configuration with respect to contexts settings.

Results: A model driven-based methodology for context-aware medical interfaces generation process. The experimentation of this methodology is performed on the EHR related to patients affected by cerebral palsy.