Articles

<b>Introduction:</b> One Key Question® is a patient-centered tool that seeks to understand patient pregnancy intention and counseling. This pilot study aimed to assess implementation of OKQ at an urban healthcare facility and improve understanding of short interpregnancy intervals (IPI). <b>Methods:</b> We describe the implementation of OKQ in our setting using the Diffusion of Innovation Theory as a framework. We broke this up into two phases – the first to assess provider acceptance of the OKQ integration into the clinic workflow and the second to assess how well documentation of OKQ answers occurred in our EMR. <b>Results:</b> Most providers in the first phase reported awareness of the inclusion of OKQ in the EHR, yet most physician providers reported only using OKQ at “some visits” (n=5) compared to the MAs, who reported using OKQ at “every visit” (n=8). Most providers felt that OKQ was an effective method of providing preconception and contraception care for women of reproductive age (n=10). Sixty-four patients completed a survey on OKQ after their visit who identified as young (mean age 28.7), either Black (46.9%) or Hispanic (51.6%) and pregnant (61%). Of those, 83% reported that they were not asked OKQ and 42% reported receiving counseling on optimal IPI. In those patients, 78% had documentation of usage of OKQ in the medical record. Discussion: The implementation of OKQ provided an opportunity to provide standardized preconception and contraception care to our patient population and improve information regarding short IPI. However, challenges existed in implementation which much be overcome to benefit from OKQ. <b>Significance:</b> OKQ has been used successfully in primary care and other settings to assess pregnancy intentions. This article adds to the literature by investigating the implementation of OKQ in a low-resource setting during prenatal and gynecology care. It shares struggles of implementing OKQ in an electronic medical record and how to roll out this program in a setting where pregnancy intention already is including in various forms by our providers.

Advances of wearables, sensors, smart devices, and electronic health records have generated patient-oriented longitudinal data sources that are analyzed with advanced analytical tools to generate enormous opportunities to understand patient health conditions and needs, transforming healthcare significantly from conventional paradigms to more patient-specific and preventive approaches. Artificial intelligence (AI) with a machine learning methodology is prominently considered as it is uniquely suitable to derive predictions and recommendations from complex patient datasets. Recent studies have shown that precise data aggregation methods exhibit an important role in the precision and reliability of clinical outcome distribution models. There is an essential need to develop an effective and powerful multifunctional machine learning platform to enable healthcare professionals to comprehend challenging biomedical multifactorial datasets to understand patient-specific scenarios and to make better clinical decisions, potentially leading to the optimist patient outcomes. There is a substantial drive to develop the networking and interoperability of clinical systems, the laboratory, and public health. These steps are delivered in concert with efforts at enabling usefully analytic tools and technologies for making sense of the eruption of overall patient’s information from various sources. However, the full efficiency of this technology can only be eliminated when ethical, legal, and social challenges related to reducing the privacy of healthcare information are successfully absorbed. Public and media are to be informed about the capabilities and limitations of the technologies and the paramount to be balanced is juvenile public healthcare data privacy debate. While this is ongoing, the measures have been progressed from patient data protection abuses for progress to realize the full potential of AI technology for hosting the health system, with benefits for all stakeholders. Any protection program should be based on fairness, transparency, and a full commitment to data privacy. On-going innovative systems that use AI to manage clinical data and analyzes are proposed. These tools can be used by healthcare providers, especially in defining specific scenarios related to biomedical data management and analysis. These platforms ensure that the significant and potentially predictive parameters associated with the diagnosis, treatment, and progression of the disease have been recognized. With the systematic use of these solutions, this work can contribute to the realization of noticeable improvements in the provision of real-time, personalized, and efficient medicine at a reduced cost [1].

Architectural frameworks for large-scale Electronic Health Record (EHR) data platforms are described. Existing EHR data platform architectures often leverage multiple cloud-based solutions blended with institutional infrastructures to manage and analyze clinical data at scale. Key design principles governing the scale of existing EHR data architecture include model design, governance structure, data access management, data security/policy/protection, data-information-language-based standardization, and analytics tool alignment, among others. The rapidly evolving technology landscape and the unprecedented volume of incident and retrospective clinical data being collected and generated within healthcare organizations have led to the emergent need for a dedicated architectural framework to support large-scale computing in the health informatics domain. The application areas of large-scale computing in health informatics include real-time predictive analytics, risk stratification, patient cohort analytics, development of predictive models for specific institutions or population groups, and many more. The use of EHR data for a multitude of decision-making processes in both clinical and non-clinical settings has prompted the establishment of policies prescribing the conditions of access and use of EHR data for non-employed individuals in the organization. Consequently, the demand for accessing, using, and managing EHR data at scale has impacted the over.

Cell division that is not controlled leads to cancer, an incurable condition. An early diagnosis has the potential to lower death rates from breast cancer, the most frequent disease in women worldwide. Imaging studies of the breast may help doctors find the disease and diagnose it. This study explores an effectiveness of DL and ML models in a classification of mammography images for breast cancer detection, utilizing the publicly available CBIS-DDSM dataset, which comprises 5,000 images evenly divided between benign and malignant cases. To improve diagnostic accuracy, models such as Gaussian Naïve Bayes (GNB), CNNs, KNN, and MobileNetV2 were assessed employing performance measures including F1-score, recall, accuracy, and precision. The methodology involved data preprocessing techniques, including transfer learning and feature extraction, followed by data splitting for robust model training and evaluation. Findings indicate that MobileNetV2 achieved a highest accuracy99.4%, significantly outperforming GNB (87.2%), CNN (96.7%), and KNN (91.2%). The outstanding capacity of MobileNetV2 to identify between benign and malignant instances was shown by the investigation, which also made use of confusion matrices and ROC curves to evaluate model performance.

This work details how the integration of cloud computing and advanced data engineering can innovate and reshape patient care and digital infrastructure. In the healthcare sector, cloud services offer the necessary support to generate digitally-oriented services and service kits. These services can contain high levels of availability, low levels of latency, and on-demand scaling capabilities, while following the strictest data protection laws and regulations. On the other hand, these services can be combined with data engineering techniques to construct an ecosystem that enhances and adds an optimized data layer on any cloud environment. This ecosystem includes technologies to acquire, process, and manage healthcare data while respecting all regulatory obligations and institutions and can be part of a comprehensive digitalization strategy. The objective is to augment the healthcare services that the industry offers by leveraging healthcare data and AI technologies. Designed services, processes, and technologies can be described either as industry-agnostic services or healthcare-specific services that process and manage electronic healthcare records (EHR). Industry-agnostic services offer a set of tools and methodologies to conduct optimized data experiments. The goal is to exploit any variety, velocity, volume, and veracity of medical data. Healthcare-specific services offer a set of tools and methodologies to connect to any common EHR vendor in a privacy-preserving manner. Participating companies are thus able to hold, share, and make use of healthcare data in real-time. The proposed architecture can be transformative for the healthcare industry, opening up and facilitating experimentation on new and scalable service models. The transition to a more digital health approach would help overcome the limits encountered in traditional settings. Limitations in the availability of healthcare facilities and healthcare professionals have underpinned the increasing share of telemedicine in the care process. However, the record-keeping of the patients that undergo care outside of traditional healthcare facilities is often missing and can severely influence the continuity of treatment. Identifying new methods to implement disease prevention and early intervention processes is crucial to avoid more extensive treatment and to support those on multiple line therapies. For chronic patients, having a service available that monitors the state of health and intervenes when parameters go off the wanted range is crucial. However, the same patients are the most under the influence of the decision of care providers; a second opinion might be given remotely which the patient can access at any time on-demand. To address these different kinds of services, an ecosystem composed of a dictionary's worth data layer is outlined, able to live and operate seamlessly in any cloud environment. This future work's envisioned outcome is the rapid evolution and re-definition of the European healthcare landscape.