A domain analysis model for eIRB systems: addressing the weak link in clinical research informatics

pre-printInstitutional Review Boards (IRBs) are a critical component of clinical research and can become a significant bottleneck due to the dramatic increase, in both volume and complexity of clinical research. Despite the interest in developing clinical research informatics (CRI) systems and supporting data standards to increase clinical research efficiency and interoperability, informatics research in the IRB domain has not attracted much attention in the scientific community. The lack of standardized and structured application forms across different IRBs causes inefficient and inconsistent proposal reviews and cumbersome workflows. These issues are even more prominent in multi-institutional clinical research that is rapidly becoming the norm. This paper proposes and evaluates a domain analysis model for electronic IRB (eIRB) systems, paving the way for streamlined clinical research workflow via integration with other CRI systems and improved IRB application throughput via computer-assisted decision support

Birth of identity: Understanding changes to birth certificates and their value for identity resolution

pre-printIntroduction Identity information is often used to link records within or among information systems in public health and clinical settings. The quality and stability of birth certificate identifiers impacts both the success of linkage efforts and the value of birth certificate registries for identity resolution. Objective Our objectives were to describe: (1) the frequency and cause of changes to birth certificate identifiers as children age, and (2) the frequency of events (ie, adoptions, paternities, amendments) that may trigger changes and their impact on names. Methods We obtained two deidentified datasets from the Utah birth certificate registry: (1) change history from 2000 to 2012, and (2) occurrences for adoptions, paternities, and amendments among births in 1987 and 2000. We conducted cohort analyses for births in 1987 and 2000, examining the number, reason, and extent of changes over time. We conducted cross-sectional analyses to assess the patterns of changes between 2000 and 2012. Results In a cohort of 48 350 individuals born in 2000 in Utah, 3164 (6.5%) experienced a change in identifiers prior to their 13th birthday, with most changes occurring before 2 years of age. Cross-sectional analysis showed that identifiers are stable for individuals over 5 years of age, but patterns of changes fluctuate considerably over time, potentially due to policy and social factors. Conclusions Identities represented in birth certificates change over time. Specific events that cause changes to birth certificates also fluctuate over time. Understanding these changes can help in the development of automated strategies to improve identity resolution

Consensus: a framework for evaluation of uncertain gene variants in laboratory test reporting

Accurate interpretation of gene testing is a key component in customizing patient therapy. Where confirming evidence for a gene variant is lacking, computational prediction may be employed. A standardized framework, however, does not yet exist for quantitative evaluation of disease association for uncertain or novel gene variants in an objective manner. Here, complementary predictors for missense gene variants were incorporated into a weighted Consensus framework that includes calculated reference intervals from known disease outcomes. Data visualization for clinical reporting is also discussed

Improving access to longitudinal patient health information within an emergency department

pre-printWe designed and implemented an electronic patient tracking system with improved user authentication and patient selection. We then measured access to clinical information from previous clinical encounters before and after implementation of the system. Clinicians accessed longitudinal information for 16% of patient encounters before, and 40% of patient encounters after the intervention, indicating such a system can improve clinician access to information. We also attempted to evaluate the impact of providing this access on inpatient admissions from the emergency department, by comparing the odds of inpatient admission from an emergency department before and after the improved access was made available. Patients were 24% less likely to be admitted after the implementation of improved access. However, there were many potential confounders, based on the inherent pre-post design of the evaluation. Our experience has strong implications for current health information exchange initiatives

Enhancing continuity of care through an emergency medical card at Intermountain Healthcare: using the continuity of care record standard

posterComplex and fragmented healthcare systems hamper provision of effective care where it is needed most. 1 In most instances, continuity of care is rarely considered during referral, transfer, or discharge of patients from one caregiver to another. 2,3 The dearth of pertinent current and historical health information at the point of care may lead to medical errors, adverse events, and poor outcomes

11th Annual Idaho Public Policy Survey

The Policy Survey attempts to identify public policy issues that are of concern to Idaho citizens. This report is the primary vehicle for dissemination of public policy concerns to the State Legislature, state agencies, and to the public at large. Since its inception in 1990, a set of questions referred to as core questions have been asked each year. Responses to these core questions on the: quality of life in Idaho; problems facing Idaho; perceptions, trust and confidence in government and taxing entities; and perceptions on funding-levels for programs and services-are important indicators of changes in attitudes and opinions of the citizens of Idaho. This year the State Department of Parks and Recreation, the State Division of Vocational Education, and BSU\u27s Department of Public Policy and Administration sponsored questions that were of interest to each respective organization. Also this year, two additional questions asked Idaho citizens their source of information and influence on their opinions on public policy concerns

Coal to Oil in China: Scientific Development or Crossing the River by Feeling the Stones?

Since the start of the 21st century, energy security concerns and rising international energy costs have led China to pursue the development of a coal to oil industry, whereby converting a portion of the nation\u27s abundant coal reserves into gasoline, diesel, or jet fuel, China might be able to increase its domestic oil production and generate profits. But a large-scale coal to oil industry exerts added pressure on China\u27s domestic coal reserves and water resources, and generates significant greenhouse gas emissions. The tension between the potential benefits of coal to oil development and its associated negative externalities present a challenge for China\u27s energy policymakers, who must balance competing demands for energy security, resource management, and equitable development. The challenge of effectively managing the development of this industry is complicated by the characteristic problems plaguing energy sector governance in China, including the absence of a powerful energy policymaking institution, the decentralized nature of the country\u27s economic development, and the influence of large energy companies. This study examines the evolution of China\u27s coal to oil industry and the policies shaping its development in order to better understand energy sector governance in China and the complex challenges confronting policymakers as they strive to balance an array of competing demands. It finds that weak energy institutions and powerful domestic actors indeed hinder China\u27s ability to efficiently formulate energy policies for the coal to oil industry, while considerations about the industry\u27s environmental and resource impacts compel a cautious approach to development. China\u27s incremental approach to formulating a long-term plan for the development of the coal to oil industry may, in the end, yield more effective policies

Product lifecycle management and distributor contribution to new product development

After the initial launch of a new product, distributors are frequently among the first to learn about product-related problems through the information they get about how it is perceived and used by customers, and how it might be improved or adapted for broader market coverage. For producers, such information, which has the potential to impact new product development (NPD) activities during the product lifecycle management (PLM) phase that follows launch, can be decisive for ensuring the continued viability of the product in the medium-to-longer term. The goal of this article is to better understand how distributors contribute to producer PLM activities by engaging in product-related information processing. A typology of four distinct scenarios is developed by integrating three conceptual themes: organizational information processing, dynamic capabilities, and task complexity. Each scenario results from the interplay of the distributor’s level (low/high) of capability—specifically, a combination of information coordination and management of inter-organization relations—and of the degree (low/high) of complexity of the product-related problem. The four scenarios are analysed and described in terms of NPD-related information processing. According to the typology, distributors act as ‘problem informers’ (low capability/high complexity), ‘solution advisors’ (low capability/low complexity), ‘solution implementers’ (high capability/low complexity) or ‘solution managers’ (high capability/high complexity). 14 in-depth interviews with distributors and producers in industrial goods provide empirical evidence for the analysis, description and support of each scenario. The article contributes to NPD by shedding light on the role of distributors in terms of incremental innovation in the context of PLM. Developers of new products can use the typology in planning for distributor involvement in PLM activities; distributors can use it to map out their current and future level of engagement in PLM-related activities