Improving HIV Surveillance Data by Using the ATra Black Box System to Assist Regional Deduplication Activities.

Background: Focused attention on Data to Care underlines the importance of high-quality HIV surveillance data. This study identified the number of total duplicate and exact duplicate HIV case records in 9 separate Enhanced HIV/AIDS Reporting System (eHARS) databases reported by 8 jurisdictions and compared this approach to traditional Routine Interstate Duplicate Review resolution.

Methods: This study used the ATra Black Box System and 6 eHARS variables for matching case records across jurisdictions: last name, first name, date of birth, sex assigned at birth (birth sex), social security number, and race/ethnicity, plus 4 system-calculated values (first name Soundex, last name Soundex, partial date of birth, and partial social security number).

Improving HIV Surveillance Data for Public Health Action in Washington, DC: A Novel Multiorganizational Data-Sharing Method.

Background: The National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing.

Objective: This study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia.

Trajectory analyses of virologic outcomes reflecting community-based HIV treatment in Washington DC 1994-2012.

Background: Effective treatment of HIV since 1996 has reduced morbidity and mortality through virologic suppression. Combination antiretroviral therapy (cART) has been recognized as key to the prevention of drug resistance and the transmission of infection. We used eighteen years of virologic outcomes in a long-standing cohort of women to describe longitudinal viral load trajectories; and examine factors associated with sustained viremia and mortality.

Using Ethical Reasoning to Amplify the Reach and Resonance of Professional Codes of Conduct in Training Big Data Scientists.

The use of Big Data--however the term is defined--involves a wide array of issues and stakeholders, thereby increasing numbers of complex decisions around issues including data acquisition, use, and sharing. Big Data is becoming a significant component of practice in an ever-increasing range of disciplines; however, since it is not a coherent "discipline" itself, specific codes of conduct for Big Data users and researchers do not exist. While many institutions have created, or will create, training opportunities (e.

Bridging the divide between genomic science and indigenous peoples.

The new science of genomics endeavors to chart the genomes of individuals around the world, with the dual goals of understanding the role genetic factors play in human health and solving problems of disease and disability. From the perspective of indigenous peoples and developing countries, the promises and perils of genomic science appear against a backdrop of global health disparity and political vulnerability. These conditions pose a dilemma for many communities when attempting to decide about participating in genomic research or any other biomedical research.

Force Health Protection: the mission and political context of the longitudinal health record.

Drawing upon an extensive search of publically available literature and discussions at the "National Forum on the Future of the Defense Health Information System," this article documents the evolving mission and political context of the longitudinal health record (LHR) as an instrument for Force Health Protection (FHP). Because of the Gulf War syndrome controversy, the Department of Defense (DoD) launched an ambitious, complex series of programs designed to create a comprehensive, integrated defense health surveillance capability to assure FHP and keep faith with the American people. This "system of systems" includes individual component systems to perform specific functions such as disease surveillance, battlefield assessment, and patient care and consolidates these diverse types of information into centrally accessible archives that serve the interests of occupational health, preventive medicine, medical strategic planning, and longitudinal patient health care.

The executive summary of the National Forum on the Future of Defense Health Information Systems.

The Department of Defense (DoD) has been engaged in the development and deployment of the longitudinal health record (LHR). It has achieved remarkable technological success by handling vast amounts of patient data coming from clinical sites around the globe. Interoperability between DoD and VA has improved and this information sharing capability is expected to continue to expand as the defense health information system becomes an integral part of the national network.

A heuristic indication and warning staging model for detection and assessment of biological events.

Objective: This paper presents a model designed to enable rapid detection and assessment of biological threats that may require swift intervention by the international public health community.

Design: We utilized Strauss' grounded theory to develop an expanded model of social disruption due to biological events based on retrospective and prospective case studies. We then applied this model to the temporal domain and propose a heuristic staging model, the Wilson-Collmann Scale for assessing biological event evolution.

Breaching the security of the Kaiser Permanente Internet patient portal: the organizational foundations of information security.

This case study describes and analyzes a breach of the confidentiality and integrity of personally identified health information (e.g. appointment details, answers to patients' questions, medical advice) for over 800 Kaiser Permanente (KP) members through KP Online, a web-enabled health care portal.

Organizing safety: conditions for successful information assurance programs.

Organizations must continuously seek safety. When considering computerized health information systems, "safety" includes protecting the integrity, confidentiality, and availability of information assets such as patient information, key components of the technical information system, and critical personnel. "High Reliability Theory" (HRT) argues that organizations with strong leadership support, continuous training, redundant safety mechanisms, and "cultures of high reliability" can deploy and safely manage complex, risky technologies such as nuclear weapons systems or computerized health information systems.

Safe teleradiology: information assurance as project planning methodology.

The Georgetown University Medical Center Department of Radiology used a tailored version of OCTAVE, a self-directed information security risk assessment method, to design a teleradiology system that complied with the regulation implementing the security provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The system addressed threats to and vulnerabilities in the privacy and security of protected health information. By using OCTAVE, Georgetown identified the teleradiology program's critical assets, described threats to the assurance of those assets, developed and ran vulnerability scans of a system pilot, evaluated the consequences of security breaches, and developed a risk management plan to mitigate threats to program assets, thereby implementing good information assurance practices.

Media attitudes vs. use: the contribution of context to the communication environment in telemedicine.

Media attitudes and media use have been the focus of considerable academic research. This article uses this research to explore patient and health care practitioner attitudes toward telemedicine interactions via videoconferencing technology.