How the reliability and validity of the patient classification system can be ensured in daily nursing work? A follow-up study.

Aims And Objectives: This study aimed to determine the reliability and validity of the RAFAELA patient classification system (PCS) for qualified and efficient nurses.

Background: The number of patients per nurse or diagnosis-based determination of nursing workload are imprecise measures that do not consider the variation in patients' care needs. Ensuring the reliability and validity of the RAFAELA is important for the efficient allocation of nursing resources.

Artificial Intelligence in Clinical Decision Support: Challenges for Evaluating AI and Practical Implications.

Objectives: This paper draws attention to: i) key considerations for evaluating artificial intelligence (AI) enabled clinical decision support; and ii) challenges and practical implications of AI design, development, selection, use, and ongoing surveillance.

Method: A narrative review of existing research and evaluation approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Informatics and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems.

Results: There is a rich history and tradition of evaluating AI in healthcare.

The Safe and Effective Use of Shared Data Underpinned by Stakeholder Engagement and Evaluation Practice.

Objectives:  The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data.

Method:  A narrative review of existing research and policy approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Care and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems.

Results:  The technological ability to merge, link, re-use, and exchange data has outpaced the establishment of policies, procedures, and processes to monitor the ethics and legality of shared use of data.

Green Turning Brown - Domain Engineering for Social and Health Services in Finland.

Being able to design information systems to an untouched domain, without the burden of existing information systems, especially legacy systems, is often seen as a dream of most information system professionals. Uncharted domains are anyway scarce, and often such greenfield projects turn into brownfield projects, also to projects where existing structures severely constrain the development of new systems. In this article we discuss the concepts of greenfield and brownfield domain engineering and software development, and reflect their possible messages to the re-engineering of the Finnish health- and social care ecosystem currently under way.

How to Teach Health IT Evaluation: Recommendations for Health IT Evaluation Courses.

Systematic health IT evaluation studies are needed to ensure system quality and safety and to provide the basis for evidence-based health informatics. Well-trained health informatics specialists are required to guarantee that health IT evaluation studies are conducted in accordance with robust standards. Also, policy makers and managers need to appreciate how good evidence is obtained by scientific process and used as an essential justification for policy decisions.

Hospital mortality and optimality of nursing workload: A study on the predictive validity of the RAFAELA Nursing Intensity and Staffing system.

Background: Patient classification systems have been developed to manage workloads by estimating the need for nursing resources through the identification and quantification of individual patients' care needs. There is in use a diverse variety of patient classification systems. Most of them lack validity and reliability testing and evidence of the relationship to nursing outcomes.

Quality of Health IT Evaluations.

Health IT evaluation studies have often been found to be of limited quality. To address this problem, several guidelines and frameworks have been developed as tools to support improvement of the quality of evaluation studies. In this contribution, we review available guidelines and then present the Good Evaluation Practice Guideline in Health Informatics (GEP-HI) in more detail.

Trust-based information system architecture for personal wellness.

Modern eHealth, ubiquitous health and personal wellness systems take place in an unsecure and ubiquitous information space where no predefined trust occurs. This paper presents novel information model and an architecture for trust based privacy management of personal health and wellness information in ubiquitous environment. The architecture enables a person to calculate a dynamic and context-aware trust value for each service provider, and using it to design personal privacy policies for trustworthy use of health and wellness services.

Privacy-related context information for ubiquitous health.

Background: Ubiquitous health has been defined as a dynamic network of interconnected systems. A system is composed of one or more information systems, their stakeholders, and the environment. These systems offer health services to individuals and thus implement ubiquitous computing.

Feasibility analysis of the privacy attributes of the personal wellness information model.

A feasibility analysis has been performed to study the applicability of privacy attributes with a developed wellness information model. Information privacy concerns specifically access to individually identifiable personal information and one's ability to control information about oneself. We carried out a user scenario walk-through of the privacy attributes related to the wellness components.

Trust information-based privacy architecture for ubiquitous health.

Background: Ubiquitous health is defined as a dynamic network of interconnected systems that offers health services independent of time and location to a data subject (DS). The network takes place in open and unsecure information space. It is created and managed by the DS who sets rules that regulate the way personal health information is collected and used.

Applying GEP-HI for the planning of an evaluation study: a case study walkthrough (workshop).

A Good evaluation practice in Health Informatics (GEP-HI) Evaluation Practice guideline has been developed through a consensus making process. The guideline lists a set of 60 issues that are relevant for planning, implementation and execution of an evaluation study in the health informatics domain. These issues cover the phases of an evaluation study: Study exploration, first study design, operationalization of methods, detailed study design, execution and finalization of an evaluation study.

A conceptual framework and principles for trusted pervasive health.

Background: Ubiquitous computing technology, sensor networks, wireless communication and the latest developments of the Internet have enabled the rise of a new concept-pervasive health-which takes place in an open, unsecure, and highly dynamic environment (ie, in the information space). To be successful, pervasive health requires implementable principles for privacy and trustworthiness.

Objective: This research has two interconnected objectives.

Evaluation of the national nursing model and four nursing documentation systems in Finland--lessons learned and directions for the future.

Objectives: To evaluate the feasibility of the national nursing model and usability of four widely used nursing documentation systems and to study their usefulness in multi-professional collaboration and information exchange.

Methods: Qualitative usability study methods were used, including the use of scenario walkthroughs, contextual inquiries, thematic interviews and inspection-based expert reviews in the users' clinical contexts.

Results: The nursing process model was shown to be feasible in nursing practice but the national nursing classification was considered too detailed, multi-layered and difficult to use and understand.

The national nursing model from the nursing practice perspective - results from a finnish evaluation study.

The objective of this study was to evaluate the feasibility of the national nursing model in Finland. The feasibility evaluation was carried out with nurses using interviews and patient case scenarios in primary, specialized and private healthcare. The nursing process model showed to be feasible in nursing practice but the current national nursing classification (FinCC) was considered to be too detailed, multi-layered and difficult to understand and use.

Guideline for good evaluation practice in health informatics (GEP-HI).

Objective: Development of a good practice guideline to plan and perform scientifically robust evaluation studies in health informatics.

Methods: Issues to be addressed in evaluation studies were identified and guidance drafted based on the evaluation literature and on experiences by key players. Successive drafts of the guideline were discussed in several rounds by an increasing number of experts during conferences and by e-mail.

Framework model and principles for trusted information sharing in pervasive health.

Trustfulness (i.e. health and wellness information is processed ethically, and privacy is guaranteed) is one of the cornerstones for future Personal Health Systems, ubiquitous healthcare and pervasive health.

Next steps in evaluation and evidence - from generic to context-related.

Introduction: E-health systems are increasingly important and widespread, but their selection and implementation are still frequently based on belief, rather than scientific evidence, and adverse effects are not systematically addressed. Progress is being made in promoting generic evaluation methodologies as a source of scientific evidence, but effort is now needed to consider methods for special situations.

Method: Review of five evaluation contexts - national e-health plans, telemedicine, Health Informatics 3.

Usability of electronic nursing record systems: definition and results from an evaluation study in Finland.

Information technologies (IT) are widely used in healthcare, however, little is known about the usability of nursing information systems. This article reports an evaluation study that aimed at researching the usability of four electronic nursing record (ENR) systems and thereby providing guidelines for further IT development. For the purposes of the study the concept of usability was defined to cover the following aspects: nurse-computer interaction in working context, information exchange, and collaboration between healthcare professionals.

Towards a National Health Information System evaluation.

Most EU Member States have a documented policy on eHealth. Documented follow-up and evaluation strategies for assessing whether national level systems have reached their set aims and outcomes are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established.

Mini Stare-HI: guidelines for reporting health informatics evaluations in conference papers.

Background: To improve the quality of reports of health informatics evaluations we recently devised and published a guideline named STARE-HI, now formally endorsed by IMIA.

Objective: To develop a prioritization framework of ranked items (a mini-STARE-HI) to assist authors when reporting health informatics evaluation studies in a restricted space conference paper.

Method: We invited 111 editors of health informatics conference proceedings and reviewers and authors of health informatics evaluation studies to score 106 reporting items on a scale ranging from "0 - not necessary" through to "10 - essential" by a web-based survey.

The role of architecture and ontology for interoperability.

Turning from organization-centric to process-controlled or even to personalized approaches, advanced healthcare settings have to meet special interoperability challenges. eHealth and pHealth solutions must assure interoperability between actors cooperating to achieve common business objectives. Hereby, the interoperability chain also includes individually tailored technical systems, but also sensors and actuators.

Planning for national health information system evaluation.

Most EU member states have a documented policy on eHealth. Documented follow-up and evaluation policies to assess reaching of the set aims, as well as evaluating outcomes of implemented systems at a national level are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established.