Browsing by Author "Alves, Domingos"
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- Data Integration in the Brazilian Public Health System for Tuberculosis: Use of the Semantic Web to Establish InteroperabilityPublication . Pellison, Felipe Carvalho; Rijo, Rui Pedro Charters Lopes; Lima, Vinicius Costa; Crepaldi, Nathalia Yukie; Bernardi, Filipe Andrade; Galliez, Rafael Mello; Kritski, Afrânio; Abhishek, Kumar; Alves, DomingosBackground: Interoperability of health information systems is a challenge due to the heterogeneity of existing systems at both the technological and semantic levels of their data. The lack of existing data about interoperability disrupts intra-unit and inter-unit medical operations as well as creates challenges in conducting studies on existing data. The goal is to exchange data while providing the same meaning for data from different sources. Objective: To find ways to solve this challenge, this research paper proposes an interoperability solution for the tuberculosis treatment and follow-up scenario in Brazil using Semantic Web technology supported by an ontology. Methods: The entities of the ontology were allocated under the definitions of Basic Formal Ontology. Brazilian tuberculosis applications were tagged with entities from the resulting ontology. Results: An interoperability layer was developed to retrieve data with the same meaning and in a structured way enabling semantic and functional interoperability. Conclusions: Health professionals could use the data gathered from several data sources to enhance the effectiveness of their actions and decisions, as shown in a practical use case to integrate tuberculosis data in the State of São Paulo.
- Data quality in tuberculosis: the case study of two ambulatories in the state of São Paulo, BrazilPublication . Yamaguti, Verena Hokino; Vicentine, Fernanda Bergamini; Lima, Inacia Bezerra de; Zago, Laís; Rodrigues, Lídia Maria Lourençon; Alves, Domingos; Crepaldi, Nathalia Yukie; Rijo, Rui Pedro Charters Lopes; Ruffino-Netto, AntónioTuberculosis is the second leading responsible cause of death from infectious diseases. Tuberculosis effective control and related activities depends on the use of different systems that aim to assist and monitor patients through managing their health data, and facilitating the activities of several health professionals. However, we noticed disparities in the information provided by some systems, which can negatively impact planning and decision-making. The study is defined as a quantitative and descriptive study of patients’ data during the treatment of tuberculosis in two different ambulatories. The data was collected from four different sources, including three information systems and the local patient archive in the ambulatories. Collected data was cleansed and standardized for semantic and structure, which allowed data comparison and analysis for its reliability and completeness. Low reliability scores are due to the absence of a semantic standard and the careless validation on recording of data by the professionals. Therefore, this study was able to effectively detect inconsistencies between the different data sources, stressing the need of health standards for data consistency, interoperability, and promoting data quality.
- Development and evaluation of an interoperable system based on the semantic web to enhance the management of patients’ tuberculosis dataPublication . Pellison, Felipe Carvalho; Rijo, Rui Pedro Charters Lopes; Lima, Vinícius Costa; Lima, Ricardo Roberto de; Martinho, Ricardo; Correia, Ricardo João Cruz; Alves, DomingosTuberculosis (TB), despite all the efforts and progress made in the last decade, continues to be very relevant in Brazil as well as in other Portuguese-speaking countries, so there is the need to join efforts for increasing the effectiveness of the fight against TB. Therefore, the epidemiological surveillance system of TB requires, not only the implementation of basic prevention and care actions, but also the strengthening of the integration between the different health services, programs and levels of care, whose resolvability varies according to financial, technical and human resources, as well as service infrastructure that comprise the network of attention. The deepening and broadening of data management techniques must constantly be carried out to achieve, at a higher level, integration and integrity of the ideal and desirable health care. Then, the goal of this article is to describe the research methods used to develop an information system using systems interoperability techniques based on the Semantic Web paradigm that will contribute to the activities of epidemiological surveillance and the follow-up of TB patients.
- Development and proposal of a reference tool for semi-structured interviews for the characterization of the management in mental health networksPublication . Vinci, André Luiz Teixeira; Rijo, Rui Pedro Charters Lopes; Marques, João Mazzoncini de Azevedo; Alves, DomingosIn 2011, Brazil’s mental health care networks were instituted; nevertheless, standardized arrangements or indicators for network evaluation and management were not established. Hence, a proposed model to evaluate municipal and regional management of such networks was elaborated. One of its steps consists of semi-structured interviews aiming the network management knowledge. Therefore, this paper aimed the development and validation of a reference tool for conducting interviews focusing on assessment of mental health care network management. Methods comprised definition of interest topics, questions elaboration for each topic, preliminary script preparation, script validation, script adequacy and definition of final script. Thus, the developed script consisted of 29 questions and 8 follow-up questions divided over 8 topics (interviewee characterization, legislation, decision-making processes, network structure, management participants, information systems, indicators, and knowledge of external experiences). The script also added individualized field reports and interview planning and execution guidelines. After validation, it was concluded that chosen topics were relevant and appropriate, despite minor modifications; and estimated average interview time remained close to prior established. Therefore, the developed tool can assist collecting information to help managers evaluate the network and improving population health. Moreover, the tool could be used in other localities or adapted for other networks.
- Development and validation of a pharmacoeconomic tool for decision making in the implementation of pharmaceutical care for hypertensive patients in the Brazilian public health system (SUS)Publication . Cazarim, Maurílio de Souza; Reis, Rodrigo; Wu, Olívia; Rijo, Rui Pedro Charters Lopes; Vinci, André Luiz Teixeira; Alves, Domingos; Pereira, Leonardo Régis LeiraSystemic Arterial Hypertension (SAH) is a risk factor for 9.4 million deaths worldwide. In Brazil, the condition attributes an annual cost of approximately USD640,000,000 to the SUS. The epidemiological and economic analysis of Pharmaceutical Care (PC) in the management of hypertensive patients showed an improvement in blood pressure control, a reduction of the risk of SAH complications, and an investment return of over USD1.7 million after ten years. Therefore, this article aims to present a pharmacoeconomic tool capable of assisting decision making in the implementation of PC in the SUS. A systematic review is being conducted for the robustness of the estimation of clinical and epidemiological impact of SAH, its results will be tabulated and applied in the improvement of the tool together with the direct medical and non-medical costs, indirect costs and costs of the SAH. In addition, a Markov model will be designed to estimate the incidence of cardiovascular diseases and SAH’s associated diseases by studies of proteomics that address the Human Network Disease. We hope to validate this auxiliary tool and thus to improve blood pressure control among hypertensive patients, quality of life, to reduce comorbidities and deaths, as well as optimizing the use of health resources.
- Development of CART model for prediction of tuberculosis treatment loss to follow up in the state of São Paulo, Brazil: A case–control studyPublication . Yamaguti, Verena Hokino; Alves, Domingos; Rijo, Rui, Rui Pedro Charters Lopes; Miyoshi, Newton Shydeo Brandão; Ruffino-Netto, AntônioBackground: Tuberculosis is the leading cause of infectious disease-related death, surpassing even the immunodeficiency virus. Treatment loss to follow up and irregular medication use contribute to persistent morbidity and mortality. This increases bacillus drug resistance and has a negative impact on disease control. Objective: This study aims to develop a computational model that predicts the loss to follow up treatment in tuberculosis patients, thereby increasing treatment adherence and cure, reducing efforts regarding treatment relapses and decreasing disease spread. Methods: This is a case-controlled study. Included in the data set were 103,846 tuberculosis cases from the state of São Paulo. They were collected using the TBWEB, an information system used as a tuberculosis treatment monitor, containing samples from 2006 to 2016. This set was later resampled into 6 segments with a 1-1 ratio. This ratio was used to avoid any bias during the model construction. Results: The Classification and Regression Trees were used as the prediction model. Training and test sets accounted for 70% in the former and 30% in the latter of the tuberculosis cases. The model displayed an accuracy of 0.76, F-measure of 0.77, sensitivity of 0.80 and specificity of 0.71. The model emphasizes the relationship between several variables that had been identified in previous studies as related to patient cure or loss to follow up treatment in tuberculosis patients. Conclusion: It was possible to construct a predictive model for loss to follow up treatment in tuberculosis patients using Classification and Regression Trees. Although the fact that the ideal predictive ability was not achieved, it seems reasonable to propose the use of Classification and Regression Trees models to predict likelihood of treatment follow up to support healthcare professionals in minimising the loss to follow up.
- Establishment of Access Levels for Health Sensitive Data Exchange through Semantic WebPublication . Lima, Vinicius Costa; Alves, Domingos; Pellison, Felipe Carvalho; Yoshiura, Vinicius Tohoru; Crepaldi, Nathalia Yukie; Rijo, Rui, Rui Pedro Charters LopesData exchange in health information systems must be carefully planned and needs to be protected from unauthorized access due to sensibility of stored content. Security aspects like authentication, authorization and encryption must be considered in this context. The main goal of this article is to present the implementation of security mechanisms to a semantic API that allows data extraction from a regional health information system designed to create notifications and to follow patients diagnosed with Tuberculosis. Data semantically tagged will be mapped individually to several access levels. It will be showed how external systems can connect, authenticate and retrieve only authorized data that are classified in the scope of its maximum access level.
- From guidelines to decision-making: using mobile applications and semantic web in the practical case of guides to support patientsPublication . Lima, Vinicius Costa; Rijo, Rui Pedro Charters Lopes; Pellison, Felipe Carvalho; Lima, Ricardo Roberto de; Correia, Ricardo João Cruz; Giuriati, Henrique Tresmonde; Alves, DomingosThe use of guidelines, procedures and recommendations is very common and also a simple way to structure, organize and retrieve relevant information that, in turn, may impact on patient care. However, it is necessary to expedite the retrieval of stored information. By simplifying the access to the desired data, it is possible to make the process practical, fast and intuitive for the health professional. The main goal of this article is to present a development approach for a project that proposes decision-making tools, based on guidelines, to assist health professionals in the care process of patients with specific diseases (or a combination of them). These tools will be developed for use on mobile devices and as a web-based system, which will transform a passive and declarative manual into an interactive tool that will provide not only data and information, but also knowledge through semantic web paradigm. Further, we will show an example of usability and feasibility of the proposed application through a functional prototype developed for Android platform.
- The process of outpatient care of children and adolescents in a tertiary‐level hospital specializing in pediatrics: A case study focused on identifying opportunities for improvement with the aid of modeling using BPMNPublication . Vinci, André Luiz Teixeira; Barbosa, Francisco; Silvia Inês Dallavalle de Pádua; Rijo, Rui, Rui Pedro Charters Lopes; Alves, DomingosIntroduction Business process management has gained importance in organizations for providing improved productivity and cost reduction, with process modeling being the central role. Usually, with reduced resources, the health area can benefit from good management of its processes. Objective To identify proposals for improvements in the process of outpatient care of children and adolescents in a tertiary-level—the most specialized and complex—pediatric hospital. Methods A bibliographic survey on the subject and a case study with in loco observation of the processes with semistructured interviews with the professionals involved were carried out. Alpha Hospital was chosen for this study, and the modeling of the process was performed using Business Process Model and Notation. Results Twelve relevant articles were identified. The “AS-IS” model of the process was obtained as a result and presents the existing 4 subprocesses (patient reception, preconsultation, consultation, and postconsultation). Specifically, the following improvement opportunities were identified: (a) process monitoring through indicators; (b) adequacy of the information system; (c) creation of service evaluation mechanisms; and (d) definition and application of training sessions for whenever a new professional begins working in a specific sector. The problem with the waiting time for patient care was also identified, but with no obvious solution; further studies should be carried to solve the problem. Conclusion The use of the business process modeling approach and process analysis allowed the hospital team awareness of the process and the identification of an improved set that can be helpful to Alpha Hospital or be used by other hospitals.
- Profiling IT Security and Interoperability in Brazilian Health Organisations From a Business PerspectivePublication . Rijo, Rui; Martinho, Ricardo; Oliveira, Adicinéia Aparecida; Alves, Domingos; Reis, Zilma Silveira Nogueira; Santos-Pereira, Cátia; Correia, Manuel E.; Antunes, Luís Filipe; Cruz-Correia, Ricardo JoãoThe proliferation of electronic health (e-Health) initiatives in Brazil over the last 2 decades has resulted in a considerable fragmentation within health information technology (IT), with a strong political interference. The problem regarding this issue became twofold: 1) there are considerable flaws regarding interoperability and security involving patient data; and 2) it is difficult even for an experienced company to enter the Brazilian health IT market. In this article, the authors aim to assess the current state of IT interoperability and security in hospitals in Brazil and evaluate the best business strategy for an IT company to enter this difficult but very promising health IT market. A face-to-face questionnaire was conducted among 11 hospital units to assess their current status regarding IT interoperability and security aspects. Global Brazilian socio-economic data was also collected, and helped to not only identify areas of investment regarding health IT security and interoperability, but also to derive a business strategy, composed out of recommendations listed in the paper.