Browsing by Author "Alves, Domingos"
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- 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.
- 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.
- Proposal for selection of mental health indicators in the management of health networks: from heuristic to process modelingPublication . Lima, Inacia Bezerra de; Yamada, Diego Bettiol; Yoshiura, Vinicius Tohoru; Lance, Rogério Cortecioni; Rodrigues, Lidia Maria Lourençön; Vinci, Andre Luiz Teixeira; Martinho, Ricardo; Pádua, Silvia Dallavalle de; Rijo, Rui Pedro Charters Lopes; Rijo, Rui, Rui Pedro Charters Lopes; Furegato, Antonia Regina Ferreira; Alves, DomingosIn 2011, Brazil instituted the Psychosocial Care Network (RAPS) for people suffering from mental disorders and needs arising from the use of alcohol and other drugs within the Unified Health System an electronic information system that supports the planning, regulation, control and evaluation of mental health actions. Several studies have been done to select a complete set of indicators for mental health in Brazil; however, these studies do not describe how these principles are transposed into indicators. In this work we will use Business Process Management Notation (BPMN) to analyze the process of patient care in a mental health unit and to search through this analysis to select and map those that apply to the specific RAPS institutions. We propose a method, using process modeling along the Thornicroft and Tansella matrix, to select the relevant indicators and their mapping along the network. The method was effective allowing the application of indicators to the concrete reality of a psychiatric hospital in Brazil.
- Proposal of an Evaluation Model for Mental Health Care Networks Using Information Technologies for its ManagementPublication . Vinci, André Luiz Teixeira; Rijo, Rui Pedro Charters Lopes; Marques, João Mazzoncini de Azevedo; Alves, DomingosThe Brazilian public health system instituted the mental health care networks in 2011. Thus, the goal of this paper is to describe the research methods used as basis for a proposal of an evaluation model of municipal and regional management of a Mental Health Care Network that comprises computerized information systems and specific indicators. Proposed steps include: Review of Brazilian legislation on management in mental health care networks, Formulation of questions about how is mental health care management in the region; Semi-structured interviews with stakeholders about the performance of the network; Study of existing indicators in mental health field used in universal public health systems; Selection of indicators for implementation and availability in a web information system; Monitoring the system's access to obtain indicators’ usage; Another set of semi-structured interviews to evaluate effective use of the provided indicators in management of mental health care. The results obtained will be evaluated qualitatively and quantitatively to compare the final overview with the initial one, regarding mental health care network management, and if the use of computerized indicators influenced it. The use of the proposed methods in specific localities will enable expansion of local knowledge improving management and health care quality.
- Proposal of an ontology for Mental Health Management in BrazilPublication . Yamada, Diego Bettiol; Yoshiura, Vinicius Tohoru; Miyoshi, Newton Shydeo Brandão; Lima, Inácia Bezerra de; Shinoda, Gustavo Yukiu Usumoto; Rijo, Rui, Rui Pedro Charters Lopes; Marques, João Mazzoncini de Azevedo; Cruz-Cunha, Maria Manuela; Alves, DomingosMental illness represent a large part of public health problems worldwide. Additionally, mental health managers need to make decisions based on complex data from dispersed sources with low levels of standardization and integration. This generally hinders knowledge extraction and its use as a reference to provide useful indicators and reports for efficient decision making. In this context, the interoperability between Information Systems is an essential characteristic to establish the capacity of communication, exchange and reuse of information for the generation of knowledge. In order to reduce the data complexity and to assist in the data interpretation, Semantic Web technology can be used. It classifies the stored information with metadata and give them meaning and thematic through the use of ontologies. Therefore, given the importance of mental health and the need for quality data, this article aims to specify and develop an ontology capable of consuming, integrating, analyzing and making available data of a regional mental healthcare network.
- Towards a Clinical Trial Protocol to Evaluate Health Information Systems: Evaluation of a Computerized System for Monitoring Tuberculosis from a Patient Perspective in BrazilPublication . Crepaldi, Nathalia Yukie; Bezerra de Lima, Inacia; Vicentine, Fernanda Bergamini; Rodrigues, Lídia Maria Lourençon; Sanches, Tiago Lara Michelin; Ruffino-Netto, Antonio; Alves, Domingos; Rijo, Rui, Rui Pedro Charters LopesAssessment of health information systems consider different aspects of the system itself. They focus or on the professional who will use the software or on its usability or on the software engineering metrics or on financial and managerial issues. The existent approaches are very resources consuming, disconnected, and not standardized. As the software becomes more critical in the health organizations and in patients, becoming used as a medical device or a medicine, there is an urgency to identify tools and methods that can be applied in the development process. The present work is one of the steps of a broader study to identify standardized protocols to evaluate the health information systems as medicines and medical devices are evaluated by clinical trials. The goal of the present work was to evaluate the effect of the introduction of an information system for monitoring tuberculosis treatment (SISTB) in a Brazilian municipality from the patients’ perspective. The Patient Satisfaction Questionnaire and the Hospital Consumer Assessment of Healthcare Providers and Systems were answered by the patients before and after the SISTB introduction, for comparison. Patients from an outpatient clinic, formed the control group, that is, at this site was not implanted the SISTB. Descriptive statistics and mixed effects model were used for data analysis. Eighty-eight interviews were conducted in the study. The questionnaire’s results presented better averages after the system introduction but were not considered statistically significant. Therefore, it was not possible to associate system implantation with improved patient satisfaction. The HIS evaluation need be complete, the technical and managerial evaluation, the safety, the impact on the professionals and direct and/or indirect impact on patients are important. Developing the right tools and methods that can evaluate the software in its entirety, from the beginning of the development cycle with a normalized scale, are needed.
- Towards a health observatory conceptual model based on the semantic webPublication . Yoshiura, Vinicius Tohoru; Yamada, Diego Bettiol; Pellison, Felipe Carvalho; Lima, Inácia Bezerra de; Damian, Ieda Pelogia Martins; Rijo, Rui, Rui Pedro Charters Lopes; Marques, João Mazzoncini de Azevedo; Alves, DomingosIntroduction. Health Observatories have gained global popularity and have been established worldwide since the 1970s. With the advent of the Semantic Web, machines can process, reuse, integrate and understand the meaning (semantics) of the information and knowledge on the World Wide Web to perform complex tasks. Objective. To propose a health observatory conceptual model based on Semantic Web in order to assist in the design, development and implementation processes of a Health Observatory. Methods. The proposed model was based on a conceptual analysis that include Semantic Web technologies narrative review, multi-layer software architecture and an integrative review of Health Observatories. Results. The proposed Health Observatory conceptual model consists of a chain of several related components based on information technology multi-layer architecture, Semantic Web technologies, Health Observatories stakeholders and key concepts. Conclusion. The proposed model can provide opportunities for the development and implementation of new observatories or for the adequacy of existing Health Observatories.
- Towards a standardized protocol for conducting randomized clinical trial for softwarePublication . Rodrigues, Lídia Maria Lourençön; Lima, Inacia Bezerra de; Santos, Luiz Ricardo Albano dos; Bollela, Valdes Roberto; Cruz-Cunha, Maria Manuela; Rijo, Rui, Rui Pedro Charters Lopes; Alves, DomingosIn the last decade, evidence-based medical practice has been aided on a large scale by computerized decision support tools, aimed at reducing diagnostic and therapeutic uncertainty, complementing the actions of the health professional. With the technological evolution, it is already possible to consider these systems as part of the clinical intervention, both for the diagnostic stage and for the treatment of diseases. This article proposes the creation of a specific clinical trial protocol to evaluate the effects of the software as clinical intervention in different medical settings. The proposal is unprecedented and extremely relevant in the scientific literature and able to standardize from the development stage to the application of the software aiding in the treatment of diseases.