@article {1281, title = {Eye injuries in children - incidence and outcomes: An observational study at a dedicated children{\textquoteright}s eye casualty.}, journal = {Eur J Ophthalmol}, volume = {29}, year = {2019}, month = {2019 Sep}, pages = {499-503}, abstract = {

PURPOSE: Trauma is an important cause of visual loss in children and may affect their quality of life. Prevention and legislation can reduce the incidence of trauma, and appropriate and timely treatment can improve prognosis. We aimed to describe incidence of eye injuries in children and the adherence to national and local management guidelines.

METHODS: Retrospective service evaluation at a tertiary hospital (Moorfields Eye Hospital, London, UK) which operates a dedicated children{\textquoteright}s eye casualty. The electronic patient administration system and electronic patient record system (Openeyes) were used to identify children who presented with eye injuries between January 2015 and December 2015.

RESULTS: Of 2397 first-time attendances to our children{\textquoteright}s casualty, 508 were for injuries (estimated incidence 21.1\%, 95\% confidence interval: 19.5\%-22.7\%). Mean age at presentation was 7.51 (standard deviation: 7.97) years; boys were more commonly affected than girls (69\%). The most common injury was corneal abrasion, followed by blunt and chemical injury; severe injuries such as penetrating trauma were rare. Injuries were sustained mostly during play or sports. Two children sustained permanent loss of vision in the affected eye.

CONCLUSION: Our findings are comparable to other published reports. Adherence to management guidelines is high, but documentation of advice given to families can be improved. Regular training of staff and collaboration with organisations outside the hospital can increase awareness of eye injuries in children.

}, keywords = {Adolescent, Child, Child, Preschool, Emergency Service, Hospital, Eye Injuries, Female, Humans, Incidence, Infant, Male, Prognosis, Quality of Life, Retrospective Studies, Treatment Outcome, Vision Disorders, Visual Acuity}, issn = {1724-6016}, doi = {10.1177/1120672118803512}, author = {Jolly, Rohit and Arjunan, Mousindha and Theodorou, Maria and Dahlmann-Noor, Annegret H} } @article {1282, title = {Effect of glycosylated hemoglobin on response to ranibizumab therapy in diabetic macular edema: real-world outcomes in 312 patients.}, journal = {Can J Ophthalmol}, volume = {53}, year = {2018}, month = {2018 08}, pages = {415-419}, abstract = {

OBJECTIVE: To investigate the effect of serum glycosylated hemoglobin (HbA1c) on the outcomes of ranibizumab therapy for diabetic macular edema (DME).

DESIGN: Retrospective cohort study.

PARTICIPANTS: Patients receiving ranibizumab injections for centre-involving DME in a National Health Service setting.

METHODS: The Moorfields OpenEyes database was used to study eyes with DME treated with ranibizumab from October 2013 to November 2015 at the Moorfields City Road, Ealing, Northwick Park, and St George{\textquoteright}s Hospital sites. Only eyes receiving a minimum of 3 injections and completing 12 months of follow-up were included. If both eyes received treatment, the first eye treated was analyzed. When both eyes received initial treatment simultaneously, random number tables were used to select the eye for analysis. HbA1c was tested at the initiation of ranibizumab treatment. Multivariate regression analysis was used to identify relationships between HbA1c and the outcome measures.

OUTCOMES: The primary outcome was change in visual acuity (VA) Early Treatment of Diabetic Retinopathy study (ETDRS) letters. The secondary outcomes were change in central subfield thickness (CSFT) and macular volume (MV), as well as number of injections in year 1.

RESULTS: Three hundred and twelve eyes of 312 patients were included in the analysis. HbA1c was not related to change in VA (p = 0.577), change in CSFT (p = 0.099), change in MV (p = 0.082), or number of injections in year 1 (p = 0.859).

CONCLUSIONS: HbA1c is not related to functional or anatomical outcomes at 1 year in DME treated with ranibizumab.

}, keywords = {Aged, Angiogenesis Inhibitors, Biomarkers, Diabetic Retinopathy, Female, Follow-Up Studies, Glycated Hemoglobin A, Humans, Intravitreal Injections, Macula Lutea, Macular Edema, Male, Middle Aged, Ranibizumab, Retrospective Studies, Tomography, Optical Coherence, Treatment Outcome, Vascular Endothelial Growth Factor A, Visual Acuity}, issn = {1715-3360}, doi = {10.1016/j.jcjo.2017.10.008}, author = {Shalchi, Zaid and Okada, Mali and Bruynseels, Alice and Palethorpe, David and Yusuf, Ammar and Hussain, Rohan and Herrspiegel, Christina and Scazzarriello, Antonio and Habib, Abubakar and Amin, Razia and Rajendram, Ranjan} } @article {1175, title = {Easy {Handling} of {Sensors} and {Actuators} over {TCP}/{IP} {Networks} by {Open} {Source} {Hardware}/{Software}}, journal = {Sensors (Basel, Switzerland)}, volume = {17}, year = {2017}, abstract = {There are several specific solutions for accessing sensors and actuators present in any process or system through a TCP/IP network, either local or a wide area type like the Internet. The usage of sensors and actuators of different nature and diverse interfaces (SPI, I2C, analogue, etc.) makes access to them from a network in a homogeneous and secure way more complex. A framework, including both software and hardware resources, is necessary to simplify and unify networked access to these devices. In this paper, a set of open-source software tools, specifically designed to cover the different issues concerning the access to sensors and actuators, and two proposed low-cost hardware architectures to operate with the abovementioned software tools are presented. They allow integrated and easy access to local or remote sensors and actuators. The software tools, integrated in the free authoring tool Easy Java and Javascript Simulations (EJS) solve the interaction issues between the subsystem that integrates sensors and actuators into the network, called convergence subsystem in this paper, and the Human Machine Interface (HMI)-this one designed using the intuitive graphical system of EJS-located on the user{\textquoteright}s computer. The proposed hardware architectures and software tools are described and experimental implementations with the proposed tools are presented.}, keywords = {Arduino, collaborative access, data acquisition, EJS, HMI, Internet-of-Things, Modbus, open source hardware/software, remote access}, issn = {1424-8220}, doi = {10.3390/s17010094}, author = {Mej{\'\i}as, Andr{\'e}s and Herrera, Reyes S. and M{\'a}rquez, Marco A. and Calder{\'o}n, Antonio Jos{\'e} and Gonz{\'a}lez, Isa{\'\i}as and And{\'u}jar, Jos{\'e} Manuel} } @article {1127, title = {Evaluating Open-Source Full-Text Search Engines for Matching ICD-10 Codes.}, journal = {Stud Health Technol Inform}, volume = {226}, year = {2016}, month = {2016}, pages = {127-30}, abstract = {

This research presents the results of evaluating multiple free, open-source engines on matching ICD-10 diagnostic codes via full-text searches. The study investigates what it takes to get an accurate match when searching for a specific diagnostic code. For each code the evaluation starts by extracting the words that make up its text and continues with building full-text search queries from the combinations of these words. The queries are then run against all the ICD-10 codes until a match indicates the code in question as a match with the highest relative score. This method identifies the minimum number of words that must be provided in order for the search engines choose the desired entry. The engines analyzed include a popular Java-based full-text search engine, a lightweight engine written in JavaScript which can even execute on the user{\textquoteright}s browser, and two popular open-source relational database management systems.

}, issn = {0926-9630}, author = {Jurc{\u a}u, Daniel-Alexandru and Stoicu-Tivadar, Vasile} } @article {1006, title = {Enabling Better Interoperability for HealthCare: Lessons in Developing a Standards Based Application Programing Interface for Electronic Medical Record Systems.}, journal = {J Med Syst}, volume = {39}, year = {2015}, month = {2015 Nov}, pages = {182}, abstract = {

We sought to enable better interoperability and easy adoption of healthcare applications by developing a standardized domain independent Application Programming Interface (API) for an Electronic Medical Record (EMR) system. We leveraged the modular architecture of the Open Medical Record System (OpenMRS) to build a Fast Healthcare Interoperability Resources (FHIR) based add-on module that could consume FHIR resources and requests made on OpenMRS. The OpenMRS FHIR module supports a subset of FHIR resources that could be used to interact with clinical data persisted in OpenMRS. We demonstrate the ease of connecting healthcare applications using the FHIR API by integrating a third party Substitutable Medical Apps \& Reusable Technology (SMART) application with OpenMRS via FHIR. The OpenMRS FHIR module is an optional component of the OpenMRS platform. The FHIR API significantly reduces the effort required to implement OpenMRS by preventing developers from having to learn or work with a domain specific OpenMRS API. We propose an integration pathway where the domain specific legacy OpenMRS API is gradually retired in favor of the new FHIR API, which would be integrated into the core OpenMRS platform. Our efforts indicate that a domain independent API is a reality for any EMR system. These efforts demonstrate the adoption of an emerging FHIR standard that is seen as a replacement for both Health Level 7 (HL7) Version 2 and Version 3. We propose a gradual integration approach where our FHIR API becomes the preferred method for communicating with the OpenMRS platform.

}, issn = {1573-689X}, doi = {10.1007/s10916-015-0356-6}, author = {Kasthurirathne, Suranga N and Mamlin, Burke and Kumara, Harsha and Grieve, Grahame and Biondich, Paul} } @article {1002, title = {Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS.}, journal = {J Biomed Inform}, volume = {53}, year = {2015}, month = {2015 Feb}, pages = {390-404}, abstract = {

Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.

}, issn = {1532-0480}, doi = {10.1016/j.jbi.2014.11.012}, author = {Zaidan, A A and Zaidan, B B and Al-Haiqi, Ahmed and Kiah, M L M and Hussain, Muzammil and Abdulnabi, Mohamed} } @article {1031, title = {Evaluation of software maintain ability with open EHR - a comparison of architectures.}, journal = {Int J Med Inform}, volume = {83}, year = {2014}, month = {2014 Nov}, pages = {849-59}, abstract = {

PURPOSE: To assess whether it is easier to maintain a clinical information system developed using open EHR model driven development versus mainstream methods.

METHODS: A new open source application (GastrOS) has been developed following open EHR{\textquoteright}s multi-level modelling approach using .Net/C$\#$ based on the same requirements of an existing clinically used application developed using Microsoft Visual Basic and Access database. Almost all the domain knowledge was embedded into the software code and data model in the latter. The same domain knowledge has been expressed as a set of open EHR Archetypes in GastrOS. We then introduced eight real-world change requests that had accumulated during live clinical usage, and implemented these in both systems while measuring time for various development tasks and change in software size for each change request.

RESULTS: Overall it took half the time to implement changes in GastrOS. However it was the more difficult application to modify for one change request, suggesting the nature of change is also important. It was not possible to implement changes by modelling only. Comparison of relative measures of time and software size change within each application highlights how architectural differences affected maintain ability across change requests.

CONCLUSIONS: The use of open EHR model driven development can result in better software maintain ability. The degree to which open EHR affects software maintain ability depends on the extent and nature of domain knowledge involved in changes. Although we used relative measures for time and software size, confounding factors could not be totally excluded as a controlled study design was not feasible.

}, keywords = {Data Curation, electronic health records, Information Dissemination, Information Storage and Retrieval, Meaningful Use, Software, Software Design}, issn = {1872-8243}, doi = {10.1016/j.ijmedinf.2014.07.006}, author = {Atalag, Koray and Yang, Hong Yul and Tempero, Ewan and Warren, James R} } @article {1025, title = {Experience of using an open source clinical trials data management software system in Kenya.}, journal = {BMC Res Notes}, volume = {7}, year = {2014}, month = {2014}, pages = {845}, abstract = {

BACKGROUND: Clinical trials data management (CTDM) remains one of the many challenges in running state of the art trials in resource-poor settings since most trials do not allocate, or have available, sufficient resources for CTDM and because of poor internet connectivity. Open-source software like OpenClinica could be a solution in such scenarios.

FINDINGS: In 2007, the KEMRI-Wellcome Trust Research Programme (KWTRP) adopted OpenClinica (OC) community edition, an open-source software system and we share our experience and lessons learnt since its adoption. We have used OC in three different modes; direct remote data entry from sites through Global System for Mobile Communications (GSM) modems, a centralized data centre approach where all data from paper records were entered at a central location and an off-line approach where data entry was done from a copy of database hosted on a field-site server laptop, then data uploaded to a centralized server later. We have used OC in eleven trials/studies with a cumulative number of participants in excess of 6000. These include large and complex trials, with multiple sites recruiting in different regions of East Africa. In the process, we have developed substantial local capacity through hands-on training and mentorship, which we have now begun to share with other institutions in the region.

CONCLUSIONS: Our experience demonstrates that an open source data management system to manage trials{\textquoteright} data can be utilized to international industry standards in resource-poor countries.

}, issn = {1756-0500}, doi = {10.1186/1756-0500-7-845}, author = {Ngari, Moses M and Waithira, Naomi and Chilengi, Roma and Njuguna, Patricia and Lang, Trudie and Fegan, Greg} } @article {945, title = {ExpertEyes: Open-source, high-definition eyetracking.}, journal = {Behav Res Methods}, year = {2014}, month = {2014 Jun 17}, abstract = {

ExpertEyes is a low-cost, open-source package of hardware and software that is designed to provide portable high-definition eyetracking. The project involves several technological innovations, including portability, high-definition video recording, and multiplatform software support. It was designed for challenging recording environments, and all processing is done offline to allow for optimization of parameter estimation. The pupil and corneal reflection are estimated using a novel forward eye model that simultaneously fits both the pupil and the corneal reflection with full ellipses, addressing a common situation in which the corneal reflection sits at the edge of the pupil and therefore breaks the contour of the ellipse. The accuracy and precision of the system are comparable to or better than what is available in commercial eyetracking systems, with a typical accuracy of less than 0.4{\textdegree} and best accuracy below 0.3{\textdegree}, and with a typical precision (SD method) around 0.3{\textdegree} and best precision below 0.2{\textdegree}. Part of the success of the system comes from a high-resolution eye image. The high image quality results from uncasing common digital camcorders and recording directly to SD cards, which avoids the limitations of the analog NTSC format. The software is freely downloadable, and complete hardware plans are available, along with sources for custom parts.

}, issn = {1554-3528}, doi = {10.3758/s13428-014-0465-z}, author = {Parada, Francisco J and Wyatte, Dean and Yu, Chen and Akavipat, Ruj and Emerick, Brandi and Busey, Thomas} } @article {1010, title = {E-health systems for management of MDR-TB in resource-poor environments: a decade of experience and recommendations for future work.}, journal = {Stud Health Technol Inform}, volume = {192}, year = {2013}, month = {2013}, pages = {627-31}, abstract = {

INTRODUCTION: Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring.

METHODS: Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments.

RESULTS: We describe here the experience with implementing these systems and evaluating many aspects of their performance, and review other systems for MDR-TB management.

CONCLUSIONS: We recommend a new approach to information systems to address the barriers to scale up MDR-TB treatment, particularly access to the appropriate drugs and lab data. We propose moving away from fragmented, vertical systems to focus on common platforms, addressing all stages of TB care, support for open data standards and interoperability, care for a wide range of diseases including HIV, integration with mHealth applications, and ability to function in resource-poor environments.

}, keywords = {Developing Countries, electronic health records, Electronic Prescribing, Extensively Drug-Resistant Tuberculosis, Haiti, Health Information Management, Humans, Medication Systems, Hospital, Pakistan, Remote Consultation}, issn = {0926-9630}, author = {Fraser, Hamish S F and Habib, Ali and Goodrich, Mark and Thomas, David and Blaya, Joaquin A and Fils-Aime, Joseph Reginald and Jazayeri, Darius and Seaton, Michael and Khan, Aamir J and Choi, Sharon S and Kerrison, Foster and Falzon, Dennis and Becerra, Mercedes C} } @article {840, title = {The Evolving Role of Open Source Software in Medicine and Health Services}, journal = {Technology Innovation Management Review}, year = {2013}, month = {01/2013}, pages = {32-39}, abstract = {The past five decades have witnessed immense coevolution of methods and tools of information technology, and their practical and experimental application within the medical and healthcare domain. Healthcare itself continues to evolve in response to change in healthcare needs, progress in the scientific foundations of treatments, and in professional and managerial organization of affordable and effective services, in which patients and their families and carers increasingly participate. Taken together, these trends impose highly complex underlying challenges for the design, development, and sustainability of the quality of supporting information services and software infrastructure that are needed. The challenges are multidisciplinary and multiprofessional in scope, and they require deeper study and learning to inform policy and promote public awareness of the problems health services have faced in this area for many years. The repeating pattern of failure to live up to expectations of policy-driven national health IT initiatives has proved very costly and remains frustrating and unproductive for all involved. In this article, we highlight the barriers to progress and discuss the dangers of pursuing a standardization framework devoid of empirical testing and iterative development. We give the example of the openEHR Foundation, which was established at University College London (UCL) in London, England, with members in 80 countries. The Foundation is a not-for-profit company providing open specifications and working for generic standards for electronic records, informed directly by a wide range of implementation experience. We also introduce the Opereffa open source framework, which was developed at UCL based on these specifications and which has been downloaded in some 70 countries. We argue that such an approach is now essential to support good discipline, innovation, and governance at the heart of medicine and health services, in line with the new mandate for health commissioning in the United Kingdom{\textquoteright}s National Health Service (NHS), which emphasizes patient participation, innovation, transparency, and accountability.}, keywords = {electronic health care record, information retrieval, open source framework, openEHR Foundation, persistence, standards based}, issn = {1927-0321}, author = {David Ingram and Sevket Seref Arikan} } @conference {Helms:2011:EAC:1987993.1988006, title = {Evaluating access control of open source electronic health record systems}, booktitle = {Proceeding of the 3rd workshop on Software engineering in health care}, series = {SEHC {\textquoteright}11}, year = {2011}, pages = {63{\textendash}70}, publisher = {ACM}, organization = {ACM}, address = {New York, NY, USA}, abstract = {Incentives and penalties for healthcare providers as laid out in the American Recovery and Reinvestment Act of 2009 have caused tremendous growth in the development and installation of electronic health record (EHR) systems in the US. For the benefit of protecting patient privacy, regulations and certification criteria related to EHR systems stipulate the use of access control of protected health information. The goal of this research is to guide development teams, regulators, and certification bodies by assessing the state of the practice in EHR access control. In this paper, we present a compilation of 25 criteria relative to access control in EHR systems found in the Health Insurance Portability and Accountability Act (HIPAA) regulation, meaningful use certification criteria, best practices embodied in the National Institute for Standards and Technology (NIST) role-based access control standard, and other best practices found in the literature. We then examine the state of the practice in access control by evaluating four open source EHR systems using these 25 evaluation criteria. Our research indicates that the NIST Meaningful Use criteria provide HIPAA compliance, but none of the regulatory and certification criteria address the implementation standards, and best practices related to access control. Additionally, our results indicate that open source EHR system designers are not implementing robust access control mechanisms for the adequate protection of patient data.}, keywords = {access control, electronic health records, health it, healthcare, privacy, role-based access control}, isbn = {978-1-4503-0585-3}, doi = {http://doi.acm.org/10.1145/1987993.1988006}, author = {Helms, Eric and Williams, Laurie} } @article {20517664, title = {E-health integration and interoperability based on open-source information technology.}, journal = {Wiener klinische Wochenschrift}, volume = {122 Suppl 2}, year = {2010}, month = {2010 May}, pages = {3-10}, author = {Dinevski, Dejan and Poli, Andrea and Krajnc, Ivan and Sustersic, Olga and Arh, Tanja} } @article {904, title = {Electronic data capture for registries and clinical trials in orthopaedic surgery: Open source versus commercial systems}, journal = {Clinical Orthopaedics and Related Research}, volume = {468}, year = {2010}, pages = {2664{\textendash}2671}, abstract = {Background: Collection and analysis of clinical data can help orthopaedic surgeons to practice evidence based medicine. Spreadsheets and offline relational databases are prevalent, but not flexible, secure, workflow friendly and do not support the generation of standardized and interoperable data. Additionally these data collection applications usually do not follow a structured and planned approach which may result in failure to achieve the intended goal. Questions/purposes: Our purposes are (1) to provide a brief overview of EDC systems, their types, and related pros and cons as well as to describe commonly used EDC platforms and their features; and (2) describe simple steps involved in designing a registry/clinical study in DADOS P, an open source EDC system. Where are we now?: Electronic data capture systems aimed at addressing these issues are widely being adopted at an institutional/national/ international level but are lacking at an individual level. A wide array of features, relative pros and cons and different business models cause confusion and indecision among orthopaedic surgeons interested in implementing EDC systems. Where do we need to go?: To answer clinical questions and actively participate in clinical studies, orthopaedic surgeons should collect data in parallel to their clinical activities. Adopting a simple, user-friendly, and robust EDC system can facilitate the data collection process. How do we get there?: Conducting a balanced evaluation of available options and comparing them with intended goals and requirements can help orthopaedic surgeons to make an informed choice. {\textcopyright} 2010 The Association of Bone and Joint Surgeons{\textregistered}.}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-77957336660\&partnerID=40\&md5=dec3706be86215e9656a06f82265cb28}, author = {Shah, J.a b and Rajgor, D.a b and Pradhan, S.a b and McCready, M.c and Zaveri, A.a d and Pietrobon, R.c} } @article {611, title = {Evaluation of adaptive radiotherapy of bladder cancer by image-based tumour control probability modelling.}, journal = {Acta oncologica (Stockholm, Sweden)}, volume = {49}, year = {2010}, month = {2010 Oct}, pages = {1045-51}, abstract = {Clinical implementation of adaptive radiotherapy strategies could benefit from extended tools for plan evaluation and selection. For this purpose we investigated the feasibility of image-based tumour control probability (TCP) modelling using the bladder as example of a tumour site with potential benefit from adaptive strategies.}, keywords = {Carcinoma, Computer Simulation, Humans, Image Processing, Computer-Assisted, Models, Statistical, Probability, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Radiotherapy, Conformal, Tumor Burden, Urinary Bladder, Urinary Bladder Neoplasms}, issn = {1651-226X}, author = {Wright, Pauliina and Muren, Ludvig P and H{\o}yer, Morten and Malinen, Eirik} } @article {1016, title = {Experience implementing a point-of-care electronic medical record system for primary care in Malawi.}, journal = {Stud Health Technol Inform}, volume = {160}, year = {2010}, month = {2010}, pages = {96-100}, abstract = {

Due to the fact that health care professionals in Malawi are often overstretched, the use and quality of health data can be compromised. The Malawi Health Management Information System (HMIS) has streamlined data collection and reporting and increased the use of data to improve care. Obstacles remain, including incomplete reporting and low staff morale. With the Baobab Health Trust and the Malawi Ministry of Health, Partners In Health piloted an innovative point-of-care data system for primary care that functions alongside OpenMRS, an open source medical record platform. The system has given access to a patient-level primary care dataset in real time. Initial results highlight some of the benefits of a point-of-care system such as improved data quality, emphasize the importance of sharing data with clinical practitioners, and shed light on how this approach could strengthen HMIS.

}, keywords = {Database Management Systems, electronic health records, Equipment Design, Information Storage and Retrieval, Malawi, Point-of-Care Systems, Primary Health Care, Software}, issn = {0926-9630}, author = {Waters, Evan and Rafter, Jeff and Douglas, Gerald P and Bwanali, Mwatha and Jazayeri, Darius and Fraser, Hamish S F} } @article {1015, title = {Experience implementing OpenMRS to support maternal and reproductive health in Northern Nigeria.}, journal = {Stud Health Technol Inform}, volume = {160}, year = {2010}, month = {2010}, pages = {332-6}, abstract = {

In Northern Nigeria a deteriorating health system has resulted in one of the World{\textquoteright}s highest rates of maternal and infant deaths. The dire situation in Northern Nigeria is only amplified by the lack of an effective health information system, leaving hospitals and clinics to make decisions about patient care with only uninformed guesses about medical history and access to unreliable and unintelligible patient registers and summary reports. In 2009 we implemented an electronic medical records system using OpenMRS for the Family Health Unit of the Shehu Idris College. The three-month process resulted in electronic forms for all clinical areas, greatly reduced data duplication and a monthly reporting process that takes minutes instead of days. This system provides not only access to the first patient-based health indicators in Nigeria (as opposed to previously error-prone aggregate data) but is also an example of the potential to overcome the harsh computing environment in Nigeria to implement eHealth systems that will improve the quality of patient care.

}, keywords = {Delivery of Health Care, electronic health records, Maternal Health Services, Maternal Welfare, Models, Organizational, Needs Assessment, Nigeria, Reproductive Medicine, Utilization Review}, issn = {0926-9630}, author = {Thompson, Adam and Castle, Evelyn and Lubeck, Paul and Makarfi, Provost Shehu} } @article {20409608, title = {The extensible open-source rigid and affine image registration module of the Medical Imaging Interaction Toolkit (MITK).}, journal = {Computer methods and programs in biomedicine}, year = {2010}, month = {2010 Apr 19}, abstract = {Although non-rigid registration methods are available or under development for many specific problems in medicine, rigid and affine registration is an important task that is often performed for pre-aligning images before using non-rigid registration. In this paper, we present a free and open-source application for rigid and affine image registration, which is designed both for developers and for end-users. The application is based on the Medical Imaging Interaction Toolkit (MITK) and allows for inter-modality and intra-modality rigid 2D-2D and 3D-3D registration of medical images such as CT, MRI, or ultrasound. The framework as well as the application can be easily extended by adding new transforms, metrics and optimizers. Thus, developers of new algorithms are enabled to test and use their algorithms more quickly, spending less work on user interfaces. Additionally, the framework provides the possibility to use image masks to restrict the evaluation of metric values by the optimizer on certain areas of the images.}, author = {Stein, D and Fritzsche, K H and Nolden, M and Meinzer, H P and Wolf, I} } @article {586, title = {The extensible open-source rigid and affine image registration module of the Medical Imaging Interaction Toolkit (MITK).}, journal = {Computer methods and programs in biomedicine}, volume = {100}, year = {2010}, month = {2010 Oct}, pages = {79-86}, abstract = {Although non-rigid registration methods are available or under development for many specific problems in medicine, rigid and affine registration is an important task that is often performed for pre-aligning images before using non-rigid registration. In this paper, we present a free and open-source application for rigid and affine image registration, which is designed both for developers and for end-users. The application is based on the Medical Imaging Interaction Toolkit (MITK) and allows for inter-modality and intra-modality rigid 2D-2D and 3D-3D registration of medical images such as CT, MRI, or ultrasound. The framework as well as the application can be easily extended by adding new transforms, metrics and optimizers. Thus, developers of new algorithms are enabled to test and use their algorithms more quickly, spending less work on user interfaces. Additionally, the framework provides the possibility to use image masks to restrict the evaluation of metric values by the optimizer on certain areas of the images.}, keywords = {Computers, Diagnostic Imaging, Image Enhancement, Image Interpretation, Computer-Assisted, Pattern Recognition, Automated, Software, User-Computer Interface}, issn = {1872-7565}, author = {Stein, D and Fritzsche, K H and Nolden, M and Meinzer, H P and Wolf, I} } @article {18952940, title = {Electronic Support for Public Health: validated case finding and reporting for notifiable diseases using electronic medical data.}, journal = {Journal of the American Medical Informatics Association : JAMIA}, volume = {16}, year = {2009}, month = {2009 Jan-Feb}, pages = {18-24}, abstract = {Health care providers are legally obliged to report cases of specified diseases to public health authorities, but existing manual, provider-initiated reporting systems generally result in incomplete, error-prone, and tardy information flow. Automated laboratory-based reports are more likely accurate and timely, but lack clinical information and treatment details. Here, we describe the Electronic Support for Public Health (ESP) application, a robust, automated, secure, portable public health detection and messaging system for cases of notifiable diseases. The ESP application applies disease specific logic to any complete source of electronic medical data in a fully automated process, and supports an optional case management workflow system for case notification control. All relevant clinical, laboratory and demographic details are securely transferred to the local health authority as an HL7 message. The ESP application has operated continuously in production mode since January 2007, applying rigorously validated case identification logic to ambulatory EMR data from more than 600,000 patients. Source code for this highly interoperable application is freely available under an approved open-source license at http://esphealth.org.}, author = {Lazarus, Ross and Klompas, Michael and Campion, Francis X and McNabb, Scott J N and Hou, Xuanlin and Daniel, James and Haney, Gillian and DeMaria, Alfred and Lenert, Leslie and Platt, Richard} } @article {496, title = {Establishing a personal electronic health record in the Rhine-Neckar region.}, journal = {Studies in health technology and informatics}, volume = {150}, year = {2009}, month = {2009}, pages = {119}, abstract = {We present an approach to establish a personal and electronic health record (PEHR) system in our region, and describe the underlying vision, the technical aspects, the current status as well as the gained experiences. Applied are international standards (HL7, DICOM) and technologies existing today. Obstacles to overcome during the implementation have been the management of access rights, data privacy as well as the integration of the primary systems.}, keywords = {Germany, Medical Records Systems, Computerized, Organizational Case Studies, Program Development, Regional Health Planning}, issn = {0926-9630}, author = {Heinze, Oliver and Brandner, Antje and Bergh, Bj{\"o}rn} } @article {17947615, title = {Early experiences with personal health records.}, journal = {Journal of the American Medical Informatics Association : JAMIA}, volume = {15}, year = {2008}, month = {2008 Jan-Feb}, pages = {1-7}, abstract = {Over the past year, several payers, employers, and commercial vendors have announced personal health record projects. Few of these are widely deployed and few are fully integrated into ambulatory or hospital-based electronic record systems. The earliest adopters of personal health records have many lessons learned that can inform these new initiatives. We present three case studies--MyChart at Palo Alto Medical Foundation, PatientSite at Beth Israel Deaconess Medical Center, and Indivo at Children{\textquoteright}s Hospital Boston. We describe our implementation challenges from 1999 to 2007 and postulate the evolving challenges we will face over the next five years.}, author = {Halamka, John D and Mandl, Kenneth D and Tang, Paul C} } @article {18302744, title = {Epigrass: a tool to study disease spread in complex networks.}, journal = {Source code for biology and medicine}, volume = {3}, year = {2008}, month = {2008}, pages = {3}, abstract = {BACKGROUND: The construction of complex spatial simulation models such as those used in network epidemiology, is a daunting task due to the large amount of data involved in their parameterization. Such data, which frequently resides on large geo-referenced databases, has to be processed and assigned to the various components of the model. All this just to construct the model, then it still has to be simulated and analyzed under different epidemiological scenarios. This workflow can only be achieved efficiently by computational tools that can automate most, if not all, these time-consuming tasks. In this paper, we present a simulation software, Epigrass, aimed to help designing and simulating network-epidemic models with any kind of node behavior. RESULTS: A Network epidemiological model representing the spread of a directly transmitted disease through a bus-transportation network connecting mid-size cities in Brazil. Results show that the topological context of the starting point of the epidemic is of great importance from both control and preventive perspectives. CONCLUSION: Epigrass is shown to facilitate greatly the construction, simulation and analysis of complex network models. The output of model results in standard GIS file formats facilitate the post-processing and analysis of results by means of sophisticated GIS software.}, author = {Coelho, Fl{\'a}vio C and Cruz, Oswaldo G and Code{\c c}o, Cl{\'a}udia T} } @mastersthesis {889, title = {An empirical investigation into the adoption of open source software in hospitals}, year = {2007}, school = {University of Maryland at Baltimore County}, type = {phd}, address = {Catonsville, MD, USA}, abstract = {Information technology holds great promise for reducing cost and improving quality in health care. Open source software (OSS) has emerged as a potential alternative to commercial and closed-source products in many domains. OSS has gained considerable attention recently in the health care arena, and proponents claim that it overcomes many of the obstacles to IT adoption that health care organizations face. Yet, how and why OSS is being adopted and implemented within hospitals in particular remains a poorly understood issue. This research attempts to further this understanding so that hospitals may make better informed decisions about adoption of IT, and OSS in particular, in the future. We use a qualitative grounded theory approach in order to explore the extent of OSS adoption in hospitals as well as the factors facilitating and inhibiting adoption. Surveys and interviews are used to acquire both breadth and depth of understanding. First, a survey was used to explore and characterize the types of OSS products adopted in hospitals and the extent to which they have been adopted. For methodological reasons, we focused on Baltimore, Washington and Northern Virginia area hospitals. Following the survey, semi-structured interviews were conducted with hospital IT managers in order to attain a deeper understanding of the factors that are facilitating and inhibiting the adoption of OSS in hospitals. The findings suggest a very limited adoption of OSS in hospitals. Adopters tend to be very large hospitals, with IT budgets of less than 3\% of the total budget and a large number of IT support staff. The results also show that hospitals tend to adopt general-purpose instead of domain-specific OSS. We also found that hospital software vendors are the critical factor facilitating the adoption of OSS in hospitals. Conversely, lack of in-house development, as well as a perceived lack of security, quality, and accountability of OSS products were factors found to be inhibiting adoption. An empirical model describing the adoption of OSS in hospitals, based upon our findings, is presented to illustrate the factors facilitating and inhibiting the adoption of OSS in hospitals.}, isbn = {978-0-549-35501-4}, author = {Munoz-Cornejo, Gilberto} } @article {15924271, title = {Establishing a Web-based DICOM teaching file authoring tool using open-source public software.}, journal = {Journal of digital imaging : the official journal of the Society for Computer Applications in Radiology}, volume = {18}, year = {2005}, month = {2005 Sep}, pages = {169-75}, abstract = {Online teaching files are an important source of educational and referential materials in the radiology community. The commonly used Digital Imaging and Communications in Medicine (DICOM) file format of the radiology community is not natively supported by common Web browsers. The ability of the Web server to convert and parse DICOM is important when the DICOM-converting tools are not available. In this paper, we describe our approach to develop a Web-based teaching file authoring tool. Our server is built using Apache Web server running on FreeBSD operating system. The dynamic page content is produced by Hypertext Preprocessor (PHP). Digital Imaging and Communications in Medicine images are converted by ImageMagick into Joint Photographic Experts Group (JPEG) format. Digital Imaging and Communications in Medicine attributes are parsed by dicom3tools and stored in PostgreSQL database. Using free software available from the Internet, we build a Web service that allows radiologists to create their own online teaching file cases with a common Web browser.}, author = {Lee, Wen-Jeng and Yang, Chung-Yi and Liu, Kao-Lang and Liu, Hon-Man and Ching, Yu-Tai and Chen, Shyh-Jye} }