Sharing of clinical data in a maternity setting: How do paper hand-held records and electronic health records compare for completeness?

Background Historically, the paper hand-held record (PHR) has been used for sharing information between hospital clinicians, general practitioners and pregnant women in a maternity shared-care environment. Recently in alignment with a National e-health agenda, an electronic health record (EHR) was introduced at an Australian tertiary maternity service to replace the PHR for collection and transfer of data. The aim of this study was to examine and compare the completeness of clinical data collected in a PHR and an EHR. Methods We undertook a comparative cohort design study to determine differences in completeness between data collected from maternity records in two phases. Phase 1 data were collected from the PHR and Phase 2 data from the EHR. Records were compared for completeness of best practice variables collected The primary outcome was the presence of best practice variables and the secondary outcomes were the differences in individual variables between the records. Results Ninety-four percent of paper medical charts were available in Phase 1 and 100% of records from an obstetric database in Phase 2. No PHR or EHR had a complete dataset of best practice variables. The variables with significant improvement in completeness of data documented in the EHR, compared with the PHR, were urine culture, glucose tolerance test, nuchal screening, morphology scans, folic acid advice, tobacco smoking, illicit drug assessment and domestic violence assessment (p = 0.001). Additionally the documentation of immunisations (pertussis, hepatitis B, varicella, fluvax) were markedly improved in the EHR (p = 0.001). The variables of blood pressure, proteinuria, blood group, antibody, rubella and syphilis status, showed no significant differences in completeness of recording. Conclusion This is the first paper to report on the comparison of clinical data collected on a PHR and EHR in a maternity shared-care setting. The use of an EHR demonstrated significant improvements to the collection of best practice variables. Additionally, the data in an EHR were more available to relevant clinical staff with the appropriate log-in and more easily retrieved than from the PHR. This study contributes to an under-researched area of determining data quality collected in patient records.

The largest Au deposits in the St Ives Goldfield (Yilgarn Craton, Western Australia) may be located in a major Neoarchean volcano-sedimentary depo-centre

The largest Neoarchean gold deposits in the world-class St Ives Goldfield, Western Australia, occur in an area known as the Argo-Junction region (e.g. Junction, Argo and Athena). Why this region is so well endowed with large deposits compared with other parts of the St Ives Goldfield is currently unclear, because gold deposits at St Ives are hosted by a variety of lithologic units and were formed during at least three different deformational events. This paper presents an investigation into the stratigraphic architecture and evolution of the Argo-Junction region to assess its implications for gold metallogenesis. The results show that the region's stratigraphy may be subdivided into five regionally correlatable packages: mafic lavas of the Paringa Basalt; contemporaneously resedimented feldspar-rich pyroclastic debris of the Early Black Flag Group; coarse polymictic volcanic debris of the Late Black Flag Group; thick piles of mafic lavas and sub-volcanic sills of the Athena Basalt and Condenser Dolerite; and the voluminous quartz-rich sedimentary successions of the Early Merougil Group. In the Argo-Junction region, these units have an interpreted maximum thickness of at least 7,130 m, and thus represent an unusually thick accumulation of the Neoarchean volcano-sedimentary successions. It is postulated that major basin-forming structures that were active during deposition and emplacement of the voluminous successions later acted as important conduits during mineralisation. Therefore, a correlation exists between the location of the largest gold deposits in the St Ives Goldfield and the thickest parts of the stratigraphy. Recognition of this association has important implications for camp-scale exploration.

Paper and electronic antenatal records: What do women and health care providers tell us about their use?

The antenatal paper hand-held record (PHR) has been used extensively in general practice (GP) shared-care management of pregnant women, but recently the antenatal electronic health record (EHR) was introduced. This study aimed to examine the experiences of women and health care providers who use the PHR and the EHR, and find out the relative role of these records in the integration of care. Purposive homogenous samples of women and health care providers were interviewed as users of the PHR in phase 1 and the EHR in phase 2 of the study. Qualitative data were collected via interview with women and GPs and focus groups held with hospital health care providers. Interviews were coded manually and analysed using qualitative content analysis. Fifteen women participated in phase 1 and 12 in phase 2. Seventeen GPs participated in phase 1 and 15 in phase 2. Five focus groups with hospital health care providers were conducted in each phase. Results were categorised into four themes: 1. Record purpose; 2. Perception of the record; 3. Content of the record, and; 4. Sharing information in the record. Both women and health care providers were familiar with the PHR, but identified that some information was missing or not utilised well, and reported underuse of the EHR. The study identified continued widespread use of the PHR and several issues concerning the use of the EHR. An improvement in the strategic implementation of the EHR is suggested as a mechanism to facilitate its wider adoption.

From maternity paper hand-held records to electronic health records: What do women tell us about their use?

The paper hand-held record (PHR) has been used extensively in general practice (GP) shared care management of pregnant women, and recently, the first Mater Shared Electronic Health Record (MSEHR) was introduced. The aim of this qualitative study was to examine women’s experiences using the records and the contribution of the records to integrate care. At the 36-week antenatal visit in a maternity tertiary centre clinic, women were identified as a user of either the PHR or the MSEHR and organised into Phase 1 and Phase 2 studies respectively. Fifteen women were interviewed in Phase 1 and 12 women in Phase 2. Semi-structured interviews were used for data collection, and analysed using qualitative content analysis. Four main themes were identified: (1) purpose of the record; (2) perceptions of the record; (3) content of the record, and; (4) sharing the record. Findings indicate that the PHR is a well-liked maternity tool. The findings also indicate there is under-usage of the MSEHR due to health-care providers failing to follow up and discuss the option of using the electronic health record option or if a woman has completed the log-in process. This paper adds to an already favourable body of knowledge about the use of the PHR. It is recommended that continued implementation of the MSEHR be undertaken to facilitate its use.

Document timespan normalisation and understanding temporality for clinical records search

Previous qualitative research has highlighted that temporality plays an important role in relevance for clinical records search. In this study, an investigation is undertaken to determine the effect that the timespan of events within a patient record has on relevance in a retrieval scenario. In addition, based on the standard practise of document length normalisation, a document timespan normalisation model that specifically accounts for timespans is proposed. Initial analysis revealed that in general relevant patient records tended to cover a longer timespan of events than non-relevant patient records. However, an empirical evaluation using the TREC Medical Records track supports the opposite view that shorter documents (in terms of timespan) are better for retrieval. These findings highlight that the role of temporality in relevance is complex and how to effectively deal with temporality within a retrieval scenario remains an open question.

Response to: Electronic health records and healthcare identifiers : legislation discussion paper

Public submission # 029 to a Australian federal parliamentary committee considering proposed legislative changes to the Commonwealth's Healthcare Identifiers Act 2010 and the Personally Controlled Electronic Health Records Act 2012.

Shariah perspective on marriage contract and practice in contemporary Muslim societies

Forced marriages are worldwide phenomena and also exist in Pakistani society. It involves the lack of free and full consent of at least one of the parties to a marriage. Mostly, females are victims of forced marriages. It is prevalent in the name of religion in many Muslim countries; however, it is purely a traditional and cultural phenomenon which has nothing to do with religion. Forced marriages are different from arranged marriages in which both parties freely consent to enter into marriage contract and they have no objection on the choice of partner selected by their parents. This study will highlights different forms of forced marriages in Pakistani society.

Using an ‘interpretative model’ for contextual design of heritage landscape databases: The case of St Helena Island National Park in Queensland, Australia

Due to the increasing speed of landscape changes and the massive development of computer technologies, the methods of representing heritage landscapes using digital tools have become a worldwide concern in conservation research. The aim of this paper is to demonstrate how an ‘interpretative model’ can be used for contextual design of heritage landscape information systems. This approach is explored through building a geographic information system database for St Helena Island national park in Moreton Bay, South East Queensland, Australia. Stakeholders' interpretations of this landscape were collected through interviews, and then used as a framework for designing the database. The designed database is a digital inventory providing contextual descriptions of the historic infrastructure remnants on St Helena Island. It also reveals the priorities of different sites in terms of historic research, landscape restoration, and tourism development. Additionally, this database produces thematic maps of the intangible heritage values, which could be used for landscape interpretation. This approach is different from the existing methods because building a heritage information system is deemed as an interpretative activity, rather than a value-free replication of the physical environment. This approach also shows how a cultural landscape methodology can be used to create a flexible information system for heritage conservation. The conclusion is that an ‘interpretative model’ of database design facilitates a more explicit focus on information support, and is a potentially effective approach to user-centred design of geographic information systems.

Roy Kenzie Kiyooka

Roy Kenzie Kiyooka Canadian, born 1926 Roy Kiyooka was born in Moose Jaw, Saskatchewan in 1926. Throughout his career, he was known as a painter, photographer, sculptor, poet, musician, filmmaker and teacher. He studied at the Provincial Institute of Technology and Art in Calgary from 1946-49, and then at the Instituto Allende in Mexico in 1955. During the summers of 1958 - 1960 he attended the Emma Lake Workshops in Saskatchewan, where he worked closely with Barnett Newman and Clement Greenberg. In 1959 he executed his first series of abstract paintings, The Hoarfrost Series, which assume a disciplined minimal quality. In the late 1960's Kiyooka began to push beyond painting and created mixed media works, including collage, photography, film and poetry. Kiyooka’s art is born out of personal experience and through it he records his relationship to the surrounding landscape; a night in a motel, a trip to the coast, or hoarfrost on the trees. Through the unfolding of Kiyooka’s interior/exterior landscapes he shares his personal journeys with us all. The Art Gallery of Ontario's collection of Roy Kiyooka's work began with the purchase of two paintings; Barometer No. 2, in 1964 and Surya, in 1987.

Personal health records as sources of productivity evidence

Capturing data from various data repositories and integrating them for productivity improvements is common in modern business organisations. With the well-accepted concept of achieving positive gains through investment in employee health and wellness, organisations have started to capture both employee health and non-health data as Employer Sponsored electronic Personal Health Records (ESPHRs). However, non-health related data in ESPHRs has hardly been taken into consideration with outcomes such as employee productivity potentially being suited for further validation and stimulation of ESPHR usage. Here we analyse selected employee demographic information (age, gender, marital status, and job grade) and health-related outcomes (absenteeism and presenteeism) of employees for evidence-based decision making. Our study considered demographic and health-related outcomes of 700 employees. Surprisingly, the analysis shows that employees with high sick leave rates are also high performers. A factor analysis shows 92% of the variance in the data can be explained by three factors, with the job grade capable of explaining 62% of the variance. Work responsibilities may drive employees to maintain high work performance despite signs of sickness, so ESPHRs should focus attention on high performers. This finding suggests new ways of extracting value from ESPHRs to support organisational health and wellness management to help assure sustainability in organisational productivity.