Post-COVID conditions and healthcare utilization among adults with and without disabilities—2021 Porter Novelli FallStyles survey
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Health Care Sciences & Services↗
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Process mining for healthcare: Characteristics and challenges
Process mining techniques can be used to analyse business processes using the data logged during their execution. These techniques are leveraged in a wide range of domains, including healthcare, where it focuses mainly on the analysis of diagnostic, treatment, and organisational processes. Despite the huge amount of data generated in hospitals by staff and machinery involved in healthcare processes, there is no evidence of a systematic uptake of process mining beyond targeted case studies in a research context. When developing and using process mining in healthcare, distinguishing characteristics of healthcare processes such as their variability and patient-centred focus require targeted attention. Against this background, the Process-Oriented Data Science in Healthcare Alliance has been established to propagate the research and application of techniques targeting the data-driven improvement of healthcare processes. This paper, an initiative of the alliance, presents the distinguishing characteristics of the healthcare domain that need to be considered to successfully use process mining, as well as open challenges that need to be addressed by the community in the future.
59 BASIC BIOLOGICAL SCIENCES↗
Communication Requirements in 5G-Enabled Healthcare Applications: Review and Considerations
Fifth generation (5G) mobile communication technology can enable novel healthcare applications and augment existing ones. However, 5G-enabled healthcare applications demand diverse technical requirements for radio communication. Knowledge of these requirements is important for developers, network providers, and regulatory authorities in the healthcare sector to facilitate safe and effective healthcare. In this paper, we review, identify, describe, and compare the requirements for communication key performance indicators in relevant healthcare use cases, including remote robotic-assisted surgery, connected ambulance, wearable and implantable devices, and service robotics for assisted living, with a focus on quantitative requirements. We also compare 5G-healthcare requirements with the current state of 5G capabilities. Finally, we identify gaps in the existing literature and highlight considerations for this space.
5G networks↗
Credible practice of modeling and simulation in healthcare: ten rules from a multidisciplinary perspective
The complexities of modern biomedicine are rapidly increasing. Thus, modeling and simulation have become increasingly important as a strategy to understand and predict the trajectory of pathophysiology, disease genesis, and disease spread in support of clinical and policy decisions. In such cases, inappropriate or ill-placed trust in the model and simulation outcomes may result in negative outcomes, and hence illustrate the need to formalize the execution and communication of modeling and simulation practices. Although verification and validation have been generally accepted as significant components of a model’s credibility, they cannot be assumed to equate to a holistic credible practice, which includes activities that can impact comprehension and in-depth examination inherent in the devel-opment and reuse of the models. For the past several years, the Committee on Credible Practice of Modeling and Simulation in Healthcare, an interdisciplinary group seeded from a U.S. interagency initiative, has worked to codify best practices. Here, we provide Ten Rules for credible practice of modeling and simulation in healthcare developed from a comparative analysis by the Committee’s multidisciplinary membership, followed by a large stakeholder com-munity survey. These rules establish a unified conceptual framework for modeling and simulation design, implementation, evaluation, dissemination and usage across the modeling and simulation life-cycle. While biomedical science and clinical care domains have somewhat different requirements and expectations for credible practice, our study converged on rules that would be useful across a broad swath of model types. In brief, the rules are: (1) Define context clearly. (2) Use contextually appropriate data. (3) Evaluate within context. (4) List limitations explicitly. (5) Use version control. (6) Document appropriately. (7) Disseminate broadly. (8) Get independent reviews. (9) Test competing imple-mentations. (10) Conform to standards. Although some of these are common sense guidelines, we have found that many are often missed or misconstrued, even by seasoned practitioners. Computational models are already widely used in basic science to generate new biomedical knowledge. As they penetrate clinical care and healthcare policy, contributing to personalized and precision medicine, clinical safety will require established guidelines for the credible practice of modeling and simulation in healthcare.
Credibility↗
TEACH (Train to Enable/Achieve Culturally Sensitive Healthcare)
Personnel from diverse ethnic and demographic backgrounds come together in both civilian and military healthcare systems, facing diagnoses that at one level are equalizers: coronary disease is coronary disease, breast cancer is breast cancer. Yet the expression of disease in individuals from different backgrounds, individual patient experience of disease as a particular illness, and interactions between patients and providers occurring in any given disease scenario, all vary enormously depending on the fortuity of the equation of "which patient happens to arrive in whose exam room." Previously, providers' absorption of lessons-learned depended on learning as an apprentice would when exposed over time to multiple populations. As a result, and because providers are often thrown into situations where communications falter through inadequate direct patient experience, diversity in medicine remains a training challenge. The questions then become: Can simulation and virtual training environments (VTEs) be deployed to short-track and standardize this sort of random-walk problem? Can we overcome the unevenness of training caused by some providers obtaining the valuable exposure to diverse populations, whereas others are left to "sink or swim"? This paper summarizes developing a computer-based VTE called TEACH (Training to Enable/Achieve Culturally Sensitive Healthcare). TEACH was developed to enhance healthcare providers' skills in delivering culturally sensitive care to African-American women with breast cancer. With an authoring system under development to ensure extensibility, TEACH allows users to role-play in clinical oncology settings with virtual characters who interact on the basis of different combinations of African American sub-cultural beliefs regarding breast cancer. The paper reports on the roll-out and evaluation of the degree to which these interactions allow providers to acquire, practice, and refine culturally appropriate communication skills and to achieve cultural and individual personalization of healthcare in their clinical practices.
Maulitz, Russell↗
Implementation of A Drone Delivery System for Healthcare in Mexico: International Precedents and Domestic Considerations
One of the Mexican healthcare system’s principal problems is providing access to its rural communities. Drone delivery has repeatedly proven to be a compelling and cost-effective solution to this problem elsewhere, yet there is currently no scholarship connecting global developments in drone technology to problems in the Mexican healthcare system. This paper is to outline lessons learned from drone systems in several countries, providing information on the potential target communities, technical drone and nest specs, goods of delivery, and regulation of a drone system for healthcare in Mexico.
Drone↗
Integrating Health and Energy Efficiency in Healthcare Facilities
In this report, PNNL presents a review of literature and current best practices along the intersection of energy efficiency and occupant health at U.S. healthcare facilities, including federally owned buildings. This report includes a review of building standards and certification systems for healthcare indoor environmental quality (IEQ) and research on building measures that optimize occupant health and energy efficiency. The healthcare industry includes a wide variety of services and thus facility types. This case study focuses primarily on inpatient facilities, such as hospitals.
32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
Knowledge, attitudes, and practices associated with bioterrorism preparedness in healthcare workers: a systematic review
Introduction Bioterrorism is an important issue in the field of biosecurity, and effectively dealing with bioterrorism has become an urgent task worldwide. Healthcare workers are considered bioterrorism first responders, who shoulder essential responsibilities and must be equipped to deal with bioterrorism. This study aims to extract and summarize the main research components of the bioterrorism knowledge, attitude, and practice dimensions among healthcare workers. Method This study utilized a systematic review research design based on the PRISMA 2020 guidelines. A literature search was conducted in the PubMed, Web of Science, and Scopus databases for peer-reviewed literature, and the Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of the literature. Result A total of 16 studies were included in the final selection. Through the analysis and summary of the included studies, three main aspects and 14 subaspects of the knowledge dimension, three main aspects and 10 subaspects of the attitude dimension, and two main aspects and six subaspects of the practice dimension were extracted. Conclusion This study conducted a literature review on bioterrorism knowledge, attitudes, and practices for healthcare workers based on the PRISMA 2020 guidelines. The findings can guide improvements in health literacy and provide beneficial information to professional organizations that need to respond effectively to bioterrorism.
Li, Tiantian↗
Theoretically-Driven Infrastructure for Supporting Healthcare Teams Training at a Military Treatment Facility
The Team Resource Center (TRC) at Naval Medical Center Portsmouth (NMCP) currently hosts a tri-service healthcare teams training course three times annually . The course consists of didactic learning coupled with simulation exercises to provide an interactive educational experience for healthcare professionals. The course is also the foundation of a research program designed to explore the use of simulation technologies for enhancing team training and evaluation. The TRC has adopted theoretical frameworks for evaluating training readiness and efficacy, and is using these frameworks to guide a systematic reconfiguration of the infrastructure supporting healthcare teams training and research initiatives at NMCP.
Turner, Robert T.↗
Leveraging large language models to automate the identification of healthcare access barriers for veterans
Objective: To develop and evaluate an automated system for identifying healthcare barriers focusing on transportation issues in veterans’ clinical notes using large language models (LLMs) and to assess the impact of different prompting strategies on classification performance and explanation consistency. Methods: We developed a hybrid system combining pattern matching for templated notes with LLM analysis for free-text notes. Using 2000 manually annotated clinical notes, we compared four prompting strategies (dual-role short, dual-role long, analysis-first, analysis-only) across Mistral-7B and Llama-3.1 models. We evaluated classification performance using standard metrics and assessed explanation consistency through embedding similarity analysis. Results: The analysis-first strategy achieved superior performance, with Mistral-7B reaching an F1 score of 0.914, outperforming traditional machine learning approaches (GBM: 0.786, BERT: 0.811). LLMs demonstrated higher explanation consistency within models (mean cosine similarity 0.887–0.908) compared to cross-model similarities (0.767–0.872). Pattern matching successfully handled 6.7% of templated notes deterministically. Mistral-7B showed greater internal consistency but higher abstention rates compared to Llama-3.1. Conclusion: Requiring LLMs to analyze evidence before classification improves both accuracy and explanation consistency for identifying transportation barriers in clinical notes. This approach enables automated barrier detection at scale while providing clinically relevant explanations, supporting both population-level healthcare planning and individual patient care decisions.
Healthcare access barriers↗
Magnetoimpedance Biosensors and Real-Time Healthcare Monitors: Progress, Opportunities, and Challenges
A small DC magnetic field can induce an enormous response in the impedance of a soft magnetic conductor in various forms of wire, ribbon, and thin film. Also known as the giant magnetoimpedance (GMI) effect, this phenomenon forms the basis for the development of high-performance magnetic biosensors with magnetic field sensitivity down to the picoTesla regime at room temperature. Over the past decade, some state-of-the-art prototypes have become available for trial tests due to continuous efforts to improve the sensitivity of GMI biosensors for the ultrasensitive detection of biological entities and biomagnetic field detection of human activities through the use of magnetic nanoparticles as biomarkers. In this review, we highlight recent advances in the development of GMI biosensors and review medical devices for applications in biomedical diagnostics and healthcare monitoring, including real-time monitoring of respiratory motion in COVID-19 patients at various stages. We also discuss exciting research opportunities and existing challenges that will stimulate further study into ultrasensitive magnetic biosensors and healthcare monitors based on the GMI effect.
60 APPLIED LIFE SCIENCES↗
Credible Practice of Models and Simulations for Healthcare
As computational models penetrate clinical care and drive healthcare policy decisions, there is increasing need to communicate that model creation and testing follows reasonable credible practice. Although verification and validation have been generally accepted as significant components of a model’s credibility, they cannot be assumed to equate to a holistic credible practice, which includes activities that can impact comprehension and in-depth examination inherent in the development and reuse of the models. This presentation introduces the Ten Rules for credible practice of modeling and simulation in healthcare developed from a comparative multidisciplinary analysis and practitioner survey. These rules establish a unified conceptual framework for modeling and simulation design, implementation, evaluation, dissemination and usage across the modeling and simulation life-cycle. Although some of these are common sense guidelines, many are often missed or misconstrued, even by seasoned practitioners.
credibility↗
Development and Future of the Ten Simple Rules for Credible Practice of Models and Simulations in HealthCare
In this session, we will review the development and implementation history of the Ten Simple Rules (TSR) for credible practice in models and simulations that support healthcare. Our focus will be initially on the need and background for the Committee on Credible Practice of Models and Simulations in Healthcare (CPMS) as well as the TSR development process and implementation. This will flow into a demonstration of how the TSR has evolved as means of communicating and understanding the model development process, likely successful application and where the model could fail. We will end this presentation with a discussion on future development avenue, the CPMS efforts to develop a comprehensive rubric supporting current TSR implementation, and efforts to support further adoption of the TSR. The audience will be encouraged to comment on the current state of the TSR, share their TSR application experiences, and provide their insights on future development.
model↗
Low Carbon Technology Strategies: Outpatient Healthcare
This document includes steps that building owners and operators can implement to achieve smart, healthy, and low-carbon outpatient healthcare buildings within their existing building portfolios. Outpatient healthcare includes diagnostic and treatment facilities for outpatient care, and these buildings often use packaged rooftop units for heating, cooling, and ventilation.
analytics↗
Domain Shift Analysis in Chest Radiographs Classification in a Veterans Healthcare Administration Population
This study aims to assess the impact of domain shift on chest X-ray classification accuracy and to analyze the influence of ground truth label quality and demographic factors such as age group, sex, and study year. We used a DenseNet121 model pre-trained MIMIC-CXR dataset for deep learning-based multi-label classification using ground truth labels from radiology reports extracted using the CheXpert and CheXbert Labeler. We compared the performance of the 14 chest X-ray labels on the MIMIC-CXR and Veterans Healthcare Administration chest X-ray dataset (VA-CXR). The validation of ground truth and the assessment of multi-label classification performance across various NLP extraction tools revealed that the VA-CXR dataset exhibited lower disagreement rates than the MIMIC-CXR datasets. Additionally, there were notable differences in AUC scores between models utilizing CheXpert and CheXbert. When evaluating multi-label classification performance across different datasets, minimal domain shift was observed in the unseen VA dataset, except for the label “Enlarged Cardiomediastinum.” The subgroup with the most significant variations in multi-label classification performance was study year. These findings underscore the importance of considering domain shift in chest X-ray classification tasks, paying particular attention to the temporality of the exam. Our study reveals the significant impact of domain shift and demographic factors on chest X-ray classification, emphasizing the need for improved transfer learning and robust model development. Addressing these challenges is crucial for advancing medical imaging research and improving patient care.
chest X-ray image classification↗
mRNA SARS-CoV-2 Immunization Confers Robust Antibody Response in Occupational Healthcare Workers and Fosters Workplace Safety
Immunization against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a major step in protecting the healthcare worker beyond standard pandemic precautions and infection control measures. Healthcare workers (HCW) are at high risk for SARS-CoV-2 exposure and infection placing burden on the workplace. Hence, reducing SARS-CoV-2 infection of HCWs serves multiple goals in the occupational health arena. These include protecting the health and safety of the HCW as well as reducing transmission of Coronavirus Disease 2019 (COVID-19) in the clinic and the larger workplace it serves. Furthermore, when HCWs demonstrate appropriate pandemic precautions and health practices, they serve as strategic models for other workers. Here, this modeling represents leadership which can inspire optimism and hope in a workforce beleaguered by the pandemic.
60 APPLIED LIFE SCIENCES↗
Integrating Health and Energy Efficiency in Healthcare Facilities
This report presents a review of literature and current best practices along the intersection of energy efficiency and occupant health at U.S. healthcare facilities, including federally owned buildings. It also includes a review of minimum code requirements for healthcare indoor environmental quality (IEQ) and research on building measures that optimize occupant health and energy efficiency.
32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
Ambulatory Healthcare Utilization in the United States: A System Dynamics Approach
Ambulatory health care needs within the United States are served by a wide range of hospitals, clinics, and private practices. The Emergency Department (ED) functions as an important point of supply for ambulatory healthcare services. Growth in our aging populations as well as changes stemming from broader healthcare reform are expected to continue trend in congestion and increasing demand for ED services. While congestion is, in part, a manifestation of unmatched demand, the state of the alignment between the demand for, and supply of, emergency department services affects quality of care and profitability. The central focus of this research is to provide an explanation of the salient factors at play within the dynamic demand-supply tensions within which ambulatory care is provided within an Emergency Department. A System Dynamics (SO) simulation model is used to capture the complexities among the intricate balance and conditional effects at play within the demand-supply emergency department environment. Conceptual clarification of the forces driving the elements within the system , quantifying these elements, and empirically capturing the interaction among these elements provides actionable knowledge for operational and strategic decision-making.
Diaz, Rafael↗