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A comprehensive standards-based framework for enabling semantic interoperability of disease surveillance data for Namibia through adopting health standards
No full textSubmitted in fulfilment of the requirements for the degree PhD in Information Technology, Durban University of Technology, Durban, South Africa, 2020.The Ministry of Health and Social Services (MoHSS) in Namibia runs silo information systems in the 14 regions of the country, and these silo systems were donated by non-governmental organisations. In addition to a regional District Health Information System (DHIS-2) for each region, there is the main DHIS-2 at the MoHSS. The Health Information Systems (HIS) that include the main DHIS-2 at the MoHSS and silo systems in the regions work in isolation currently. Hence this study aimed at finding a framework to enable semantic interoperability of disease surveillance data in these HIS. This is meant to enable the main DHIS-2 and these silo systems in the Namibian public hospitals to act as an integrated platform that shares and exchanges disease-surveillance information. Semantic interoperability is the ability to automatically interpret the information exchanged meaningfully and accurately to produce useful results as defined by the end users of both systems. To achieve semantic interoperability, both sides must defer to a common information exchange reference. Utilising the Integrating the Healthcare Enterprise (IHE) standard and Health Level Seven (HL7), this research provides guidelines on how to integrate these heterogeneous HIS through the adoption of established health standards. Thus, IHE and HL7 standards were adopted to interface the main DHIS-2 and silo systems at a data level. The result of this research is a framework to enable the semantic interoperability of disease surveillance data in Namibian public hospitals through the adoption of IHE and HL7 standards, in addition to a prototype that demonstrates how disease surveillance data can be integrated in the Namibia healthcare environment.
In the Namibian health domain, there is no known protocol that governs or aggregates disease surveillance data from remote heterogeneous HIS. Therefore, the study developed an interlink protocol that can aggregate disease surveillance data from remote HIS. This means that health professionals in Namibia would use the system for fast decision-making simply because they are accessing disease surveillance data in real-time. In this case, the protocol was applied to govern heterogeneous systems in Namibian public hospitals for data semantic interoperability of the main DHIS-2 and these other health information silo systems so that they can exchange health data and information, specifically, disease surveillance data. This interlink protocol is based on JSon. To test the Interlink protocol, a number of use case scenarios were used. The scenarios include integrating crowd-sourced disease surveillance data through the communities’ mobile phones, integrating disease surveillance data collected through community health workers’ (CWH) visits, and also integrating disease surveillance data collected from community members during hospital visits. In each case, the interlink protocol is paired to an HL7 standard to facilitate communication of the disease surveillance data from the source to the integrated HIS. A prototype for each use case is developed as proof of concept, to test that the protocol can enable integration of the disease surveillance data in these HIS. The Retrieval Display profile was identified from HL7 standards as the closest to suit the integration of disease surveillance information obtained through mobile crowdsourcing. The Cross-Gateway Patient Discovery (XCPD) profile that supports the means to locate communities that hold patient-relevant health data and the translation of patient identifiers across communities holding the same patient data was adapted to support communication between CHWs, the DHIS-2 in the MoHSS and silo HIS in the regional hospitals. The Patient Demographics Actor (PDA) profile was adapted to support communication for data collected within the hospitals.
The research was conducted in two phases. The first phase was the collection of data on the status of semantic interoperability of HIS in the Namibian healthcare sector. The case study setting was based on public hospitals from eight regions in Namibia using two (2) public hospitals per region, which were purposely sampled. The study population comprised of system analysts, programmers, chief system administrators, system administrators, disease surveillance office, chief disease surveillance office nurses, doctors, therapists, health assistants, public health officers, health administrators, regional health coordinators and regional assistant coordinators. A stratified purposive sampling of the study participants was done. This first phase followed an interpretive approach. This first phase supported a mixed methods approach encompassing both qualitative and quantitative data analyses. The Grounded Theory was the underlying theory of this research. The second phase was the design and development of the semantic interoperability framework. The Design Science Research (DSR) approach guided the development of the framework and prototype. Expert reviews were sought to review and validate the framework and prototype that were developed. The study contributions to the body of knowledge were that the researcher has proven silo HIS in Namibia can be integrated, developed a prototype, integrating health standards to Namibia which hasn’t been done before.
A Mobile Application for Health Information Dissemination: a Namibian Context
No full textMobile devices have become the most powerful tool to
disseminate information across communities in today’s world.
The current method of disseminating health-related information
to the communities in Namibia is a manual system which is not
efficient and effective. This study sought to identify an efficient
and effective way to disseminate health information. The first
phase of the study was qualitative, applying an interpretive
approach and a qualitative multi-case study research design.
Two hospitals, the Ministry of Health and Social Services
(MoHSS), the Centre for Disease Control (CDC) and members of
the community participated in this study. Face-to-face interviews,
focus group interviews, questionnaires and document sampling
were used as data collection methods to identify the requirements
for a mobile application. Through laboratory experimentation,
the second phase of the study led to the development of a
prototype mobile application that will enable anyone to install the
application on their phones in order to access general diseases
information from the CDC.The first phase of the research
concluded that a large number of Namibians own cellphones
hence a mobile application would suffice. The most prevalent
diseases from the research are malaria, diabetes, cancer and
HIV, hence the initial application should concentrate on
information dissemination for such. The mobile application
content covers the common diseases in Namibia, their definition,
the causes of the disease, the symptoms of the disease, how to
prevent the disease and whom to contact.In the research
conducted, the majority of the population is literate hence the
application can support text-based information in addition to
graphics. The research also found that a large number of people
visit clinics and hospitals hence the mobile application will
benefit both even those who visit clinics and hospitals as well
provided they have smartphone
A framework to enable semantic interoperability of data in heterogeneous health information systems: a case of Namibia
No full textThe District Health Information System (DHIS) is an information
system that is hosted in the Khomas regional office of the Ministry of Health and
Social Services (MoHSS) in Namibia. Parallel to the DHIS, the MoHSS runs
silo information systems in the 14 regions of Namibia which were donated by
non-governmental organisations in addition to a regional DHIS. The DHIS and
silo systems currently work in isolation from one another, hence this study is on
finding a framework to enable semantic interoperability of data in these
heterogeneous health information systems (HIS) so that the DHIS and these silo
systems in the Namibian public hospitals can act as an integrated platform to
share and exchange health- related information with each other. Thus, a protocol
called Interlink protocol is developed in this research to enable integration.
The DHIS and silo- interfaced system that will be developed in this research
should be able to link or connect all the public hospitals in Namibia to the
central database at the MoHSS for health information feed. The system would
allow public hospitals to interlink with each other through a technology integrated
platform. The study therefore seeks to interface DHIS and silo systems at
a data level. The aim of this research therefore is to design and develop a
framework for data semantic interoperability of DHIS and these other health
information silo systems so that they can exchange health data and information
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Enabling Semantic Interoperability of Regional Trends of Disease Surveillance Data for Namibia Through a Health-Standards-Based Approach
Get PDFThe Ministry of Health and Social Services in Namibia under the division of epidemiology uses a manual paper-based approach to capture disease surveillance data through 5 levels of reporting which include the community level, the health facility level, the district level, and the national level. As a result, this method of communicating and exchanging disease surveillance information is cost and time consuming, which delay disease surveillance information from reaching the head office on time. The current method that is being used to exchange and communicate disease surveillance data is a manual process which very time consuming due to the fact that surveillance officers have to organise and store the files and hunt down the information when it is needed and this can take time. Therefore, the study developed a prototype that aggregates disease surveillance data from the 14 regions in Namibia and can thus enable the disease service office to capture disease surveillance data through the use of mobile devices. The functionality of the prototype would allow a disease surveillance office in one regional office to access disease surveillance data of other regional office in real time. The method used to communicate disease surveillance data is through the excel spreadsheet (IDSR) which is called the integrated disease surveillance and response. Furthermore, the excel file will be sent to the relevant authority through email. However, we still do not have a web based system to report cases of diseases, instead this is a process starting from the intermediate hospital disease surveillance data which is captured then sent to the regional office and from the regional office the information is sent to the district office and then sent to the national office and from the national office the information is further sent to the WHO and other development partners as well as to the top management or to the highest authority. So it does not end at the national level but goes to management such as the Permanent Secretary, and the data is used to inform the development partners and the national surveillance office prepares official letters to the management as a form of reporting disease surveillance data. The symphonic surveillance office helps to detect a particular disease. The doctors send an investigation case form to the laboratory for testing the disease that has been identified
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