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Ten Topics to Get Started in Medical Informatics Research

Markus wolfien.

1 Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

2 Center for Scalable Data Analytics and Artificial Intelligence, Dresden, Germany

Najia Ahmadi

3 Core Unit Data Integration Center, University Medicine Greifswald, Greifswald, Germany

Sophia Grummt

Kilian-ludwig heine, dagmar krefting.

4 Department of Medical Informatics, University Medical Center, Goettingen, Germany

Andreas Kühn

Ines reinecke, julia scheel.

5 Department of Systems Biology and Bioinformatics, University of Rostock, Rostock, Germany

Tobias Schmidt

6 Institute for Medical Informatics, University of Applied Sciences Mannheim, Mannheim, Germany

Paul Schmücker

Christina schüttler.

7 Central Biobank Erlangen, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

Dagmar Waltemath

8 Department of Medical Informatics, University Medicine Greifswald, Greifswald, Germany

Michele Zoch

Martin sedlmayr.

The vast and heterogeneous data being constantly generated in clinics can provide great wealth for patients and research alike. The quickly evolving field of medical informatics research has contributed numerous concepts, algorithms, and standards to facilitate this development. However, these difficult relationships, complex terminologies, and multiple implementations can present obstacles for people who want to get active in the field. With a particular focus on medical informatics research conducted in Germany, we present in our Viewpoint a set of 10 important topics to improve the overall interdisciplinary communication between different stakeholders (eg, physicians, computational experts, experimentalists, students, patient representatives). This may lower the barriers to entry and offer a starting point for collaborations at different levels. The suggested topics are briefly introduced, then general best practice guidance is given, and further resources for in-depth reading or hands-on tutorials are recommended. In addition, the topics are set to cover current aspects and open research gaps of the medical informatics domain, including data regulations and concepts; data harmonization and processing; and data evaluation, visualization, and dissemination. In addition, we give an example on how these topics can be integrated in a medical informatics curriculum for higher education. By recognizing these topics, readers will be able to (1) set clinical and research data into the context of medical informatics, understanding what is possible to achieve with data or how data should be handled in terms of data privacy and storage; (2) distinguish current interoperability standards and obtain first insights into the processes leading to effective data transfer and analysis; and (3) value the use of newly developed technical approaches to utilize the full potential of clinical data.

Introduction

Digital health care information, as opposed to analog information, empowers clinicians, researchers, and patients with a wealth of information aiming to improve diagnosis, therapy outcome, and clinical care in general. According to Wyatt and Liu [ 1 ], medical informatics is the study and application of methods to improve the management of patient data, clinical knowledge, population data, and other information relevant to patient care and community health. Medical informatics can be seen as the subset of health informatics that is focused on clinical care, while the latter encompasses a wider range of applications. However, knowing, integrating, and using current computational technologies bears numerous pitfalls, limitations, and questions [ 2 ]. To shed light on current standards, applications, and underlying technologies, we present 10 topics to get started in the field of medical informatics research. Our key objective here was to improve interdisciplinary communication among stakeholders (eg, clinicians, experimental researchers, computer scientists, students, patient representatives), thereby bringing everyone on the same page of state-of-the-art medical informatics practices. In particular, improved interdisciplinary communication is essential in real-world problems and can be motivated by the following aspects:

• Advancing open research: Open collaboration between parties from different disciplines can lead to new research questions, innovative approaches, and novel discoveries [ 3 ].
• Bridging knowledge domains: Interdisciplinary communication can stimulate novel solutions, allowing researchers to gain a more comprehensive understanding of a specific problem or phenomenon [ 4 ], or can improve clinical decision-making [ 5 ].
• Addressing complex problems: Complex problems, such as the latest disease outbreak, require input from multiple domains to be comprehensively understood. Here, interdisciplinary communication is one key aspect to pinpoint the root causes and develop effective solutions [ 6 ].
• Promoting scientific inclusivity and diversity: Interdisciplinary communication was recently shown to foster diversity and inclusivity in science, by bringing together researchers from different backgrounds, cultures, and perspectives [ 7 , 8 ].

Here, we describe in detail how the initial topics have been selected from the literature and what design principles and structure each topic follows. A brief outline of the utilized methods for topic dissemination and an exemplary embedding into an educational training program are also presented.

Topic Selection

The initial topics were defined based on current developments in the health informatics field and an increasing number of published manuscripts between 2000 and 2021 (based on title-abstract-keyword screening in Scopus using the keywords “Health” AND “Informatics” AND “domain”) in the respective subdomains ( Figure 1 A). After a first definition of the specific topics, these were critically revised by internal and external domain experts, as well as scientists previously not familiar with medical informatics research.

Schematic summary and representation of the presented topics: (A) brief literature screening (title-abstract-keywords) for published manuscripts between 2000 and 2021, and the y-axis gap provides improved visibility of the less-occurring keywords; (B) most common topic terminologies, keywords (color-coded sections), and potential connections (grey) among topics in the medical informatics research domain. CDSS: clinical decision support system; CIS: clinical information system; EHR: electronic health record; ETL: extract, transform, and load; FAIR: findable, accessible, interoperable, reusable; FHIR: Fast Healthcare Interoperability Resources; GDPR: General Data Protection Regulation; i2b2: Informatics for Integrating Biology and the Bedside; OMOP: Observational Medical Outcomes Partnership.

Topic Design

The initial number of important topics and keywords exceeded the anticipated number of 10 topics, which found inspiration from the “Ten Simple Rules” collection in PLOS Computational Biology [ 9 ]. This is why the authors merged the most matching terms topic wise into groups. These groups finally produced topics that represent the broad range of the medical informatics domain in 3 main concepts, namely “Regulations and concepts,” “Harmonization and processing,” and “Evaluation, visualization, and dissemination” ( Figure 1 B). Figure 1 B also shows the initial keywords for each individual topic, as well as potential cross references between topics, which are highlighted in grey. The following sections provide important “do's and don'ts,” practical hints, and best practice guidelines. Further in-depth resources and practical tutorials will provide basic introductions to the referred domains. Kohane et al [ 10 ] already showed the importance of such clarifying introductions. This work extends the initial study and, in addition, provides detailed examples from the German national Medical Informatics Initiative (MII) [ 11 ].

All topics were divided into 3 parts to improve comprehension by the readers:

• Introduction: Background definitions for the specific context that motivated the topic
• Insight: Practical context to get started, including how to avoid pitfalls, state current limitations, and address current challenges
• Impact: Take home message and useful resources and best practices to deepen knowledge about the topic

Topic Utilization, Extension, and Embedding

Since it is of the utmost importance to keep the content current and as versatile as possible, we initiated an online resource at GitHub, in which contributions are highly emphasized [ 12 ]. Here, keywords and the corresponding literature are collected to allow for swift extension of the currently presented literature body in this article. In addition, the introduction of novel important topics that are not covered in this article might be included. To additionally demonstrate the practicability and adaptability of our proposed topic content, we exemplarily present how these can be embedded in higher education training and share external, introductory hands-on material ( Table 1 ).

Summary of tutorials and hands-on material about medical informatics standards and applications.

Topic number	Name	Description	Link
2	SNOMED CT	This 5-step briefing presents a high-level overview of SNOMED CT, how it works, and the benefits of use.	[ ]
4	DataSHIELD	This tutorial introduces users to DataSHIELD commands and syntax in R/R Studio.	[ ]
5	ETL	This provides introductory material to get from the native/raw data to the OMOP CDM one needs to create an ETL process.	[ ]
6	FHIR training	This contains a series of FHIR tutorials for those just beginning to learn the new specification.	[ ]
6	SMART App Gallery	The SMART platform is composed of open-standard, open-source tools for developers building apps, and a publicly accessible gallery.	[ ]
7	EHDEN Academy	This contains a series of tutorials for OMOP CDM and additional OHDSI tools (eg, PLP [ ]).	[ ]
8	Synthetic data generation	This is a hands-on tutorial from the ODI [ ] showing how to use Python to create synthetic data	[ ]
10	R Studio education	This provides an introduction to basic R programming.	[ ]
10	Python Dash	This tutorial helps develop data visualization interfaces.	[ ]

a SNOMED CT: Systematized Nomenclature of Medicine and Clinical Terms.

b ETL: extract, transform, and load.

c OMOP: Observational Medical Outcomes Partnership.

d CDM: common data model.

e FHIR: Fast Healthcare Interoperability Resources.

f OHDSI: Observational Health Data Sciences and Informatics.

g PLP: patient-level prediction.

h ODI: Open Data Institute.

Regulations and Concepts

Topic 1: privacy and ethics—“data privacy and ethics are the most important assets in the clinical domain.”.

Health information is sensitive and hence needs to be highly protected and should not be generously shared. Sharing regulations and data privacy matters are defined in the European General Data Protection Regulation (GDPR) [ 13 ]. The implementation of the GDPR is an ongoing process as the quickly evolving technology, data, and scientific practices demand continuous improvement, which include periodic adaptations of the technical and legal aspects [ 14 , 15 ]. In terms of ethics and with the rise of novel technologies, like artificial intelligence (AI), the possible re-identification of data, such as images and genomic information, is a major concern [ 16 , 17 ].

Anonymization is one important way to keep data private. It can also be achieved for high-dimensional data by changing patient-specific identifiers through removal, substitution, distortion, generalization, or aggregation [ 18 ]. In contrast, data pseudonymization is another de-identification procedure by which personally identifiable information fields within a data record are replaced by one or more artificial identifiers or pseudonyms [ 19 ]. To overcome the paucity of annotated medical data in real-world settings and (fully) save the patients’ anonymity, synthetic data generation is used to increase the diversity in data sets and to enhance the robustness and adaptability of AI models [ 20 ]. To conform with ethical regulations in a research context, medical data are only available in a highly controlled manner and according to strict procedures. New concepts, such as “systemic oversight” [ 21 ] or “embedded ethics” [ 22 ], might be needed to tackle the new data-driven developments around “medical big data” and AI in health care. To engage with the adoption of broad consent, systemic oversight was suggested as an approach, in which mechanisms like auditing mechanisms, expert advice, and public engagement initiatives (among others) should be adapted as additional layers to the newly arising ecosystem of health data [ 21 ]. Recently, embedded ethics was jointly suggested by ethicists and developers to address ethical issues via an iterative and continuous process from the outset of development, which could be an effective means of integrating robust ethical considerations into practical development [ 22 ]. A digital representation of information encoded in signed consent forms is needed to facilitate common data use and sharing, as already implemented in an MII informed consent template [ 23 ].

As a researcher in medical informatics, it is inevitable to be informed and knowledgeable about the fact that patients own their medical records and any use of those data requires great care. In Germany, health care providers can only use the data for first medical use. Secondary use, like research, needs to be approved by either broad or individual consent, which can be made available via the electronic health record (EHR). In addition to digitization efforts, it is still a considerable hurdle to convince patients to make their data available for medical research because personal skepticism commonly makes the entire data acquisition process more difficult [ 24 ]. Here, well-received external communication, transparency, and increased awareness are necessary for substantial improvements. In general, it is a balance between privacy, patient needs, and the use of data for the common good versus economic interests [ 25 ]. In particular, one should be aware of the specific legal regulations that apply within the country and additionally get in touch with the relevant data protection departments. Following this, a plan for infrastructure that meets these regulations and that contains, for example, a trustee for the electronic recording of patient consent and anonymization or direct pseudonymization processes to collect the data needs to be developed. Risk assessments for potential data leakage, approvals by ethics committee, as well as consultation with a data protection officer are essential considerations to further assure data security.

Topic 2: EHR and Clinical Information Systems—“Get to Know Your Clinical Information System to Understand the Required Data.”

Hospitals run clinical information systems (CIS) to collect, store, and alter clinical data about patients. A CIS, independent of the specialization and specific vendor, covers many clinical subdomains and integrates patient-related data to support doctors in their daily routine. Without a doubt, medical data are only useful if meaningful information can be derived from them. This requires high-quality data sets, seamless communication across IT systems, and standard data formats that can be processed by humans and machines [ 2 ]. Typical challenges in clinical IT implementations, especially for patient recruitment systems, were recently evaluated by Fitzer et al [ 26 ] for 10 German university hospitals, including requirements for data, infrastructure, and workflow integration. The implementation of an EHR, including an individual's medical data in a bundled form, into the CIS is a key aspect to prevent low reliability and poor user-friendliness of EHRs, which has recently been shown to affect time pressure among medical staff [ 27 ]. For example, in Scandinavia, the United States, and the United Kingdom, the Open Notes initiative [ 28 ] facilitates patients’ access to EHRs and health data sharing via “PatientsKnowBest ” to give health care professionals and families direct access to medical information [ 29 ].

An EHR is used primarily for the purposes of setting objectives and planning patient care, documenting the delivery of care, and assessing the outcomes of care [ 30 ]. EHRs have so far consisted of unstructured, narrative text as well as structured, coded data. Thus, it will be necessary to implement more systematic terminologies and codes so that the data contained in these records can be reused in clinical research, health care management, health services planning, and government reporting in an improved manner [ 31 , 32 ]. Since the domain of medical informatics is rather new, there are many possibilities for software solutions to improve EHR-related issues [ 33 ]. Exemplary for the EHR domain, the Systematized Nomenclature of Medicine and Clinical Terms (SNOMED CT) is utilized to develop comprehensive high-quality clinical content [ 34 ]. It provides a standardized way to represent clinical phrases captured by the clinician and enables automatic interpretation of these, which is showcased in a “five-step briefing” [ 35 ]. Interestingly, the number of annual publications on this subject has decreased since 2012. However, the need for a formal semantic representation of free text in health care remains, and automatic encoding into a compositional ontology could be a solution [ 36 ]. In terms of usability and user acceptance, evaluations and improvements of EHRs and clinical decision support systems (CDSS) are currently ongoing [ 37 ], for which already well-received examples can be attributed to CeoSYS [ 38 ] or the IPSS-M Risk Calculator [ 39 ]. Moreover, the actions of patients directly contributing to their own EHR records are also being evaluated. The study by Klein et al [ 40 ] indicates that such an approach facilitates the development of individual solutions for each patient, which in turn requires a flexible EHR during the course of a treatment process. Additionally, it was argued that data incorporation via different devices can also facilitate the convenient utilization of the application and, hence, may increase secondary use.

Modern CIS support the interaction by doctors and patients with the recorded patient data (eg, using the EHR or patient portals, eHealth platforms). It is important to understand the basic architecture, especially challenges [ 26 ], of the hospital IT infrastructure to know where data are located and how they can be retrieved and integrated. Major improvements can be made when supporting international standards for data exchange. Beyond standard EHR, this includes interoperability standards like Fast Healthcare Interoperability Resources (FHIR; see Topic 6) and standard data models like the Observational Medical Outcomes Partnership (OMOP; see Topic 7). These criteria should be considered with every new order of clinical systems.

Topic 3: Data Provenance—“Trace Your Data, Even Within Large-scale Efforts.”

Meaningful and standardized metadata facilitate the interpretation of, retrieval of, and access to data [ 41 ]. When explainable data are processed with interoperable tools, scientists can create automated and reusable workflows and provide access to reproducible research outcomes and data analysis pipelines [ 42 ].

Data provenance describes the history of digital objects, where they came from, how they came to be in their present state, and who or what acted upon them [ 43 ]. In health care, provenance maintains the integrity of digital objects (eg, the results of data analyses engender greater trust if their provenance shows how they were obtained). In addition, it can be used to deliver auditability and transparency, specifically, in learning health systems, and it is applicable across a range of applications [ 44 ]. Inau et al [ 45 ] argued that the lessons learned from “FAIRification” processes in other domains will also support evidence-based clinical practice and research transparency in the era of big medical data and open research. Further work demonstrated that a findable, accessible, interoperable, reusable (FAIR) research data management plan can provide a data infrastructure in the hospital for machine-actionable digital objects [ 46 ]. Recently, the openEHR approach was also suggested for creating FAIR-compliant clinical data repositories as an alternative representation [ 47 ].

Key data management requirements are defined by the FAIR guiding principles [ 48 ]. Since data protection laws led to additional requirements for data privacy and data security, the FAIR-Health principles focused on defining additional requirements for information on the sample material used from biobanks, for provenance information, and incentive schemes [ 49 ]. Further work is needed to establish provenance frameworks in health research infrastructures [ 50 ].

Topic 4: Data Sharing—“If Data Won’t Come to the Model, the Model Must Go to the Data.”

Cross-sectional medical data-sharing is critical in modern clinical practice and medical research, in which the challenge of privacy-preserving transfer and utility needs to be addressed [ 51 ]. In order to facilitate high reuse of the data, a decentralized computational scheme that treats the available data as part of a federated (virtual) database, avoiding centralized data collection, processing, and raw data exchanges, is still needed in many countries to analyze large and widespread clinical data [ 52 ].

One possible solution for this federated learning approach is DataSHIELD [ 53 ]. In particular, orchestrating privacy-protected analyses of “medical big data'' from different resources is applicable within R and DataSHIELD [ 54 ]. Here, the developed computerized models represent mathematical concepts or trained machine learning (ML)–based approaches to solve a specific task. In this sense, the model is applied to distributed data sets of the protected (clinical) server infrastructure, and the user only sees the model results but does not retrieve any medical records. Moreover, implementations in other programming languages (eg, Python, Julia) have been introduced in the genomic domain and beyond [ 55 ]. Further concepts, such as Personal Health Train, specifically follow the FAIR principles during distributed analyses [ 56 ]. Secure multiparty computation (SMPC) is also a viable technology for solving clinical use cases that require cross-institution data exchange and collaboration [ 57 ]. Current limitations are thought to be addressed in a stepwise manner [ 58 ] or as blockchain [ 59 ].

By using approaches for distributed analyses, researchers are able to train, test, and validate their models on large-scale real-world clinical data. In combination with standardized data formats, these 2 concepts facilitate the use of those models in clinical routine, potentially in the form of a CDSS. This provides a basis for secondary use of observational data in the context of clinical trials, which show particular potential for identifying data characteristics in small cohorts (eg, identification of the individual patient risk for rare diseases or comorbidities).

Harmonization and Processing

Topic 5: extract, transform, and load (etl)—“ etl processes are computational approaches for data harmonization and data unification.”.

Data handling in medical informatics remains a major challenge. Even though most data in medicine are available electronically, the data often lack interoperability [ 60 ]. As a first step to actually use the data, processes to extract, transform, and load (ETL) are needed to obtain harmonized data from different data systems or clinical entities. One important example, among many others, reflects the uniform representation of the date and time in a common format (eg, Year-Month-Date, not Date-Month-Year). The ETL process is therefore a crucial, individual step toward data unification in large clinical systems, which must be secure, safe, and accurate [ 61 ].

The design of an ETL process faces several challenges, including the following: (1) The ETL process should be able to process huge amounts of data at once [ 62 ]; (2) the ETL process should be repeatable—if the source data change, the ETL process needs to be rerun to process the source data (Observational Health Data Sciences and Informatics [OHDSI]) [ 63 ]; (3) expert-level anonymization methodologies might be integrated into ETL workflows whenever possible [ 61 ]; and (4) there is a need to check for loss of data and compromised data integrity. The latter was highlighted in a recent study, in which inaccurate cohort identification took place because erroneous vocabulary mappings of a common data model were used (eg, ETL programming bugs and errors not captured during the quality assurance stages) [ 64 ]. Common solutions to implement ETL processes are code-based (eg, FHIR-to-OMOP [ 65 ]) or via Pentaho Data Integration, which is one of many ETL tools. Further subsequent processing may also include loading data into research data repositories, like OMOP (see Topic 7), tranSMART, and Talend Open Studio, which is a central component of the Integrated Data Repository Toolkit [ 66 ].

Since ETL processes are at the core of data handling, all risks associated with the ETL process need to be thoroughly checked, identified, and assessed, and contingency plans to mitigate these risks should be in place [ 67 ]. Once the ETL processes are executed, the resulting data will be trusted by researchers, who heavily rely on comprehensively checked data integrity to be able to conduct their research on this basis.

Topic 6: FHIR—“Set FHIR to Gain a Communication Standard for Real-time Applications at the Device-to-Device Level.”

Interoperability levels can be divided into technical, syntactic, semantic, and organizational interoperability [ 2 ]. Semantic and syntactic interoperability can be ensured by communication exchange standards, such as the FHIR [ 68 ] standard of Health Level 7 (HL7) and medical terminologies. A suitable starting point for the basic procedures is offered by FHIR drills [ 69 ] or fire.ly [ 70 ].

FHIR is one of many communication standards but will likely change the domain of clinical IT significantly [ 71 , 72 ]. As a communication standard, FHIR harmonizes data formats coming from different CIS and enables data exchange between institutions via a RESTful approach [ 73 ]. Moreover, FHIR is used to connect devices with each other, which means, in particular, that the Integrating the Healthcare Enterprise (IHE) [ 74 ] standard has been revised to support HL7 messaging as well. In turn, IHE has been developing an open-source device tool set for home and hospital use that recently enabled device control capabilities, a capability accelerated during the COVID-19 pandemic to allow nurses and physicians to operate ventilators and infusion devices outside the contaminated patient room [ 75 ].

Utilizing FHIR in multiple applications already shows its versatile and flexible use (eg, in mobile health applications [ 76 ], electrocardiogram monitoring [ 77 ], or wearable devices and precision medicine in digital health [ 72 ]). In particular, the SMART-on-FHIR technology enables third-party app development for health care applications [ 78 ] and encompasses feasible, secure, and time- and resource-efficient solutions [ 79 , 80 ].

Topic 7: OMOP—“Use Common Data Models as Well-defined Representations of Large-scale Research Projects.”

Data harmonization enables research teams to run real-world observational studies based on heterogeneous data across country borders. Thus, harmonized data embedded in a common data model (CDM), which is an agreement about the utilization of standardized terminologies for data representation, is crucial to exchange data and results on a large scale. To foster reliability and trust in the results of observational research on real-world data, it is essential to utilize CDMs whenever possible to ensure a high degree of data analysis reproducibility.

Several CDMs exist for that purpose; the OMOP CDM from the OHDSI community is one of the most promising and established approaches. In comparison with other CDMs, such as the Sentinel CDM or Informatics for Integrating Biology and the Bedside (i2b2), the OMOP CDM has broader terminology coverage [ 81 ]. The importance of the OMOP CDM increased a lot over the last years [ 82 ], not least since the European Medicines Agency initiated the Data Analysis and Real World Interrogation Network (DARWIN) [ 83 ] project to establish a research network in Europe to gain real-world evidence based on OMOP. Moreover, representations of genomic data [ 84 ], oncology [ 85 ], and imaging projects [ 86 ] are also suitable. In addition, the common representation of the data in OMOP semantic interoperability is ensured by utilizing international terminologies and vocabularies, such as SNOMED-CT, the International Statistical Classification of Diseases and Related Health Problems (ICD), the Logical Observation Identifiers Names and Codes (LOINC), and RxNorm to represent every clinical fact in OMOP. Additionally, the open-source OHDSI software stack provides standardized methodology and libraries for data analyses (Athenahene, Atlas, HADES) and training (EHDEN Academy) [ 87 ], as well as a framework to assess and improve data quality to foster reliability and trust in research results [ 88 ].

The OMOP CDM is one possibility to represent and analyze clinical data on a research scale. Definition of new cohorts within OMOP enables researchers to quickly investigate questions spanning multiple research entities. Collectively, both FHIR and OMOP can define the structure and relations of the clinical data corpus, and the individual EHRs provide content to these standardized data reservoirs. In comparison, OMOP is commonly used for static large-scale data analysis of research data, and FHIR is more suitable for rapid data integration scenarios (ie, for real-time applications and analysis). In summary, it is important to know and utilize newly established standards to participate in broader clinical networks for research. This way, all information within the EHR is comparable across different clinical sites and research settings.

Evaluation, Visualization, and Dissemination

Topic 8: data quality—“guarantee high quality and then publish the data.”.

What is meant to be appropriate data quality for health informatics research? In this domain, data quality depends on the quality of single data elements, data completeness, data conformance, and data plausibility aspects that may considerably determine the validity and veracity of analysis results [ 89 , 90 ]. Moreover, data quality across different institutional entities and even health sectors requires additional efforts concerning the different personnel, instruments, and more [ 91 ]. High-quality data at hand is one fundamental requirement that is often difficult or impossible to achieve, which is why the generation of synthetic data can be an alternative that satisfies privacy problems as well as research needs when data are expensive, scarce, or unavailable by augmentation [ 92 ].

First, a major problem is that clinical data have to be electronically recorded, accessed, and standardized in order to run quality assessment processes [ 26 ]. In addition, it would be important to design and use the same data quality tool, standard operating procedures, or ETL mapping rules in all involved institutions. However, in real-life scenarios, there is a lack of both centrally coordinated data quality indicators and formalization of plausibility rules, as well as a repository for automatic querying of the rules, especially in ETL processes [ 93 ]. Although numerous data quality evaluation frameworks exist, no clear and widespread approach has been adopted so far [ 67 , 94 - 96 ]. Even after a well-chosen data quality procedure is properly implemented, clinical data as such cannot be published along with the performed study. As an alternative, synthetic data generation models function in the following 2 different ways: (1) The model is trained, for example, using real-world data and, once trained, will not require any data in the future (model-based approaches), and (2) the model is constantly fed with data to generate synthetic data (data-driven approaches). There are 3 different categories of algorithms used in the generation of synthetic data: probabilistic models, such as Bayesian networks [ 97 ] and Copulas [ 98 ]; ML, such as Classification and Regression Trees (CART); and deep learning methods, such as a generative adversarial network (GAN) [ 99 - 101 ] and variational autoencoder (VAE) [ 102 ].

A combination of appropriate data quality evaluation and synthetic data generation highly facilitates the development of accurate AI models, which are essential in medical studies [ 103 ]. Thus, a corpus of high-quality synthetic data with many patients can be reused by other AI experts for model development and benchmarking. Moreover, it is essential to create an infrastructure that is used across a large community of hospitals; maps the entire treatment process electronically; and only generates interoperable, structured data based on FHIR (Topic 6) and OMOP (Topic 7) in accordance with the FAIR principles (Topic 3). Afterward, one can finally run quality assessment processes.

Topic 9: Clinical Decision Support Systems—“Bring Insights, Not Additional Work, Back to the Clinics via a CDSS and Other User-Centric Applications.”

CDSS are computer systems designed to assist the medical staff with decision-making tasks about individual patients and based on clinical data [ 104 ]. The decision-making process is still, and will remain, on the shoulders of the physician [ 105 ]. The categories of CDSS include knowledge-based systems that make use of clinical rules, nonknowledge-based systems (eg, AI-based systems), and hybrid CDSS that likewise utilize clinical models and knowledge in combination with AI.

The use of a CDSS in a well-implemented clinical workflow has many positive aspects. It may lead to fewer error rates [ 106 ], accelerate rare disease diagnosis [ 107 ], increase radiologists’ job satisfaction [ 108 ], offer personalized cancer treatment [ 109 ], or help with real-time cardiovascular risk assessment [ 110 ]. Interestingly, computerized alerting systems, which are one of the most disseminated CDSS, can decrease drug-drug interactions significantly [ 111 ]. On the other hand, if done improperly, a CDSS can cause alert fatigue by creating too many alerts. If a system is not context-sensitive, alerts can even be inappropriate [ 112 ]. According to Olakotan et al [ 112 ], influencing factors of a well-designed CDSS need to include aspects about the (1) technology (eg, usability, alert presentation, workload, and data entry), (2) human (eg, training, knowledge, skills, attitude, and behavior), (3) organization (eg, rules and regulations, privacy, and security), and (4) and process (eg, waste, delay, tuning, and optimization). To avoid a lack of transparency and facilitate acceptance by physicians, especially with nonknowledge-based systems, current CDSS seek to use explainable AI approaches; however, the selection of methods used to present explanations in an informative and efficient ( clinically useful ) manner remains challenging [ 113 ]. Of note, a CDSS may also have a negative influence on the performance of physicians, especially if inadequate suggestions occur more often, which cannot be compensated with explanations [ 114 ]. However, one among many other prominent approaches to obtain such explanations via ML-based feature selection and ranking can be found in the work from Wolfien et al [ 115 ]. In terms of an OMOP-based implementation in research, there is patient-level prediction (PLP), which is designed to foster the clinical decision-making process concerning diagnoses or treatment pathways based on the EHR of the patient and the current clinical guideline. It is used to answer questions, such as identifying patients among a larger population at higher risk of a certain outcome (eg, occurrence of cancer, severe side effects, or death) by using data in standardized formats (eg, as previously described via OMOP CDM). Once the model is designed, the covariates will be extracted from the respective CDM of the target person within the cohort, and the respective outcome will be predicted (eg, via PLP [ 116 , 117 ] or other customized prediction algorithms). Importantly, the results from model prediction should first be internally validated with previously unseen data and afterward compared with established scoring systems (eg, Framingham Risk Score [ 118 ], SCORE2 [ 119 ]) to connect with already known domain-specific contexts and to prove its benefit in clinical practice. An additional validation with external data, as part of a multicenter study, can be seen as highly beneficial, in which the already presented topics of federated learning (Topic 4) and OMOP (Topic 7) could significantly foster such an essential scenario [ 120 ].

Collectively, a CDSS increases patient safety, assists in clinical management, and can be cost-effective [ 104 ]. In general, findings of even erroneous CDSS can be used to guide the design of new CDSS alerts. However, the existing risks cannot be solved solely on a technical basis and require an interdisciplinary effort. In particular, continuous, clear communication between IT professionals (developers) and health professionals (end users) during the design process is key. Only a profound understanding of the needs and requirements of either of the involved parties can lead to well-designed systems that are actually able to support and relieve physicians in doing their job.

Topic 10: Visualizations—“Improved Dissemination of Local and External Data From Computational Models by Well-defined Interactive Visualizations.”

Large volumes of data collected from patient registries, health centers, genomic databases, and public records can potentially improve the efficiency and quality of health care via enhancing the interoperability of medical systems, assisting in clinical decision-making, and delivering feedback on effective procedures [ 121 ]. However, each and every raw data point must go through different analytical processes until they become useful and interpretable at the point of care.

R and Python are 2 versatile open-source programming languages that have gained popularity for different purposes, such as preprocessing (eg, tidyverse), statistical tests (eg, dplyr), ML and deep learning (eg, mlr package, caret), visualization (eg, ggplot), and writing reports directly using knitr and R markdown (RStudio education [ 122 ]). Like R, Python offers different libraries for data science tasks (eg, open mined [ 123 ]) in addition to a library specifically for health predictive models, namely PyHealth [ 124 ]. Another versatile visualization functionality is offered for both languages via R Shiny [ 125 ] and Plotly Dash [ 126 ]. These 2 platforms enable data scientists to create interactive web applications directly from a script. The applications can be extended using embedded CSS themes, HTML widgets, and Javascript actions. There is already evidence that implementing clinical dashboards or CDSS for immediate access to current patient information can improve processes and patient outcomes [ 127 ], especially if the data sets are further evaluated and refined [ 128 ]. Similar to FHIR, OHDSI provides tools for analyzing data in the OMOP CDM, which are written in R and use Shiny for the visualization. As a plus, data already stored in the OMOP CDM format can be used in systematic studies, patient-level analysis, and population-based estimations from scratch. The cBioPortal is one prime example of a web resource for exploring, visualizing, and analyzing multidimensional data, which reduces molecular profiling data from cancer tissues and cell lines into readily understandable genetic, epigenetic, gene expression, and proteomic events [ 129 ]. It was recently demonstrated how cBioPortal can be extended and integrated with other tools to a comprehensive and easily deployable software solution that supports the work of a molecular tumor board [ 130 ] and even deliver meaningful scientific insights [ 131 ]. Another translational research platform for the construction and integration of modern clinical research charts is Informatics for i2b2, which is also at the heart of clinical research [ 132 , 133 ].

Computational approaches and data analyses are tightly connected with medical research; the visualization of such complex data for clinicians in a routine setting especially plays a larger role. The current developments of translational research platforms, such as cBioPortal and i2b2, enable swift translation of research results into the clinic, if adequately adopted and enough trained people supervise the process.

The need for qualified IT specialists in medical informatics has increased continuously in recent years and will continue to grow in the future. On the other hand, medical informatics in Germany faces problems with the ​​promotion of young researchers. These current developments mean that vacancies in IT in hospitals and the health care industry can often not be filled or only after very long vacancies. In addition, these positions often have to be filled with nonspecialist staff due to a lack of applications. To keep track of these recent developments and provide a basis for interdisciplinary communication, we provide our list of 10 topics that could be used by different stakeholders individually ( Figure 2 ). With a particular focus in medicine, improved interdisciplinary communication has already been shown to positively impact patient outcomes and enhance employee engagement [ 134 ].

Exemplary outcome visualization of the underlying study, in which the color coding reflects the initial colors of the proposed sections; it starts with an individual perception of the term medical informatics (MI) based on the individual’s background and ends with acquisition of common domain knowledge for current important topics. CDSS: clinical decision support system; EHR: electronic health record; ETL; extract, transform, and load; FAIR; findable, accessible, interoperable, reusable; FHIR; Fast Healthcare Interoperability Resources; OMOP: Observational Medical Outcomes Partnership.

Furthermore, medical informatics has developed rapidly in recent years. This applies, for example, to new methods, techniques, tools, framework conditions, and organizational structures, especially in the field of medical data science. In particular, definitions of standards and a national digitized data corpus, namely the German Core Dataset [ 135 ], were agreed upon. The actual assessment and collection of digitized data in local university hospitals are utilized in so-called data integration centers. These interoperable research data infrastructures enable rapid multisite research, for example, with complex COVID-19 research data sets (German Corona Consensus Dataset [GECCO]) [ 136 ] including clinical data and data on biosamples from all German university hospitals in pseudonymized form (CODEX) [ 137 , 138 ] or the COVID-19 Data Portal [ 139 ]. The subsequent formation of the Network University Medicine (NUM) strengthens the existing interaction between research and patient care, stabilizes existing structures, and creates new structures that ensure more effective feedback and close cooperation between the clinics. The presented examples of NUM and CODEX, among others [ 140 ], attempt a central approach to bundle and harmonize necessary resources like broad consent or the elektronische Patientenakte (ePa), which is the implementation of EHR as a national entity to ultimately facilitate an interconnected health care system.

Finally, all those involved in medical informatics are called upon to engage in lifelong learning and continuously acquire further qualifications.

Exemplary Implementation of the Addressed Topics in the German Medical Informatics in Research and Care in University Medicine Consortium

This article offers newcomers to medical informatics a first introduction and a wealthy overview of current IT-related topics in research and patient care. Nevertheless, there is also a need for further qualification of employees through new, innovative offers for training, further education, and further training. As part of the MII [ 11 ], all consortia were asked to develop and set up appropriate offers and formats. The Medical Informatics in Research and Care in University Medicine (MIRACUM) consortium [ 141 ] has reacted and set up the part-time training and further education program “Biomedical Informatics and Data Science” [ 142 ] and introduced it at the Mannheim University of Applied Sciences in October 2020. The program includes a time-flexible and individually adaptable part-time online master’s course, as well as certificate courses and programs for further scientific education. In addition to the establishment and continuous further development of a cloud-based learning platform, many new digital and target group–oriented learning resources and application-oriented learning environments were developed and introduced for the master's program.

All 10 topics listed in this article are reflected in the curriculum of the master’s degree and have been offered and dealt with in-depth in the individual courses for more than 2 years. The demand for the master’s program and certificate courses is high, and the evaluation has shown that these topic-specific foci correspond to the training and further education needs of the target groups. One particular aspect that was not covered in the final topics refers to the underlying infrastructure needed to provide the data storage and processing backbone. This aspect would have been too technical for a more broadly set, introductory article, such as this article. A starting point for more in-depth information about this aspect can be obtained from further literature [ 143 , 144 ]. However, to offer a practical start to the 10 topics, we provide links to well-known tutorials and hands-on materials ( Table 1 ).

We suggest a set of 10 topics to ease the start for researchers and clinicians to become engaged with basic concepts in health informatics research. We provide current review articles for more in-depth reading about the specific topic and present practical hands-on material. The presented topics likewise serve as a broad overview of the medical informatics research domain but also guide individuals and their specific interests. For example, a computer scientist familiar with CDSS development could more easily connect with important aspects, such as data privacy, FHIR, and specific EHRs that are highly relevant for daily work. In contrast, medical experts can obtain an overview of behind-the-scenes technologies, like ETL processes and underlying data quality approaches that are finally visualized as a summarizing clinical dashboard. For readers, we provided a first step toward an improved understanding of a lively and quickly expanding field, but more novel technologies and practical knowledge are ahead. Suggestions and contributions to improve the current topics can be made at GitHub, which will likewise enable content and readers to stay current [ 12 ].

Acknowledgments

This work was supported by the Federal Ministry of Health (BMG) and the German Federal Ministry of Education and Research (BMBF) within the Medical Informatics Initiative Medical Informatics in Research and Care in University Medicine (MIRACUM) Consortium (FKZ: 01ZZ180L [Dresden]; FZK: 01ZZ180A [Erlangen]; FKZ: 01ZZ1801M [Greifswald]). The article processing charge was funded by the joint publication funds of the Technische Universität (TU) Dresden, including the Carl Gustav Carus Faculty of Medicine; Saxon State and University Library (SLUB) Dresden; and the Open Access Publication Funding of the German Research Foundation (DFG).

The funding sources had no involvement in the conduct of the research and preparation of the article.

Abbreviations

AI	artificial intelligence
CART	Classification and Regression Tree
CDM	common data model
CDSS	clinical decision support system
CIS	clinical information system
DARWIN	Data Analysis and Real World Interrogation Network
EHR	electronic health record
ePa	elektronische Patientenakte
ETL	extract, transform, and load
FAIR	findable, accessible, interoperable, reusable
FHIR	Fast Healthcare Interoperability Resources
GAN	generative adversarial network
GDPR	General Data Protection Regulation
GECCO	German Corona Consensus Dataset
HL7	Health Level 7
i2b2	Informatics for Integrating Biology and the Bedside
ICD	International Statistical Classification of Diseases and Related Health Problems
IHE	Integrating the Healthcare Enterprise
LOINC	Logical Observation Identifiers Names and Codes
MII	Medical Informatics Initiative
MIRACUM	Medical Informatics in Research and Care in University Medicine
ML	machine learning
NUM	Network University Medicine
OHDSI	Observational Health Data Sciences and Informatics
OMOP	Observational Medical Outcomes Partnership
PLP	patient-level prediction
SMPC	secure multiparty computation
SNOMED CT	Systematized Nomenclature of Medicine and Clinical Terms
VAE	variational autoencoder

Authors' Contributions: MW conceptualized the study, curated the data, and wrote the original manuscript draft. MW also defined the initial topics 1 and 2; MZ defined the initial topics 3 and 4; YP defined the initial topics 5 and 6; IR defined the initial topics 7 and 8; and NA defined the initial topics 8, 9, and 10. MS provided the resources and supervised the study. The topics were revised and extended by KF, AK, SG, DK, KLH, ICJ, CS, JS, TS, PS, and DW. MW, NA, YP, MZ, IR, and MS performed the formal analysis, and MW, NA, and MS created the visualizations. NA, YP, MZ, IR, and MS wrote, reviewed, and edited the manuscript, and all authors read and agreed to the final version of the manuscript.

Conflicts of Interest: None declared.

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You are here > Dissertations > By Degree > Previous Degrees > M.Sc. in Health Informatics

Dissertations M.Sc. in Health Informatics

(2017/18)  

"Towards Medical Data Ownership by Patients: Implications, Challenges and Solutions"
(Supervised by: Hederman, Lucy) (2017/18)  

"HOW A CLOSED LOOP INFUSION THERAPY SYSTEM COULD AFFECT WORK PRACTICES IN A PAEDIATRIC HOSPITAL"
(Supervised by: Berry, Damon) (2017/18)  

"The Benefits and Barriers towards the Implementation of an Electronic Nursing Record and the Potential to use Speech-to-text Technology to Support Point of Care Documentation in the Irish Context"
(Supervised by: Stephens, Gaye) (2017/18) -->

"Errors, Inaccuracies and Omissions in Electronic Birth Notification Data and User Perception of Patient Data Entry in to Electronic Hospital System."
(Supervised by: Sharp, Mary) (2017/18)  

"Towards a prototype and strategy for an electronic medication reconciliation capture in e-medication management systems in an Irish acute care setting"
(Supervised by: Stephens, Gaye) (2017/18)  

"What role does identification play to support Metabolic Dieticians and Scientists for care and research of patients with Phenylketonuria (PKU) - An information modelling perspective "
(Supervised by: Stephens, Gaye) (2017/18)  

"An analysis of whether and how a National Medical Laboratory System (MedLIS) can improve public health surveillance of notifiable infectious diseases in Ireland"
(Supervised by: Hederman, Lucy) (2017/18)  

"Challenges and Enablers in the Collection of Health Data for use in Phase II-III Clinical Trials"
(Supervised by: Hederman, Lucy) (2017/18)  

"Documentation of nursing practice: A closer look at care plans in semi-electronic and conventional paper based-records during a time of change"
(Supervised by: Berry, Damon) (2017/18)  

"Can the Potential Role of Business intelligence tools (with the application of predictive analytics) identify patients at high risk of not attending Irish Healthcare appointments"
(Supervised by: Hederman, Lucy) (2017/18)  

"Audit trails in Patient Portals"
(Supervised by: Stephens, Gaye) (2017/18)  

"Bridging the quality chasm in emergency mental healthcare, with access to the mental health EPR in the emergency department"
(Supervised by: Hederman, Lucy) (2017/18)  

"How ICT might support access to clinical expertise for timely diagnosis of genetic disorders in Irish Travellers at point of care"
(Supervised by: Hederman, Lucy) (2016/17)  

"Shared Electronic Patient Record Access for Community Pharmacists Is there a need and what are important considerations for the design, use and implementation?"
(Supervised by: Stephens, Gaye) (2016/17)  

"Implementation of Healthcare IT Solutions: What are some common difficulties and some possible solutions?"
(Supervised by: Stephens, Gaye) (2016/17)  

"Digitising clinical service records in community pharmacy"
(Supervised by: Hederman, Lucy) (2016/17)  

"Risk Management Process for Physiological Monitors on a Medical IT Network. An evaluation of the Process Assessment Model presented in ISO/TR 80001-2-7"
(Supervised by: Stephens, Gaye) (2016/17)  

"The benefits and challenges of linking health and administrative data with research data - A case-study review of using data linkage with longitudinal surveys"
(Supervised by: Stephens, Gaye) (2016/17)  

"A simulation study to prospectively evaluate the clinical workflow for administering high-risk infusions in a neonatal intensive care unit in upcoming maternal & newborn electronic health record"
(Supervised by: Sharp, Mary) (2016/17)  

"Forming a baseline for open health data. Towards a scorecard based on a preliminary mapping study"
(Supervised by: Hederman, Lucy) (2016/17)  

"Evaluating the effect of clinical dashboards designed to measure and improve the quality of nursing care and patient safety, in a mental health setting."
(Supervised by: Sharp, Mary) (2016/17)  

"The Impact of a Mobile Application for Kidney Transplant Patients on Improved Medication Adherence, Blood Pressure Control, and Patient Engagement"
(Supervised by: Hederman, Lucy) (2016/17)  

"An investigation into the current workflow of a melanoma service utilising an Electronic Patient Record"
(Supervised by: Sharp, Mary) (2016/17)  

"The impact of digitisation of the FRAIL assessment in the emergency department setting"
(Supervised by: Hederman, Lucy) (2016/17)  

"Patient Generated Health Data in Ireland: A Study of the Patient Perspective"
(Supervised by: Hederman, Lucy) (2015/16)  

"What is the optimal design of a Mountain Rescue Patient Assessment Smartphone Application"
(Supervised by: Sharp, Mary) (2015/16)  

"An Initial Exploration of the Transition of Care Communication from a Paediatric Emergency Department to GP care with a view to improving Patient Safety and Continuity of Care"
(Supervised by: Stephens, Gaye) --> (2015/16)  

"Data collection and quality issues in relation to cancer staging and treatments for the Irish National Cancer Registry. Can information and communication technology access improve data capture?"
(Supervised by: Sharp, Mary) (2015/16)  

"An exploration of information needs for adolescents with epilepsy."
(Supervised by: Stephens, Gaye) (2015/16)  

"Learning lessons: A discussion on the unintended consequences of electronic record adoption on nurses documentation practices and implications for a national Electronic Health Record (EHR)"
(Supervised by: Hederman, Lucy) (2015/16)  

"An Exploration of Discharge Summaries of Psychiatric Patients"
(Supervised by: Stephens, Gaye) (2015/16)  

"An Investigation into the Use of CDS to Improve the Appropriateness of Ordering of Specialist Radiological Examinations"
(Supervised by: Hederman, Lucy) (2015/16)  

"The effect of a prescriber training intervention on the prevalence and types of prescribing errors generated by an electronic prescribing system"
(Supervised by: Stephens, Gaye) (2015/16)  

"A decision support system for scheduling carers in domiciliary care settings: What are the key factors, weightings, and constraints?"
(Supervised by: Sharp, Mary) (2015/16)  

"THE IMPACT OF PREOPERATIVE ASSESSMENT CLINICS ON SURGICAL CANCELLATIONS AND OPERATING THEATRE EFFICIENCY"
(Supervised by: Hederman, Lucy) (2015/16)  

"Information needs within the national forensic mental health services in Ireland"
(Supervised by: Hederman, Lucy) (2014/15)  

"Secondary use of data captured during the administration of Intravenous (IV) treatment in the community"
(Supervised by: Hederman, Lucy) (2014/15)  

"An investigation of the Information Process and Requirements in the Care of Patients with Ehlers Danlos Syndrome Hypermobility Type / Joint Hypermobility Syndrome"
(Supervised by: Stephens, Gaye) (2014/15)  

"Is it feasible to design a useful interface for COPD self-management?"
(Supervised by: Stephens, Gaye) (2014/15)  

"A study into the adverse event data required by the Mental Health Commission to support the regulation of in-patient mental health services in Ireland"
(Supervised by: Stephens, Gaye) (2014/15)  

"Secondary Use of Clinical Data Contained in Optometry Electronic Patient Records to Establish a Population Profile of Refractive Error"
(Supervised by: Hederman, Lucy) (2014/15)  

"The Impact of Computerisation of the Patient Pathway within a National Centre for Prostate Cancer"
(Supervised by: Sharp, Mary) (2014/15)  

"Can recorded data from elite athlete monitoring systems be used to improve athlete abilities during training and create injury prevention regimes?"
(Supervised by: Sharp, Mary) (2014/15)  

"Development of minimum data set for postnatal discharge summaries"
(Supervised by: Kane, Bridget) (2014/15)  

"An analysis of the information and communication needs surrounding intensive care unit inter-hospital bed sourcing, referral and transfer coordination"
(Supervised by: Kane, Bridget) (2014/15)  

"Improving fit-for-purpose objectives for spatial data management in emergency and disaster planning"
(Supervised by: Hederman, Lucy) (2014/15)  

"Analysis of the Nursing Shift Handover Practice and the Development of a Structured Format for Handover to Improve Communication and Patient Safety"
(Supervised by: Kane, Bridget) (2014/15)  

"To openEHR is Human"
(Supervised by: Berry, Damon) (2013/14)  

"A Business Analytics Software Tool for Monitoring and Predicting Radiology Throughput Performance"
(Supervised by: Hederman, Lucy) (2013/14)  

"Secondary use of data as a method to improve Data Quality in a theatre Setting"
(Supervised by: Sharp, Mary) (2013/14)  

"Development & Validation of an Assessment Method for the International Standard IEC 80001-1"
(Supervised by: Berry, Damon) (2013/14)  

"Could Irish Nursing Homes avoid sub-optimal prescribing by utilising the OPTI-SCRIPT intervention "
(Supervised by: McDonnell, Ronan) (2013/14)  

"Towards an Access Control and Consent Strategy for an Electronic Healthcare Record (EHR) in Ireland: What can we learn from the experience of other nations?"
(Supervised by: Berry, Damon) (2013/14)  

"Comparing the Utility and Usability of the Microsoft Kinect and Leap Motion Sensor Devices in the Context of Their Application for Gesture Control of Biomedical Images"
(Supervised by: O'Hare, Neil) (2013/14)  

"Increasing the Relevance of Patient Registries to the Public"
(Supervised by: Grimson, Jane) (2013/14)  

"Lost in translation: towards a standard hospital health passport for people with Intellectual Disability, an exploration of minimum data sets"
(Supervised by: Kane, Bridget) (2013/14)  

"The Role of Information Communication Technology (ICT) Towards the Management of Patients with Cancer as Chronic Disease"
(Supervised by: Stephens, Gaye) (2012/13)  

"Process Improvement in a Physiotherapy Outpatients Setting"
(Supervised by: Hederman, Lucy) (2012/13)  

"The Potential Impact of Money Follows the Patient and Universal Health Insurance on Clinical Coding in Ireland"
(Supervised by: Grimson, Jane) (2012/13)

"Understanding Participation in Knowledge-Sharing in Virtual Communities of Practice on the HSELanD elearning Portal"
(Supervised by: Kane, Bridget) (2012/13)  

"Challenges to Collecting Health Data for Secondary Use: A Case Study"
(Supervised by: Hederman, Lucy) (2012/13)  

"An analysis of factors likely to impact on the interoperability required for health information exchanges in the Health Service Executive as perceived"
(Supervised by: Bannister, Frank) (2012/13)  

"Towards supporting community healthcare in Ireland through the use of information communication technology: a cloud-based proposition"
(Supervised by: Berry, Damon) (2012/13)  

"USERS EXPECTATIONS AND PERCEIVED BENEFITS REALISATION OF PICTURE ARCHIVING AND COMMUNICATION SYSTEM (PACS) "
(Supervised by: Sharp, Mary) (2012/13)  

"An investigation into international community pharmacy anticoagulation management services"
(Supervised by: Stephens, Gaye) (2012/13)  

"Can Lean Six Sigma be used to improve the Specimen Sample Process Flow within the NDTC Laboratory?"
(Supervised by: Stephens, Gaye) (2012/13)  

"Developing an Electronic Health Record for Ireland"
(Supervised by: Grimson, Jane) (2012/13)  

"The Impact of an Electronic Clinical Decision Support for Hospital Admission and Continued Stay Appropriateness Determination on Healthcare Quality"
(Supervised by: Sharp, Mary) (2012/13)  

"Design and evaluation of a mobile application for pre-procedural safety checklists"
(Supervised by: Hederman, Lucy)

Previous Years

(2011/12) "What are the Barriers to E-Coding of Quality Clinical Data in Irish Hospitals from a Coder's Perspective?" (Supervised by: Stephens, Gaye)

(2011/12) "Telemedicine is perceived to be cost effective by health organisations, with many wishing to implement: But what are the views of staff and patients?" (Supervised by: Sharp, Mary)

(2011/12) "The Obstacles and Enablers to implementing a Patient Held Prescribing Record in Ireland" (Supervised by: Grimson, Jane)

(2011/12) "Wound Bed Assessment Using Calibrated Images and Representation in OpenEHR" (Supervised by: Berry, Damon)

(2011/12) "Implementing an Individual Health Identifier in Ireland" (Supervised by: Grimson, Jane)

(2011/12) "Maximizing patient flow in the provision of cardiac surgery care" (Supervised by: Sharp, Mary)

(2011/12) "Defeasible Reasoning and Argumentation Theory for Decision Support in Health Care" (Supervised by: Hederman, Lucy)

(2011/12) "The potential benefits of a traceability solution for surgical trays in the Irish Health Service" (Supervised by: Bannister, Frank)

(2011/12) "Expectations and Perceptions of Electronic Health Record Users: A Case Study" (Supervised by: McGinnes, Simon)

(2010/11) "Pre-operative Assessment In The Reduction Of Unplanned Hospital Admission And Cancelled Day Cases And The Role Of Information Technology In The 21st Century" (Supervised by: Sharp, Mary)

(2010/11) "Impact Of SMS Reminders On CBT Appointments" (Supervised by: Kane, Bridget)

(2010/11) "How DSS For Radiology Ordering Should Be Designed To Maximize Adherence To Guidelines" (Supervised by: Hederman, Lucy)

(2010/11) "The National Renal Patient Record System & Technology Acceptance" (Supervised by: Stephens, Gaye)

(2010/11) "To What Extent Can An ICT Based Geospatial Tool Be Used To Assist In The Collection Of Quality Blood" (Supervised by: Conlon, Owen)

(2010/11) "Investigating The Key Factors To Technology Acceptance In An Optical Retail System" (Supervised by: Leahy, Denise)

(2010/11) "Benefits Realisation Using Information Technology In A National Surveillance System" (Supervised by: Sharp, Mary)

(2010/11) "Design Of A User Interface For Process Control In A Medication Production Facility" (Supervised by: Kane, Bridget)

(2010/11) "An Investigation Into The Use Of HL7 Clinical Document Architecture As A Standard For Discharge Summaries In Ireland" (Supervised by: Berry, Damon)

(2010/11) "Submitted December 2011 Waiting For Information Will Update Later" (Supervised by: Lacey, Gerard)

(2010/11) "Does An Online Medical Directory Increase The Efficiency Of Referral By Family Doctors To Specialist Healthcare Services" (Supervised by: Sharp, Mary)

(2010/11) "Exploration Of The Value Of Real Time Coding By Clinicians In A Critical Care Setting" (Supervised by: Stephens, Gaye)

(2010/11) "A Medicines And Drugs Reference Catalogue For E-prescribing In Ireland" (Supervised by: Grimson, Jane)

(2010/11) "Health Informatics Capacity Building In Uganda" (Supervised by: Grimson, Jane)

(2010/11) "Adoption Of EOHRs (electronic Oral Health Records) By Irish Dentists" (Supervised by: Hederman, Lucy)

(2010/11) "The Potential Role Of Maturity Models In An Assessment Of Hospital I.T. Capability In Ireland" (Supervised by: Berry, Damon)

(2010/11) "Success And Failure: A Grounded Theory Study Of Software Implementation In Three Clinical Settings" (Supervised by: McGinnes, Simon)

(2010/11) "An Exploration Into The Design, Implementation And Evaluation Of An Electronic Nursing Careplan" (Supervised by: Sharp, Mary)

(2010/11) "What Are Service Providers' Perceptions About The Use And Need Of Assistive Technology By People In Ireland With Intellectual Disability In The Context Of Providing A Personal Centered Service?" (Supervised by: Stephens, Gaye)

(2009/10) "Can the application of a benefits realisation process release greater value from an existing obstretic information sheet?" (Supervised by: Hederman, Lucy)

(2009/10) "Key factors that should be taken into consideration in planning for implementation of IT to support primary care functions at a local level" (Supervised by: McGinnes, Simon)

(2009/10) "Towards use of Open EHR Archetypes to support views of Cystic Fibrosis Revised Awards" (Supervised by: Berry, Damon)

(2009/10) "Remote Patient Monitoring" (Supervised by: Sharp, Mary)

(2009/10) "A study of the benefits of Benefits Realisation" (Supervised by: Grimson, Jane)

(2009/10) "Why should the HSE adapt best practice and standards for Open Source software?" (Supervised by: Bannister, Frank)

(2009/10) "Exploring the acceptance and barriers to usage of information and communication technology by Irish Occupational Therapists" (Supervised by: Hederman, Lucy)

(2009/10) "To assess the requirement for capturing Performance Indicators (PI) for General Practitioners in Primary care." (Supervised by: Grimson, Bill)

(2009/10) "Why Healthcare Professionals resist change when work changing technologies such as PACs and CR are implemented" (Supervised by: McGinnes, Simon)

(2009/10) "How could Maternity Referrals be supported by an Online CDSS in Practice and Education" (Supervised by: Hederman, Lucy)

(2009/10) "How will an Electronic Adverse Event Reporting Management System Improve the Time Management and the Quality Processes of the Adverse Event Reporting Process in a Private Healthcare Organisation" (Supervised by: Sharp, Mary)

(2009/10) "HL7 Conformance Profile Development for National Messaging Standards" (Supervised by: Hederman, Lucy)

(2009/10) "Investigation of the Requirements for an Intellectual Disability Information System for an Adult Service of St. John of God Hospitaller Services" (Supervised by: Hederman, Lucy)

(2009/10) "In search of good Health Messages. An investigation of the properties of a messaging standard that makes it useable and applicable" (Supervised by: Berry, Damon)

(2009/10) "Use of Open Source Business Intelligence Software in Hospital Management" (Supervised by: Grimson, Jane)

(2009/10) "Towards best practice in the Archetype Development Process" (Supervised by: Berry, Damon)

(2008/09) "A Study into the electronic transfer of patient data between hospitals and long term care facilities" (Supervised by: Sharp, Mary)

(2008/09) "Evaluating an Electronic Database in an Operation Theatre Situation. Can benefits be realised through the migration of paper based medical data capture to electronic systems in an Operating Theatre Situation?" (Supervised by: Sharp, Mary)

(2008/09) "Operative note writing: barriers to an electronic record and the possible implications for patient safety" (Supervised by: Hederman, Lucy)

(2008/09) "Towards identifying the barriers to developing an electronic patient record (EPR) in a sexual health setting and to evaluate available systems and identify the system most suitable for use at a Sexual Health Clinic at a large Dublin public hospital" (Supervised by: Hederman, Lucy)

(2008/09) "Developing a Dental Electronic Patient Record for the Permanent Defence Forces" (Supervised by: Grimson, Bill)

(2008/09) * "How Can Business Process Reengineering Improve The Quality And Availability Of Information For The Admissions Staff In The Mater Private Hospital And Improve Efficiency And The Quality Of Service To The Patient: Withheld For 5 Years" (Supervised by: Bannister, Frank)

(2008/09) "Developing key performance indicators to monitor healthcare quality" (Supervised by: Grimson, Jane)

(2008/09) "Using Adaptive e-learning technology to provide medical education for children with cancer" (Supervised by: Hicks, Paula)

(2008/09) "The challenges of implementing RemoteCardiac Patient Monitoring Solutions" (Supervised by: Berry, Damon)

(2008/09) "Can Computerised Clinical Decision Support Improve Antimicrobial Prescribing?" (Supervised by: Hederman, Lucy)

(2008/09) "How can Privacy Impact Assessments be adapted to the Health Sector in Ireland?" (Supervised by: Grimson, Jane)

(2008/09) "Attitudes Of Health Professionals To Electronic Data Sharing Within An Integrated Care Electronic Health Record (icehr)" (Supervised by: Berry, Damon)

(2008/09) "Can a Web Portal Enhance Collaboration between Speech and Language Therapists and Primary School Teachers?" (Supervised by: Hederman, Lucy)

(2008/09) "A vision for Ireland for an electronic patient referral system from primary to secondary care" (Supervised by: Hederman, Lucy)

(2008/09) "Towards an Irish Joint Register" (Supervised by: Sharp, Mary)

(2007/08) "Raising Awareness Of Health Informatics Among Nigerian Healthcare Professionals" (Supervised by: Grimson, Jane)

(2007/08) "An Analysis Of How Information Technology Can Contribute To Reducing Acute Hospital Admissions And Length Of Stay" (Supervised by: Grimson, Jane)

(2007/08) "A National Renal Registry: An Irish Perspective" (Supervised by: Sharp, Mary)

(2007/08) "The Design Of A Support Framework For Education About Dementia And Its Application Within An E Learning Environment" (Supervised by: Sharp, Mary)

(2007/08) "Towards An Integrated Web Based Service For The Management Of Patients Requiring Oral Anticoagulation In Ireland" (Supervised by: Hederman, Lucy)

(2007/08) "How Will The Publics' Use Of The Internet Including Their Experience Of Ebanking Affect Their Perception Of Privacy And Confidentiality Of Electronic Health Records?" (Supervised by: Hederman, Lucy)

(2007/08) "An Evaluation And Enhancement Of Clinical Decision Support Software For Telephone Nurse Triage In The Out Of Hours Setting" (Supervised by: Hederman, Lucy)

(2007/08) --> "How Community Based Policy Management Can Improve Access To The Solas Online Community" (Supervised by: O'Sullivan, Declan)

(2007/08) "Obstacles To The Implementation Of A National Chronic Disease Management System For Cardiovascular Care" (Supervised by: Hederman, Lucy)

(2007/08) "Potential Benefits Of A Wifi Patient Tracking System In A Surgical Unit" (Supervised by: Grimson, Jane)

(2007/08) "Introducing Electronic Health Records In Ireland" (Supervised by: Grimson, Jane)

(2007/08) "The Development Of Electronic Health Messaging Services In Denmark And Lessons For Ireland" (Supervised by: Grimson, Bill)

(2007/08) "An Overview of Information Technology, Data Quality and Data Standards in Irish Emergency Departments: Are we Comparing Like with Like?" (Supervised by: Grimson, Bill)

(2006/07) "Evaluation of Data from an Urgent Out of Hours GP Service as a Potential Early Warning System for Influenza" (Supervised by: Hederman, Lucy)

(2006/07) "A Discussion of the Issues surrounding the Design of an Effective Infectious Disease Surveillance System which meets the Needs of all Users in an Irish Hospital Setting" (Supervised by: Hederman, Lucy)

(2006/07) "What can a GIS bring to an epidemiological study in Ireland: A case study of nitrates in drinking water and cancer risk" (Supervised by: Sharp, Mary)

(2006/07) "'Migration Through Value Added Services' - A Viable Approach to a Service Orientated Architecture for the medical domain?" (Supervised by: O'Sullivan, Declan)

(2006/07) "Can a Decision Support System assist in the prevention of inappropriate elective surgical admissions and reduce the spread of MRSA in a private hospital in Dublin?" (Supervised by: Sharp, Mary)

(2006/07) "Requirements analysis for the development of a Nurse Resource Management System for Critical care" (Supervised by: Hederman, Lucy)

(2006/07) "The Potential for Development of an Automated System for Diagnosis of Acute Intra-Cranial Haemorrhage from CT scans" (Supervised by: Hederman, Lucy)

(2006/07) "Making clinical data accessible to people with Intellectual Disability" (Supervised by: Hederman, Lucy)

(2006/07) "The Person Identification Service as an Enabler of Electronic Healthcare Record Communication" (Supervised by: Berry, Damon)

(2006/07) "Analysis of data flow in a Hospital Lab to aid in the investigation of the potential benefits of IT in increasing efficiency" (Supervised by: Grimson, Bill)

(2005/06) "Towards The Recognition & Establishment Of The Position Informatics Nurse Specialist In Ireland" (Supervised by: Sharp, Mary)

(2005/06) "Quality Improvement In The Clinical Laboratory...Use Of Information Technology In The Extra Analytical Processes Of The Irish Clinical Laboratory" (Supervised by: Stephens, Gaye)

(2005/06) "Information Deficits In Emergency Mental Health Care In Ireland: Could A Minimum Data Set Offer A Solution" (Supervised by: Stephens, Gaye)

(2005/06) "An Evaluation Of The Benefits Experienced With Picture Archiving & Communications Systems (pacs) Versus Conventional Image Management Systems In Irish Hospitals" (Supervised by: Normand, Charles)

(2005/06) "Electronic Patient Records: An Investigation Into Issues Surrounding Privacy, Confidentiality & Data Protectionr" (Supervised by: Sharp, Mary)

(2005/06) "Eliciting A User Specification For Electronic Patient Identification In An Emergency Department" (Supervised by: Berry, Damon)

(2005/06) "Informatics As A Key To Environmental Protection" (Supervised by: Berry, Damon)

(2005/06) "Assessing The Computer Competency Of Forensic Mental Health Nurses" (Supervised by: Stephens, Gaye)

(2005/06) "Assisted Human Reproduction National Data Registries - Do they accomplish a balance between the monitoring and publishing of performance and quality? Proposals for an Irish registry" (Supervised by: Hederman, Lucy)

(2005/06) "User Requirements: Their Elicitation & Evaluation In The Development Of A Neuro Interventional Radiology Information System" (Supervised by: Grimson, Bill)

(2005/06) "Can ICT Bridge The Gap Between Research & Practice To Support The Early Identification Of Autism? An exploratory study." (Supervised by: Hederman, Lucy)

(2005/06) "Investigation Into The Security Practices Of Irish Hospitals For Wireless Networks" (Supervised by: O'Sullivan, Declan)

(2004/05) "Design, Implementation & Evaluation Of A National Neocare Transport Prototype System" (Supervised by: Stephens, Gaye)

(2004/05) "The Collection Of Biometric Data & Its Impact On Healthcare Providers" (Supervised by: Stephens, Gaye)

(2004/05) "The Potential Benefit Of ICT In Reducing Anxiety Levels And Increasing Satisfaction With Patient Information In The Radiotherapy Setting" (Supervised by: Hederman, Lucy)

(2004/05) "Factors That Influence HIPE Data Quality From A Coders Perspective" (Supervised by: Sharp, Mary)

(2004/05) "Cancer Data System Analysis: A Data System Analysis Of Two Affiliated Teaching Hospitals With A View To National Integration" (Supervised by: Sharp, Mary)

(2004/05) "A Problem Based Learning Approach To Nursing Informatics For Undergraduate Students" (Supervised by: Grimson, Jane)

(2004/05) "Towards A Distributed E Laboratory: Analysis & Design For More Efficient Laboratory Referrals" (Supervised by: Berry, Damon)

(2004/05) "The Application Of Formative Usability Evaluation Techniques To Improve Software Usability In St. John Of God Services" (Supervised by: Stephens, Gaye)

(2004/05) "The Development Of A Departmental And Web Based Teaching Syllabus For Radiological Anatomy" (Supervised by: Bresnihan, Nina)

(2004/05) "Customisable EHR Views: Using Portal Technology To Exploit Existing Electronic Patient Data" (Supervised by: Grimson, Bill)

(2004/05) "Review Of Technology Systems And Coding Sets Towards Designing A Conceptual Patient Record Model For Intellectual Disabilities (Id) Nursing Practice Settings And For The Id Electronic Patient Record (Epr) In Ireland" (Supervised by: Stephens, Gaye)

(2004/05) "Wireless Lans In Healthcare Delivery" (Supervised by: O'Sullivan, Declan)

(2004/05) "Evaluation Of The Use Of Laerdal Microsim As An Adjunct To Traditional Learning Methods For Teaching Advanced Cardiovascular Life Support" (Supervised by: Grimson, Jane)

(2004/05) "Developing, Implementing & Evaluating An Elearning Tool For A Casemix Coding Department" (Supervised by: Stephens, Gaye)

(2004/05) "Automatic Speech Recognition Implementations In Healthcare" (Supervised by: Grimson, Jane)

(2004/05) "Mobile Technology & Decision Support For The Administration Of Antiretrovirals In Developing Countries" (Supervised by: Stephens, Gaye)

(2003/04) "Quizmed: Development And Evaluation Of A Distributed Self Test & Information Exchange Healthcare Application" (Supervised by: Jung, Benjamin)

(2003/04) "Towards A Unique Identification System For The Irish Health Sector" (Supervised by: Stephens, Gaye)

(2003/04) "Telemedicine: Telemonitoring, Telehealth & Heart Failure" (Supervised by: Stephens, Gaye)

(2003/04) "A Technical Look At Electronic Lab Ordering Using HL7 & XML" (Supervised by: Stephens, Gaye)

(2003/04) "Designing An Electronic Patient Record That Incorporates Clinical Practice Guidelines As A Decision Support System For The Treatment Of Symptomatic Breast Disease In Ireland" (Supervised by: Hederman, Lucy)

(2003/04) "Distance Education In Health Informatics" (Supervised by: Stephens, Gaye)

(2003/04) "An Investigation Of The Internet As A Resource For Nurses Working In Ireland And Its Role In Supporting Their Clinical Practice And Promoting Their Professional Development" (Supervised by: Carroll, Tony)

(2003/04) "The Application Of Data Mining Techniques To A Cardiac Surgery Database" (Supervised by: Sharp, Mary)

(2003/04) "Towards An Irish Speech And Language Therapy Knowledge Centre: Building An Online Community" (Supervised by: Hederman, Lucy)

(2003/04) "Requirements Engineering: Epilepsy & The Electronic Patient Record" (Supervised by: Stephens, Gaye)

(2003/04) "Secure Internet Access To Medical Laboratory Results" (Supervised by: Sharp, Mary)

(2003/04) "A Practical Implementation Of Risk Management To Healthcare Online" (Supervised by: Stephens, Gaye)

(2003/04) "The Cancer Data Manager And The Role Of IT: An Assessment Of How IT Can Be Used To Enhance The Role Of Cancer Data Managers" (Supervised by: Hederman, Lucy)

(2002/03) "A Review Of Performance Management Systems In Selected Irish Hospitals" (Supervised by: Carroll, Tony)

(2002/03) "An Assessment And Primary Development Of An Integrated Computerised Tracking System For Sterile Instruments In The Operating Theatre" (Supervised by: Stephens, Gaye)

(2002/03) "Modified Directly Observed Therapy For Tuberculosis: A Possible Alternative" (Supervised by: Grimson, Bill)

(2002/03) "Risk Management Within Project Management As Part Of The Implementation Of Information Systems In A Healthcare Environment" (Supervised by: Grimson, Bill)

(2002/03) "Computer Support For Collaborative Work In Lung Cancer Diagnosis: An Ethnographic Study And Critical Assessment" (Supervised by: Luz, Saturnino)

(2002/03) "Analysis Of An Electronic Future Of Clinical Coding" (Supervised by: Stephens, Gaye)

(2002/03) "A Data Privacy Code Of Practice For Irish General Practice" (Supervised by: Sharp, Mary)

(2002/03) "Developing A Computer Based Interactive Tutorial For Psychiatric Nurses On The Prevention And Management Of Violent Behaviour" (Supervised by: Berry, Damon)

(2002/03) "The Design And Development Of An Interactive Multimedia Learning Package For Adult Learners" (Supervised by: Grimson, Jane)

(2002/03) "A Model Of Telephone Triage Software For Irish Out Of Hours General Practice Clinics" (Supervised by: Sharp, Mary)

(2002/03) "Creating A Secure Environment For Patient Data Within The South Eastern Health Board" (Supervised by: Grimson, Jane)

(2002/03) "Using ICTS To Support Nurse Workforce Planning: An Irish Perspective" (Supervised by: Carroll, Tony)

(2002/03) "Technical And Safety Issues With Medical Tracking Systems" (Supervised by: Sharp, Mary)

(2002/03) "An Analysis Of The Preparation Needed For The Implementation Of A Mental Health Information System In A Diverse Mental Health Community Setting" (Supervised by: O'Sullivan, Declan)

(2001/02) "An Assessment Of Patient Information In The Field Of Breast Cancer In Ireland" (Supervised by: Stephens, Gaye)

(2001/02) "Teaching IT To Health Professionals" (Supervised by: Wade, Vincent)

(2001/02) "Usability Design Of An Electronic Flow Sheet For A General Intensive Care Unit" (Supervised by: McGrath, Rose)

(2001/02) "An Exploration Of Educational Theory & A Study Into The Feasibility Of Its Application To A Computer Based Tutorial For The Health Care Domain" (Supervised by: McNally, Kieran)

(2001/02) "A Basic Health Information And Immunisation Registry For The University Of Dublin Student Health Service: Design, Development, Implementation And Evaluation" (Supervised by: McKeown, John)

(2001/02) "The Development & Implementation Of Protocols For A Diabetes Shared Care Project" (Supervised by: Boran, Gerard)

(2001/02) "The Role & User Requirements Of A Relational Database For Outcome Measures In Stroke Care Physiotherapy: Stroke Rehabilitation System Prototype" (Supervised by: Sharp, Mary)

(2001/02) "A Study To Determine Nurses' Attitudes To Care Plans" (Supervised by: Grimson, Jane)

(2001/02) "The First Stages Of Development Of A Computer Based Wheelchair & Wheelchair Seating Assessment & Prescription System: Identifying User Requirements" (Supervised by: Grimson, Bill)

(2001/02) "Implementation & Use Of A Dicom Based Centralised Image Store" (Supervised by: Cawley, Martin)

(2001/02) "Communication Between Professionals In A Shared Care Environment To Manage Patients Taking Lithium" (Supervised by: Stephens, Gaye)

(2001/02) "A Specification Of Requirements For A Computerised Speech & Language Therapy Information System" (Supervised by: Carroll, Tony)

(2001/02) "An Assessment Of The Information & Communications Technology (ICT) Requirements Of Irish Healthcare Workers" (Supervised by: Carroll, Tony)

(2001/02) "Towards An Electronic Register, Tracking & Management System For The National Childhood Primary Immunisation Programme" (Supervised by: Berry, Damon)

(2001/02) "Information Extraction: An Approach To Facilitate The Analysis & Structuring Of Free Text Physiotherapy Discharge Summaries" (Supervised by: Hederman, Lucy)

(2001/02) "The Development & Optimisation Of A Radiographic Digitisation System Using A Digital Camera" (Supervised by: McKavanagh, Jackie)

(2000/01) "Designing A Clinical Support System For Occupational Therapy In A Child & Adolescent Mental Health Clinic" (Supervised by: Hederman, Lucy)

(2000/01) "An Assessment Of Information Technology In Irish Healthcare" (Supervised by: Stephens, Gaye)

(2000/01) "A User Centric Specification For A Clinical Audit System For Vascular Surgery Using The UML" (Supervised by: Berry, Damon)

(2000/01) "Implementation Of A Low Cost Telemedicine System" (Supervised by: Doyle, Linda)

(2000/01) "The Use Of Computers In Nurse Education In The Republic Of Ireland: Development Of A Computer Aided Learning Package For Psychiatric Nursing Students" (Supervised by: Carroll, Tony)

(2000/01) "Proposal For A Visual Modelling Language For Medical Knowledge" (Supervised by: Berry, Damon)

(2000/01) "The Impact Of Maternity Information Systems On Midwifery Services In Dublin: A Survey Across The 3 Maternity Hospitals" (Supervised by: Carroll, Tony)

(2000/01) "User Requirements & Analysis Of A Web Based Automated Scheduling System For Nurses" (Supervised by: Boran, Gerard)

(2000/01) "The Development Of A System To Support The National Newborn Screening Programme In The Context Of An Electronic Healthcare Record" (Supervised by: Grimson, Jane)

(2000/01) "An Exploration Of Student Nurses' And Clinical Staff Experiences Of Information Technology In A Mental Health Service With Recommendations For Future Development" (Supervised by: Higgins, Agnes)

(1999/2000) "E Communication: A New Era For Mental Healthcare In Ireland" (Supervised by: O'Moore, Rory)

(1999/2000) "Development Of A Test Request Protocol For A Critical Care Area" (Supervised by: Boran, Gerard)

(1999/2000) "Information Technology Supporting Near Patient Testing" (Supervised by: Boran, Gerard)

(1999/2000) "Implementation Of Required Laptop Ownership In A Medical School: Proposed Design Of An Effective Model For Introduction & Support" (Supervised by: Grimson, Jane)

(1999/2000) "Maintaining Your Own Personal Health Data: The Possibilities For Web Based Patient Centred Health Data Management Systems" (Supervised by: Grimson, Jane)

(1999/2000) "Security For Distributed Data In XML" (Supervised by: Grimson, Jane)

(1999/2000) "Cost Benefit Analysis Of Acquiring An Open Distributed Hospital Information System Using Business Process Reengineering" (Supervised by: Carroll, Tony)

(1999/2000) "Web Based Training In Health Informatics: The Electronic Healthcare Record" (Supervised by: Grimson, Jane)

(1999/2000) "The Web Based Design Of A Laboratory Advice System" (Supervised by: Hederman, Lucy)

(1999/2000) "Data Standards In Clinical Research: Learning By Involvement In A Colorectal Cancer Audit" (Supervised by: Berry, Damon)

(1999/2000) "Computer Based Oral Health Record: A Requirements Analysis" (Supervised by: Grimson, Bill)

Nursing Informatics Research Topics and Titles for Nursing students

Nursing informatics research topics are a viable way to acquire evidence-based knowledge to be used in improving the quality of healthcare. As you write about different topics, you also get to solve nursing informatics-related issues, challenges, and barriers in your area of practice or given facilities.

Before we delve into the topics, let's begin by defining nursing informatics for purposes of clarity henceforth. According to the HIMSS, nursing informatics entails the integration of nursing science with multiple analytical and information sciences to define, identify, manage, and disseminate information, data, wisdom, and knowledge in nursing practice.

One must have a BSN, MSN, or certification to take up the nursing informatics roles. The nursing roles that fall under nursing informatics include nursing informaticist, nursing informatics specialist, nursing informatics clinician, chief nurse informatics officer, or perioperative informatics nurse.

115 Nursing and Healthcare Informatics Titles and Topics

• The Impact of nursing informatics on patient outcomes and patient care efficiencies
• Electronic Health Records (EHRs) and Meaningful Use
• The benefits of Electronic Case Reporting (eCR)
• Benefits of Health Information Exchange (HIE)
• Types of Health Information Exchange
• Use of Syndrome Surveillance
• Clinical Data Registry
• Cancer Registry Reporting
• How Immunization Information Systems and informatics Promote Immunizations
• Information Management in Cancer Registries
• Role of cancer registries
• Evolution of the cancer registrar in the era of Informatics
• Interoperability of patient population-based registries
• Interoperability and EHR
• Benefits of implementing Electronic Laboratory Reporting
• Eligibility and registration for public health meaningful use
• Benefits of understanding the onboarding process for EHR systems
• Rulemaking in electronic health systems
• Ethical Issues in electronic health records
• National laws governing the implementation of electronic health records
• Privacy and security issues in electronic health information
• Value of the electronic medical record for hospital care
• HITECH Act and the implementation of EHR
• Challenges facing the implementation of electronic health records
• Risks facing electronic health records
• Barriers to implementing electronic health records
• The Health Insurance Portability and Accountability Act and implementation of health information
• Steps of implementing electronic health records in a Hospital
• How does the 21 st Century Cures Act or the Cures Act impact the implementation of electronic health records
• Role of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) in the implementation of EHR
• Importance of clinical decision-making systems (CDSS)
• How implementing electronic healthcare can solve emergency room overcrowding
• Use of artificial intelligence in electronic health systems
• Application of predictive analytics in healthcare
• Benefits of implementing clinical image capture
• Benefits of patient portals
• Benefits of implementing telemedicine
• Benefits of Telepsychiatry for remote patients
• Decision Modeling and Natural Language Processing in Healthcare
• The use of computerized provider order entry (CPOE) by providers
• How to Become a Nursing Informatics Specialist
• Role of Nursing Informatics Educator
• Importance of nursing informatics
• The advocacy role of the American Health Information Management Association (AHIMA)
• Organizations coordinating the implementation of healthcare informatics in America
• Why get the AHIMA certification
• How to Become a Registered Health Information Technician (RHIT)
• The use of Big Data and data analytics in healthcare
• How electronic health records promote evidence-based Practice
• Electronic health records and teamwork
• Hof electronic health records promote interprofessional collaboration
• Role of Leadership in healthcare systems implementation
• Measuring the use of electronic health records in primary care
• How electronic health records facilitate nursing research
• Use of electronic health records among diabetic patients
• Attitudes and readiness of healthcare workers to use electronic health records
• How Electronic Health Records influences nurse Burnout
• Physician fatigue and electronic health records
• Factors affecting the access of patients to electronic medical records
• Role of Blockchain in mental health records management
• Impacts of Emergency Department EHR on Patient care outcomes
• The usability of emergency medicine electronic health record
• Are emergency rooms too busy for electronic records?
• How EHR in emergency departments improve diagnostic accuracy
• Benefits of mHealth to patients from remote areas
• Can HER be applied for psychiatry and behavioral health?
• Telepsychiatry system providers in the USA
• How telepsychiatry improves access and Use of mental health facilities
• Barriers to integrating EHRs in the mental healthcare sector
• Requirements for Psychiatry EHR
• The use of telepsychiatry during pandemics and disasters
• The benefits of telemedicine in the context of Covid-19
• Challenges in implementing telehealth
• Telehealth for the treatment of serious mental health illnesses and substance use disorders
• The application of telepsychiatry with adolescents and children: Issues, challenges, and promises
• Telepsychiatry malpractice insurance
• Role of the American psychiatric association in the Implementation of telepsychiatry
• Factors to consider before choosing online therapy
• Role of psychiatric nurses in telehealth advocacy
• Impacts of statewide telehealth policies on implementing telepsychiatry
• Strategies to improve telehealth visits
• Impacts of CMS Expansion of Medicare on telehealth implementation
• Perceptions and attitudes of perceptions of consumers on telehealth for mental health
• How telehealth was used to meet mental health needs during the COVID-19 pandemic
• The experiences of nursing students on remote consultations during the COVID-19 pandemic
• Impacts of using online simulations on nurse students
• Laws and policies governing the implementation of telemedicine and telehealth
• Use of telehealth and Telemedicine to address opioid overdose epidemics
• Use of telemedicine to address polypharmacy
• Using patient-centered EHR to teach students
• EHR-based medication support and nurse-led medication therapy management
• Benefits of electronic health record training for nurse leaders
• Challenges and benefits of implementing electronic health records in nursing education
• Postimplementation training and EHR
• Simulation-based training for EHR in nursing education
• How to Become an HER Trainer
• Are nurses the HER superuser?
• Clinical impacts of the use of electronic health records in operation rooms
• How EHR Improves the operating room efficiency
• Impacts of implementing EHR during surgeries
• How using EHR systems can increase operation times
• How poor usability of electronic health records leads to drug errors
• Role of clinical decision support systems (CDSS) in improving patient care
• Implications of using the digitally structured format for nursing shifts
• Impacts of health information technology on patient safety
• Improving healthcare quality through the use of healthcare technologies
• Does the use of technology enhance the diagnostic outcomes of patients?
• Effectiveness of simulation-based nursing Education
• Simulation-based training and attitudes and behavior of new nurses handling complex patients
• The effectiveness of using virtual reality in Nursing Education
• Does the use of point-of-care simulation help manage acute deterioration better?
• Impacts of using clinical virtual simulation in Nursing
• Does using Shadow Health clinical simulation exercises improve nurse students' grasp of concepts?
• Can simulation replace most of the clinical hours?
• The impacts of using 3D nursing simulations for nursing students

Check out our list of nursing essay and research paper topics to select one that suits your perspective, practice area, and interests.

Final Take!

Choosing a promising technology, informatics, and electronic health topic for a nursing essay , research paper, capstone, or dissertation can be challenging. As a result, you can be confused and uncertain. However, the 115 Nursing informatics topics list can help you navigate the process and brainstorm ideas to improve your nursing papers' titles.

Related Readings:

• A list of common nursing theories
• Excellent nursing capstone project ideas and topics.
• Review of WGU RN to BSN Program.
• Nursing paper topics to write papers about
• Steps for nursing care planning
• How to write a perfect capstone project.

If you have highlighted some topics off this list, you should consult with your nurse educator, teacher, professor, or dissertation supervisor. You can then get ideas on how to approach the topic. You can also tailor the topic to the needs of your course.

Good luck as you choose. If you need help choosing the topics, order a one-page paper from our website, and our nursing writers will research 3-4 of the best topics with a few sentences of explanation on the potential focus.

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This paper is in the following e-collection/theme issue:

Published on 24.7.2023 in Vol 25 (2023)

Ten Topics to Get Started in Medical Informatics Research

Authors of this article:

• Markus Wolfien 1, 2 , Dr-Ing   ; 
• Najia Ahmadi 1 , MSc   ; 
• Kai Fitzer 3 , MSc   ; 
• Sophia Grummt 1 , MSc   ; 
• Kilian-Ludwig Heine 1 , MA   ; 
• Ian-C Jung 1 , MSc   ; 
• Dagmar Krefting 4 , Prof Dr   ; 
• Andreas Kühn 1 , Dr med   ; 
• Yuan Peng 1 , MSc   ; 
• Ines Reinecke 1 , MSc   ; 
• Julia Scheel 5 , MSc   ; 
• Tobias Schmidt 6 , MA   ; 
• Paul Schmücker 6 , Prof Dr   ; 
• Christina Schüttler 7 , PhD   ; 
• Dagmar Waltemath 3, 8 , Prof Dr   ; 
• Michele Zoch 1 , Dipl.-Wi.-Inf.   ; 
• Martin Sedlmayr 1, 2 , Prof Dr  

1 Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

2 Center for Scalable Data Analytics and Artificial Intelligence, Dresden, Germany

3 Core Unit Data Integration Center, University Medicine Greifswald, Greifswald, Germany

4 Department of Medical Informatics, University Medical Center, Goettingen, Germany

5 Department of Systems Biology and Bioinformatics, University of Rostock, Rostock, Germany

6 Institute for Medical Informatics, University of Applied Sciences Mannheim, Mannheim, Germany

7 Central Biobank Erlangen, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

8 Department of Medical Informatics, University Medicine Greifswald, Greifswald, Germany

Corresponding Author:

Markus Wolfien, Dr-Ing

Institute for Medical Informatics and Biometry

Faculty of Medicine Carl Gustav Carus

Technische Universität Dresden

Fetscherstraße 74

Dresden, 01307

Phone: 49 3514587723

Email: [email protected]

The vast and heterogeneous data being constantly generated in clinics can provide great wealth for patients and research alike. The quickly evolving field of medical informatics research has contributed numerous concepts, algorithms, and standards to facilitate this development. However, these difficult relationships, complex terminologies, and multiple implementations can present obstacles for people who want to get active in the field. With a particular focus on medical informatics research conducted in Germany, we present in our Viewpoint a set of 10 important topics to improve the overall interdisciplinary communication between different stakeholders (eg, physicians, computational experts, experimentalists, students, patient representatives). This may lower the barriers to entry and offer a starting point for collaborations at different levels. The suggested topics are briefly introduced, then general best practice guidance is given, and further resources for in-depth reading or hands-on tutorials are recommended. In addition, the topics are set to cover current aspects and open research gaps of the medical informatics domain, including data regulations and concepts; data harmonization and processing; and data evaluation, visualization, and dissemination. In addition, we give an example on how these topics can be integrated in a medical informatics curriculum for higher education. By recognizing these topics, readers will be able to (1) set clinical and research data into the context of medical informatics, understanding what is possible to achieve with data or how data should be handled in terms of data privacy and storage; (2) distinguish current interoperability standards and obtain first insights into the processes leading to effective data transfer and analysis; and (3) value the use of newly developed technical approaches to utilize the full potential of clinical data.

Introduction

Digital health care information, as opposed to analog information, empowers clinicians, researchers, and patients with a wealth of information aiming to improve diagnosis, therapy outcome, and clinical care in general. According to Wyatt and Liu [ 1 ], medical informatics is the study and application of methods to improve the management of patient data, clinical knowledge, population data, and other information relevant to patient care and community health. Medical informatics can be seen as the subset of health informatics that is focused on clinical care, while the latter encompasses a wider range of applications. However, knowing, integrating, and using current computational technologies bears numerous pitfalls, limitations, and questions [ 2 ]. To shed light on current standards, applications, and underlying technologies, we present 10 topics to get started in the field of medical informatics research. Our key objective here was to improve interdisciplinary communication among stakeholders (eg, clinicians, experimental researchers, computer scientists, students, patient representatives), thereby bringing everyone on the same page of state-of-the-art medical informatics practices. In particular, improved interdisciplinary communication is essential in real-world problems and can be motivated by the following aspects:

• Advancing open research: Open collaboration between parties from different disciplines can lead to new research questions, innovative approaches, and novel discoveries [ 3 ].
• Bridging knowledge domains: Interdisciplinary communication can stimulate novel solutions, allowing researchers to gain a more comprehensive understanding of a specific problem or phenomenon [ 4 ], or can improve clinical decision-making [ 5 ].
• Addressing complex problems: Complex problems, such as the latest disease outbreak, require input from multiple domains to be comprehensively understood. Here, interdisciplinary communication is one key aspect to pinpoint the root causes and develop effective solutions [ 6 ].
• Promoting scientific inclusivity and diversity: Interdisciplinary communication was recently shown to foster diversity and inclusivity in science, by bringing together researchers from different backgrounds, cultures, and perspectives [ 7 , 8 ].

Here, we describe in detail how the initial topics have been selected from the literature and what design principles and structure each topic follows. A brief outline of the utilized methods for topic dissemination and an exemplary embedding into an educational training program are also presented.

Topic Selection

The initial topics were defined based on current developments in the health informatics field and an increasing number of published manuscripts between 2000 and 2021 (based on title-abstract-keyword screening in Scopus using the keywords “Health” AND “Informatics” AND “domain”) in the respective subdomains ( Figure 1 A). After a first definition of the specific topics, these were critically revised by internal and external domain experts, as well as scientists previously not familiar with medical informatics research.

Topic Design

The initial number of important topics and keywords exceeded the anticipated number of 10 topics, which found inspiration from the “Ten Simple Rules” collection in PLOS Computational Biology [ 9 ]. This is why the authors merged the most matching terms topic wise into groups. These groups finally produced topics that represent the broad range of the medical informatics domain in 3 main concepts, namely “Regulations and concepts,” “Harmonization and processing,” and “Evaluation, visualization, and dissemination” ( Figure 1 B). Figure 1 B also shows the initial keywords for each individual topic, as well as potential cross references between topics, which are highlighted in grey. The following sections provide important “do's and don'ts,” practical hints, and best practice guidelines. Further in-depth resources and practical tutorials will provide basic introductions to the referred domains. Kohane et al [ 10 ] already showed the importance of such clarifying introductions. This work extends the initial study and, in addition, provides detailed examples from the German national Medical Informatics Initiative (MII) [ 11 ].

All topics were divided into 3 parts to improve comprehension by the readers:

• Introduction: Background definitions for the specific context that motivated the topic
• Insight: Practical context to get started, including how to avoid pitfalls, state current limitations, and address current challenges
• Impact: Take home message and useful resources and best practices to deepen knowledge about the topic

Topic Utilization, Extension, and Embedding

Since it is of the utmost importance to keep the content current and as versatile as possible, we initiated an online resource at GitHub, in which contributions are highly emphasized [ 12 ]. Here, keywords and the corresponding literature are collected to allow for swift extension of the currently presented literature body in this article. In addition, the introduction of novel important topics that are not covered in this article might be included. To additionally demonstrate the practicability and adaptability of our proposed topic content, we exemplarily present how these can be embedded in higher education training and share external, introductory hands-on material ( Table 1 ).

Regulations and Concepts

Topic 1: privacy and ethics—“data privacy and ethics are the most important assets in the clinical domain.”.

Health information is sensitive and hence needs to be highly protected and should not be generously shared. Sharing regulations and data privacy matters are defined in the European General Data Protection Regulation (GDPR) [ 13 ]. The implementation of the GDPR is an ongoing process as the quickly evolving technology, data, and scientific practices demand continuous improvement, which include periodic adaptations of the technical and legal aspects [ 14 , 15 ]. In terms of ethics and with the rise of novel technologies, like artificial intelligence (AI), the possible re-identification of data, such as images and genomic information, is a major concern [ 16 , 17 ].

Anonymization is one important way to keep data private. It can also be achieved for high-dimensional data by changing patient-specific identifiers through removal, substitution, distortion, generalization, or aggregation [ 18 ]. In contrast, data pseudonymization is another de-identification procedure by which personally identifiable information fields within a data record are replaced by one or more artificial identifiers or pseudonyms [ 19 ]. To overcome the paucity of annotated medical data in real-world settings and (fully) save the patients’ anonymity, synthetic data generation is used to increase the diversity in data sets and to enhance the robustness and adaptability of AI models [ 20 ]. To conform with ethical regulations in a research context, medical data are only available in a highly controlled manner and according to strict procedures. New concepts, such as “systemic oversight” [ 21 ] or “embedded ethics” [ 22 ], might be needed to tackle the new data-driven developments around “medical big data” and AI in health care. To engage with the adoption of broad consent, systemic oversight was suggested as an approach, in which mechanisms like auditing mechanisms, expert advice, and public engagement initiatives (among others) should be adapted as additional layers to the newly arising ecosystem of health data [ 21 ]. Recently, embedded ethics was jointly suggested by ethicists and developers to address ethical issues via an iterative and continuous process from the outset of development, which could be an effective means of integrating robust ethical considerations into practical development [ 22 ]. A digital representation of information encoded in signed consent forms is needed to facilitate common data use and sharing, as already implemented in an MII informed consent template [ 23 ].

As a researcher in medical informatics, it is inevitable to be informed and knowledgeable about the fact that patients own their medical records and any use of those data requires great care. In Germany, health care providers can only use the data for first medical use. Secondary use, like research, needs to be approved by either broad or individual consent, which can be made available via the electronic health record (EHR). In addition to digitization efforts, it is still a considerable hurdle to convince patients to make their data available for medical research because personal skepticism commonly makes the entire data acquisition process more difficult [ 24 ]. Here, well-received external communication, transparency, and increased awareness are necessary for substantial improvements. In general, it is a balance between privacy, patient needs, and the use of data for the common good versus economic interests [ 25 ]. In particular, one should be aware of the specific legal regulations that apply within the country and additionally get in touch with the relevant data protection departments. Following this, a plan for infrastructure that meets these regulations and that contains, for example, a trustee for the electronic recording of patient consent and anonymization or direct pseudonymization processes to collect the data needs to be developed. Risk assessments for potential data leakage, approvals by ethics committee, as well as consultation with a data protection officer are essential considerations to further assure data security.

Topic 2: EHR and Clinical Information Systems—“Get to Know Your Clinical Information System to Understand the Required Data.”

Hospitals run clinical information systems (CIS) to collect, store, and alter clinical data about patients. A CIS, independent of the specialization and specific vendor, covers many clinical subdomains and integrates patient-related data to support doctors in their daily routine. Without a doubt, medical data are only useful if meaningful information can be derived from them. This requires high-quality data sets, seamless communication across IT systems, and standard data formats that can be processed by humans and machines [ 2 ]. Typical challenges in clinical IT implementations, especially for patient recruitment systems, were recently evaluated by Fitzer et al [ 26 ] for 10 German university hospitals, including requirements for data, infrastructure, and workflow integration. The implementation of an EHR, including an individual's medical data in a bundled form, into the CIS is a key aspect to prevent low reliability and poor user-friendliness of EHRs, which has recently been shown to affect time pressure among medical staff [ 27 ]. For example, in Scandinavia, the United States, and the United Kingdom, the Open Notes initiative [ 28 ] facilitates patients’ access to EHRs and health data sharing via “PatientsKnowBest ” to give health care professionals and families direct access to medical information [ 29 ].

An EHR is used primarily for the purposes of setting objectives and planning patient care, documenting the delivery of care, and assessing the outcomes of care [ 30 ]. EHRs have so far consisted of unstructured, narrative text as well as structured, coded data. Thus, it will be necessary to implement more systematic terminologies and codes so that the data contained in these records can be reused in clinical research, health care management, health services planning, and government reporting in an improved manner [ 31 , 32 ]. Since the domain of medical informatics is rather new, there are many possibilities for software solutions to improve EHR-related issues [ 33 ]. Exemplary for the EHR domain, the Systematized Nomenclature of Medicine and Clinical Terms (SNOMED CT) is utilized to develop comprehensive high-quality clinical content [ 34 ]. It provides a standardized way to represent clinical phrases captured by the clinician and enables automatic interpretation of these, which is showcased in a “five-step briefing” [ 35 ]. Interestingly, the number of annual publications on this subject has decreased since 2012. However, the need for a formal semantic representation of free text in health care remains, and automatic encoding into a compositional ontology could be a solution [ 36 ]. In terms of usability and user acceptance, evaluations and improvements of EHRs and clinical decision support systems (CDSS) are currently ongoing [ 37 ], for which already well-received examples can be attributed to CeoSYS [ 38 ] or the IPSS-M Risk Calculator [ 39 ]. Moreover, the actions of patients directly contributing to their own EHR records are also being evaluated. The study by Klein et al [ 40 ] indicates that such an approach facilitates the development of individual solutions for each patient, which in turn requires a flexible EHR during the course of a treatment process. Additionally, it was argued that data incorporation via different devices can also facilitate the convenient utilization of the application and, hence, may increase secondary use.

Modern CIS support the interaction by doctors and patients with the recorded patient data (eg, using the EHR or patient portals, eHealth platforms). It is important to understand the basic architecture, especially challenges [ 26 ], of the hospital IT infrastructure to know where data are located and how they can be retrieved and integrated. Major improvements can be made when supporting international standards for data exchange. Beyond standard EHR, this includes interoperability standards like Fast Healthcare Interoperability Resources (FHIR; see Topic 6) and standard data models like the Observational Medical Outcomes Partnership (OMOP; see Topic 7). These criteria should be considered with every new order of clinical systems.

Topic 3: Data Provenance—“Trace Your Data, Even Within Large-scale Efforts.”

Meaningful and standardized metadata facilitate the interpretation of, retrieval of, and access to data [ 41 ]. When explainable data are processed with interoperable tools, scientists can create automated and reusable workflows and provide access to reproducible research outcomes and data analysis pipelines [ 42 ].

Data provenance describes the history of digital objects, where they came from, how they came to be in their present state, and who or what acted upon them [ 43 ]. In health care, provenance maintains the integrity of digital objects (eg, the results of data analyses engender greater trust if their provenance shows how they were obtained). In addition, it can be used to deliver auditability and transparency, specifically, in learning health systems, and it is applicable across a range of applications [ 44 ]. Inau et al [ 45 ] argued that the lessons learned from “FAIRification” processes in other domains will also support evidence-based clinical practice and research transparency in the era of big medical data and open research. Further work demonstrated that a findable, accessible, interoperable, reusable (FAIR) research data management plan can provide a data infrastructure in the hospital for machine-actionable digital objects [ 46 ]. Recently, the openEHR approach was also suggested for creating FAIR-compliant clinical data repositories as an alternative representation [ 47 ].

Key data management requirements are defined by the FAIR guiding principles [ 48 ]. Since data protection laws led to additional requirements for data privacy and data security, the FAIR-Health principles focused on defining additional requirements for information on the sample material used from biobanks, for provenance information, and incentive schemes [ 49 ]. Further work is needed to establish provenance frameworks in health research infrastructures [ 50 ].

Topic 4: Data Sharing—“If Data Won’t Come to the Model, the Model Must Go to the Data.”

Cross-sectional medical data-sharing is critical in modern clinical practice and medical research, in which the challenge of privacy-preserving transfer and utility needs to be addressed [ 51 ]. In order to facilitate high reuse of the data, a decentralized computational scheme that treats the available data as part of a federated (virtual) database, avoiding centralized data collection, processing, and raw data exchanges, is still needed in many countries to analyze large and widespread clinical data [ 52 ].

One possible solution for this federated learning approach is DataSHIELD [ 53 ]. In particular, orchestrating privacy-protected analyses of “medical big data'' from different resources is applicable within R and DataSHIELD [ 54 ]. Here, the developed computerized models represent mathematical concepts or trained machine learning (ML)–based approaches to solve a specific task. In this sense, the model is applied to distributed data sets of the protected (clinical) server infrastructure, and the user only sees the model results but does not retrieve any medical records. Moreover, implementations in other programming languages (eg, Python, Julia) have been introduced in the genomic domain and beyond [ 55 ]. Further concepts, such as Personal Health Train, specifically follow the FAIR principles during distributed analyses [ 56 ]. Secure multiparty computation (SMPC) is also a viable technology for solving clinical use cases that require cross-institution data exchange and collaboration [ 57 ]. Current limitations are thought to be addressed in a stepwise manner [ 58 ] or as blockchain [ 59 ].

By using approaches for distributed analyses, researchers are able to train, test, and validate their models on large-scale real-world clinical data. In combination with standardized data formats, these 2 concepts facilitate the use of those models in clinical routine, potentially in the form of a CDSS. This provides a basis for secondary use of observational data in the context of clinical trials, which show particular potential for identifying data characteristics in small cohorts (eg, identification of the individual patient risk for rare diseases or comorbidities).

Harmonization and Processing

Topic 5: extract, transform, and load (etl)—“ etl processes are computational approaches for data harmonization and data unification.”.

Data handling in medical informatics remains a major challenge. Even though most data in medicine are available electronically, the data often lack interoperability [ 60 ]. As a first step to actually use the data, processes to extract, transform, and load (ETL) are needed to obtain harmonized data from different data systems or clinical entities. One important example, among many others, reflects the uniform representation of the date and time in a common format (eg, Year-Month-Date, not Date-Month-Year). The ETL process is therefore a crucial, individual step toward data unification in large clinical systems, which must be secure, safe, and accurate [ 61 ].

The design of an ETL process faces several challenges, including the following: (1) The ETL process should be able to process huge amounts of data at once [ 62 ]; (2) the ETL process should be repeatable—if the source data change, the ETL process needs to be rerun to process the source data (Observational Health Data Sciences and Informatics [OHDSI]) [ 63 ]; (3) expert-level anonymization methodologies might be integrated into ETL workflows whenever possible [ 61 ]; and (4) there is a need to check for loss of data and compromised data integrity. The latter was highlighted in a recent study, in which inaccurate cohort identification took place because erroneous vocabulary mappings of a common data model were used (eg, ETL programming bugs and errors not captured during the quality assurance stages) [ 64 ]. Common solutions to implement ETL processes are code-based (eg, FHIR-to-OMOP [ 65 ]) or via Pentaho Data Integration, which is one of many ETL tools. Further subsequent processing may also include loading data into research data repositories, like OMOP (see Topic 7), tranSMART, and Talend Open Studio, which is a central component of the Integrated Data Repository Toolkit [ 66 ].

Since ETL processes are at the core of data handling, all risks associated with the ETL process need to be thoroughly checked, identified, and assessed, and contingency plans to mitigate these risks should be in place [ 67 ]. Once the ETL processes are executed, the resulting data will be trusted by researchers, who heavily rely on comprehensively checked data integrity to be able to conduct their research on this basis.

Topic 6: FHIR—“Set FHIR to Gain a Communication Standard for Real-time Applications at the Device-to-Device Level.”

Interoperability levels can be divided into technical, syntactic, semantic, and organizational interoperability [ 2 ]. Semantic and syntactic interoperability can be ensured by communication exchange standards, such as the FHIR [ 68 ] standard of Health Level 7 (HL7) and medical terminologies. A suitable starting point for the basic procedures is offered by FHIR drills [ 69 ] or fire.ly [ 70 ].

FHIR is one of many communication standards but will likely change the domain of clinical IT significantly [ 71 , 72 ]. As a communication standard, FHIR harmonizes data formats coming from different CIS and enables data exchange between institutions via a RESTful approach [ 73 ]. Moreover, FHIR is used to connect devices with each other, which means, in particular, that the Integrating the Healthcare Enterprise (IHE) [ 74 ] standard has been revised to support HL7 messaging as well. In turn, IHE has been developing an open-source device tool set for home and hospital use that recently enabled device control capabilities, a capability accelerated during the COVID-19 pandemic to allow nurses and physicians to operate ventilators and infusion devices outside the contaminated patient room [ 75 ].

Utilizing FHIR in multiple applications already shows its versatile and flexible use (eg, in mobile health applications [ 76 ], electrocardiogram monitoring [ 77 ], or wearable devices and precision medicine in digital health [ 72 ]). In particular, the SMART-on-FHIR technology enables third-party app development for health care applications [ 78 ] and encompasses feasible, secure, and time- and resource-efficient solutions [ 79 , 80 ].

Topic 7: OMOP—“Use Common Data Models as Well-defined Representations of Large-scale Research Projects.”

Data harmonization enables research teams to run real-world observational studies based on heterogeneous data across country borders. Thus, harmonized data embedded in a common data model (CDM), which is an agreement about the utilization of standardized terminologies for data representation, is crucial to exchange data and results on a large scale. To foster reliability and trust in the results of observational research on real-world data, it is essential to utilize CDMs whenever possible to ensure a high degree of data analysis reproducibility.

Several CDMs exist for that purpose; the OMOP CDM from the OHDSI community is one of the most promising and established approaches. In comparison with other CDMs, such as the Sentinel CDM or Informatics for Integrating Biology and the Bedside (i2b2), the OMOP CDM has broader terminology coverage [ 81 ]. The importance of the OMOP CDM increased a lot over the last years [ 82 ], not least since the European Medicines Agency initiated the Data Analysis and Real World Interrogation Network (DARWIN) [ 83 ] project to establish a research network in Europe to gain real-world evidence based on OMOP. Moreover, representations of genomic data [ 84 ], oncology [ 85 ], and imaging projects [ 86 ] are also suitable. In addition, the common representation of the data in OMOP semantic interoperability is ensured by utilizing international terminologies and vocabularies, such as SNOMED-CT, the International Statistical Classification of Diseases and Related Health Problems (ICD), the Logical Observation Identifiers Names and Codes (LOINC), and RxNorm to represent every clinical fact in OMOP. Additionally, the open-source OHDSI software stack provides standardized methodology and libraries for data analyses (Athenahene, Atlas, HADES) and training (EHDEN Academy) [ 87 ], as well as a framework to assess and improve data quality to foster reliability and trust in research results [ 88 ].

The OMOP CDM is one possibility to represent and analyze clinical data on a research scale. Definition of new cohorts within OMOP enables researchers to quickly investigate questions spanning multiple research entities. Collectively, both FHIR and OMOP can define the structure and relations of the clinical data corpus, and the individual EHRs provide content to these standardized data reservoirs. In comparison, OMOP is commonly used for static large-scale data analysis of research data, and FHIR is more suitable for rapid data integration scenarios (ie, for real-time applications and analysis). In summary, it is important to know and utilize newly established standards to participate in broader clinical networks for research. This way, all information within the EHR is comparable across different clinical sites and research settings.

Evaluation, Visualization, and Dissemination

Topic 8: data quality—“guarantee high quality and then publish the data.”.

What is meant to be appropriate data quality for health informatics research? In this domain, data quality depends on the quality of single data elements, data completeness, data conformance, and data plausibility aspects that may considerably determine the validity and veracity of analysis results [ 89 , 90 ]. Moreover, data quality across different institutional entities and even health sectors requires additional efforts concerning the different personnel, instruments, and more [ 91 ]. High-quality data at hand is one fundamental requirement that is often difficult or impossible to achieve, which is why the generation of synthetic data can be an alternative that satisfies privacy problems as well as research needs when data are expensive, scarce, or unavailable by augmentation [ 92 ].

First, a major problem is that clinical data have to be electronically recorded, accessed, and standardized in order to run quality assessment processes [ 26 ]. In addition, it would be important to design and use the same data quality tool, standard operating procedures, or ETL mapping rules in all involved institutions. However, in real-life scenarios, there is a lack of both centrally coordinated data quality indicators and formalization of plausibility rules, as well as a repository for automatic querying of the rules, especially in ETL processes [ 93 ]. Although numerous data quality evaluation frameworks exist, no clear and widespread approach has been adopted so far [ 67 , 94 - 96 ]. Even after a well-chosen data quality procedure is properly implemented, clinical data as such cannot be published along with the performed study. As an alternative, synthetic data generation models function in the following 2 different ways: (1) The model is trained, for example, using real-world data and, once trained, will not require any data in the future (model-based approaches), and (2) the model is constantly fed with data to generate synthetic data (data-driven approaches). There are 3 different categories of algorithms used in the generation of synthetic data: probabilistic models, such as Bayesian networks [ 97 ] and Copulas [ 98 ]; ML, such as Classification and Regression Trees (CART); and deep learning methods, such as a generative adversarial network (GAN) [ 99 - 101 ] and variational autoencoder (VAE) [ 102 ].

A combination of appropriate data quality evaluation and synthetic data generation highly facilitates the development of accurate AI models, which are essential in medical studies [ 103 ]. Thus, a corpus of high-quality synthetic data with many patients can be reused by other AI experts for model development and benchmarking. Moreover, it is essential to create an infrastructure that is used across a large community of hospitals; maps the entire treatment process electronically; and only generates interoperable, structured data based on FHIR (Topic 6) and OMOP (Topic 7) in accordance with the FAIR principles (Topic 3). Afterward, one can finally run quality assessment processes.

Topic 9: Clinical Decision Support Systems—“Bring Insights, Not Additional Work, Back to the Clinics via a CDSS and Other User-Centric Applications.”

CDSS are computer systems designed to assist the medical staff with decision-making tasks about individual patients and based on clinical data [ 104 ]. The decision-making process is still, and will remain, on the shoulders of the physician [ 105 ]. The categories of CDSS include knowledge-based systems that make use of clinical rules, nonknowledge-based systems (eg, AI-based systems), and hybrid CDSS that likewise utilize clinical models and knowledge in combination with AI.

The use of a CDSS in a well-implemented clinical workflow has many positive aspects. It may lead to fewer error rates [ 106 ], accelerate rare disease diagnosis [ 107 ], increase radiologists’ job satisfaction [ 108 ], offer personalized cancer treatment [ 109 ], or help with real-time cardiovascular risk assessment [ 110 ]. Interestingly, computerized alerting systems, which are one of the most disseminated CDSS, can decrease drug-drug interactions significantly [ 111 ]. On the other hand, if done improperly, a CDSS can cause alert fatigue by creating too many alerts. If a system is not context-sensitive, alerts can even be inappropriate [ 112 ]. According to Olakotan et al [ 112 ], influencing factors of a well-designed CDSS need to include aspects about the (1) technology (eg, usability, alert presentation, workload, and data entry), (2) human (eg, training, knowledge, skills, attitude, and behavior), (3) organization (eg, rules and regulations, privacy, and security), and (4) and process (eg, waste, delay, tuning, and optimization). To avoid a lack of transparency and facilitate acceptance by physicians, especially with nonknowledge-based systems, current CDSS seek to use explainable AI approaches; however, the selection of methods used to present explanations in an informative and efficient ( clinically useful ) manner remains challenging [ 113 ]. Of note, a CDSS may also have a negative influence on the performance of physicians, especially if inadequate suggestions occur more often, which cannot be compensated with explanations [ 114 ]. However, one among many other prominent approaches to obtain such explanations via ML-based feature selection and ranking can be found in the work from Wolfien et al [ 115 ]. In terms of an OMOP-based implementation in research, there is patient-level prediction (PLP), which is designed to foster the clinical decision-making process concerning diagnoses or treatment pathways based on the EHR of the patient and the current clinical guideline. It is used to answer questions, such as identifying patients among a larger population at higher risk of a certain outcome (eg, occurrence of cancer, severe side effects, or death) by using data in standardized formats (eg, as previously described via OMOP CDM). Once the model is designed, the covariates will be extracted from the respective CDM of the target person within the cohort, and the respective outcome will be predicted (eg, via PLP [ 116 , 117 ] or other customized prediction algorithms). Importantly, the results from model prediction should first be internally validated with previously unseen data and afterward compared with established scoring systems (eg, Framingham Risk Score [ 118 ], SCORE2 [ 119 ]) to connect with already known domain-specific contexts and to prove its benefit in clinical practice. An additional validation with external data, as part of a multicenter study, can be seen as highly beneficial, in which the already presented topics of federated learning (Topic 4) and OMOP (Topic 7) could significantly foster such an essential scenario [ 120 ].

Collectively, a CDSS increases patient safety, assists in clinical management, and can be cost-effective [ 104 ]. In general, findings of even erroneous CDSS can be used to guide the design of new CDSS alerts. However, the existing risks cannot be solved solely on a technical basis and require an interdisciplinary effort. In particular, continuous, clear communication between IT professionals (developers) and health professionals (end users) during the design process is key. Only a profound understanding of the needs and requirements of either of the involved parties can lead to well-designed systems that are actually able to support and relieve physicians in doing their job.

Topic 10: Visualizations—“Improved Dissemination of Local and External Data From Computational Models by Well-defined Interactive Visualizations.”

Large volumes of data collected from patient registries, health centers, genomic databases, and public records can potentially improve the efficiency and quality of health care via enhancing the interoperability of medical systems, assisting in clinical decision-making, and delivering feedback on effective procedures [ 121 ]. However, each and every raw data point must go through different analytical processes until they become useful and interpretable at the point of care.

R and Python are 2 versatile open-source programming languages that have gained popularity for different purposes, such as preprocessing (eg, tidyverse), statistical tests (eg, dplyr), ML and deep learning (eg, mlr package, caret), visualization (eg, ggplot), and writing reports directly using knitr and R markdown (RStudio education [ 122 ]). Like R, Python offers different libraries for data science tasks (eg, open mined [ 123 ]) in addition to a library specifically for health predictive models, namely PyHealth [ 124 ]. Another versatile visualization functionality is offered for both languages via R Shiny [ 125 ] and Plotly Dash [ 126 ]. These 2 platforms enable data scientists to create interactive web applications directly from a script. The applications can be extended using embedded CSS themes, HTML widgets, and Javascript actions. There is already evidence that implementing clinical dashboards or CDSS for immediate access to current patient information can improve processes and patient outcomes [ 127 ], especially if the data sets are further evaluated and refined [ 128 ]. Similar to FHIR, OHDSI provides tools for analyzing data in the OMOP CDM, which are written in R and use Shiny for the visualization. As a plus, data already stored in the OMOP CDM format can be used in systematic studies, patient-level analysis, and population-based estimations from scratch. The cBioPortal is one prime example of a web resource for exploring, visualizing, and analyzing multidimensional data, which reduces molecular profiling data from cancer tissues and cell lines into readily understandable genetic, epigenetic, gene expression, and proteomic events [ 129 ]. It was recently demonstrated how cBioPortal can be extended and integrated with other tools to a comprehensive and easily deployable software solution that supports the work of a molecular tumor board [ 130 ] and even deliver meaningful scientific insights [ 131 ]. Another translational research platform for the construction and integration of modern clinical research charts is Informatics for i2b2, which is also at the heart of clinical research [ 132 , 133 ].

Computational approaches and data analyses are tightly connected with medical research; the visualization of such complex data for clinicians in a routine setting especially plays a larger role. The current developments of translational research platforms, such as cBioPortal and i2b2, enable swift translation of research results into the clinic, if adequately adopted and enough trained people supervise the process.

The need for qualified IT specialists in medical informatics has increased continuously in recent years and will continue to grow in the future. On the other hand, medical informatics in Germany faces problems with the ​​promotion of young researchers. These current developments mean that vacancies in IT in hospitals and the health care industry can often not be filled or only after very long vacancies. In addition, these positions often have to be filled with nonspecialist staff due to a lack of applications. To keep track of these recent developments and provide a basis for interdisciplinary communication, we provide our list of 10 topics that could be used by different stakeholders individually ( Figure 2 ). With a particular focus in medicine, improved interdisciplinary communication has already been shown to positively impact patient outcomes and enhance employee engagement [ 134 ].

Furthermore, medical informatics has developed rapidly in recent years. This applies, for example, to new methods, techniques, tools, framework conditions, and organizational structures, especially in the field of medical data science. In particular, definitions of standards and a national digitized data corpus, namely the German Core Dataset [ 135 ], were agreed upon. The actual assessment and collection of digitized data in local university hospitals are utilized in so-called data integration centers. These interoperable research data infrastructures enable rapid multisite research, for example, with complex COVID-19 research data sets (German Corona Consensus Dataset [GECCO]) [ 136 ] including clinical data and data on biosamples from all German university hospitals in pseudonymized form (CODEX) [ 137 , 138 ] or the COVID-19 Data Portal [ 139 ]. The subsequent formation of the Network University Medicine (NUM) strengthens the existing interaction between research and patient care, stabilizes existing structures, and creates new structures that ensure more effective feedback and close cooperation between the clinics. The presented examples of NUM and CODEX, among others [ 140 ], attempt a central approach to bundle and harmonize necessary resources like broad consent or the elektronische Patientenakte (ePa), which is the implementation of EHR as a national entity to ultimately facilitate an interconnected health care system.

Finally, all those involved in medical informatics are called upon to engage in lifelong learning and continuously acquire further qualifications.

Exemplary Implementation of the Addressed Topics in the German Medical Informatics in Research and Care in University Medicine Consortium

This article offers newcomers to medical informatics a first introduction and a wealthy overview of current IT-related topics in research and patient care. Nevertheless, there is also a need for further qualification of employees through new, innovative offers for training, further education, and further training. As part of the MII [ 11 ], all consortia were asked to develop and set up appropriate offers and formats. The Medical Informatics in Research and Care in University Medicine (MIRACUM) consortium [ 141 ] has reacted and set up the part-time training and further education program “Biomedical Informatics and Data Science” [ 142 ] and introduced it at the Mannheim University of Applied Sciences in October 2020. The program includes a time-flexible and individually adaptable part-time online master’s course, as well as certificate courses and programs for further scientific education. In addition to the establishment and continuous further development of a cloud-based learning platform, many new digital and target group–oriented learning resources and application-oriented learning environments were developed and introduced for the master's program.

All 10 topics listed in this article are reflected in the curriculum of the master’s degree and have been offered and dealt with in-depth in the individual courses for more than 2 years. The demand for the master’s program and certificate courses is high, and the evaluation has shown that these topic-specific foci correspond to the training and further education needs of the target groups. One particular aspect that was not covered in the final topics refers to the underlying infrastructure needed to provide the data storage and processing backbone. This aspect would have been too technical for a more broadly set, introductory article, such as this article. A starting point for more in-depth information about this aspect can be obtained from further literature [ 143 , 144 ]. However, to offer a practical start to the 10 topics, we provide links to well-known tutorials and hands-on materials ( Table 1 ).

Topic number	Name	Description	Link
2	SNOMED CT	This 5-step briefing presents a high-level overview of SNOMED CT, how it works, and the benefits of use.	[ ]
4	DataSHIELD	This tutorial introduces users to DataSHIELD commands and syntax in R/R Studio.	[ ]
5	ETL	This provides introductory material to get from the native/raw data to the OMOP CDM one needs to create an ETL process.	[ ]
6	FHIR training	This contains a series of FHIR tutorials for those just beginning to learn the new specification.	[ ]
6	SMART App Gallery	The SMART platform is composed of open-standard, open-source tools for developers building apps, and a publicly accessible gallery.	[ ]
7	EHDEN Academy	This contains a series of tutorials for OMOP CDM and additional OHDSI tools (eg, PLP [ ]).	[ ]
8	Synthetic data generation	This is a hands-on tutorial from the ODI [ ] showing how to use Python to create synthetic data	[ ]
10	R Studio education	This provides an introduction to basic R programming.	[ ]
10	Python Dash	This tutorial helps develop data visualization interfaces.	[ ]

a SNOMED CT: Systematized Nomenclature of Medicine and Clinical Terms.

b ETL: extract, transform, and load.

c OMOP: Observational Medical Outcomes Partnership.

d CDM: common data model.

e FHIR: Fast Healthcare Interoperability Resources.

f OHDSI: Observational Health Data Sciences and Informatics.

g PLP: patient-level prediction.

h ODI: Open Data Institute.

We suggest a set of 10 topics to ease the start for researchers and clinicians to become engaged with basic concepts in health informatics research. We provide current review articles for more in-depth reading about the specific topic and present practical hands-on material. The presented topics likewise serve as a broad overview of the medical informatics research domain but also guide individuals and their specific interests. For example, a computer scientist familiar with CDSS development could more easily connect with important aspects, such as data privacy, FHIR, and specific EHRs that are highly relevant for daily work. In contrast, medical experts can obtain an overview of behind-the-scenes technologies, like ETL processes and underlying data quality approaches that are finally visualized as a summarizing clinical dashboard. For readers, we provided a first step toward an improved understanding of a lively and quickly expanding field, but more novel technologies and practical knowledge are ahead. Suggestions and contributions to improve the current topics can be made at GitHub, which will likewise enable content and readers to stay current [ 12 ].

Acknowledgments

This work was supported by the Federal Ministry of Health (BMG) and the German Federal Ministry of Education and Research (BMBF) within the Medical Informatics Initiative Medical Informatics in Research and Care in University Medicine (MIRACUM) Consortium (FKZ: 01ZZ180L [Dresden]; FZK: 01ZZ180A [Erlangen]; FKZ: 01ZZ1801M [Greifswald]). The article processing charge was funded by the joint publication funds of the Technische Universität (TU) Dresden, including the Carl Gustav Carus Faculty of Medicine; Saxon State and University Library (SLUB) Dresden; and the Open Access Publication Funding of the German Research Foundation (DFG).

The funding sources had no involvement in the conduct of the research and preparation of the article.

Authors' Contributions

MW conceptualized the study, curated the data, and wrote the original manuscript draft. MW also defined the initial topics 1 and 2; MZ defined the initial topics 3 and 4; YP defined the initial topics 5 and 6; IR defined the initial topics 7 and 8; and NA defined the initial topics 8, 9, and 10. MS provided the resources and supervised the study. The topics were revised and extended by KF, AK, SG, DK, KLH, ICJ, CS, JS, TS, PS, and DW. MW, NA, YP, MZ, IR, and MS performed the formal analysis, and MW, NA, and MS created the visualizations. NA, YP, MZ, IR, and MS wrote, reviewed, and edited the manuscript, and all authors read and agreed to the final version of the manuscript.

Conflicts of Interest

None declared.

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• Reimer N, Unberath P, Busch H, Börries M, Metzger P, Ustjanzew A, et al. Challenges and experiences extending the cBioPortal for cancer genomics to a molecular tumor board platform. Stud Health Technol Inform. Nov 18, 2021;287:139-143. [ CrossRef ] [ Medline ]
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Abbreviations

artificial intelligence

Classification and Regression Tree

common data model

clinical decision support system

clinical information system

Data Analysis and Real World Interrogation Network

electronic health record

elektronische Patientenakte

extract, transform, and load

findable, accessible, interoperable, reusable

Fast Healthcare Interoperability Resources

generative adversarial network

General Data Protection Regulation

German Corona Consensus Dataset

Health Level 7

Informatics for Integrating Biology and the Bedside

International Statistical Classification of Diseases and Related Health Problems

Integrating the Healthcare Enterprise

Logical Observation Identifiers Names and Codes

Medical Informatics Initiative

Medical Informatics in Research and Care in University Medicine

machine learning

Network University Medicine

Observational Health Data Sciences and Informatics

Observational Medical Outcomes Partnership

patient-level prediction

secure multiparty computation

Systematized Nomenclature of Medicine and Clinical Terms

variational autoencoder

Edited by A Mavragani; submitted 23.01.23; peer-reviewed by I Mircheva, Q Wu, H Oh; comments to author 22.02.23; revised version received 29.03.23; accepted 11.04.23; published 24.07.23.

©Markus Wolfien, Najia Ahmadi, Kai Fitzer, Sophia Grummt, Kilian-Ludwig Heine, Ian-C Jung, Dagmar Krefting, Andreas Kühn, Yuan Peng, Ines Reinecke, Julia Scheel, Tobias Schmidt, Paul Schmücker, Christina Schüttler, Dagmar Waltemath, Michele Zoch, Martin Sedlmayr. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 24.07.2023.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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Student blogs

Preparation for health informatics master’s thesis: reflections and data.

As you prepare for your thesis semester in the Health Informatics joint master’s program at Karolinska Institutet and Stockholm University, I hope you are ready for what is likely to be a challenging semester. I wanted to share some general advice, as well as share some data to help you gauge various factors involved in your preparations. I am usually one of your Instagram digital ambassadors rather than a blogger, so I will recap my background: I studied biochemistry and journalism at the University of Washington and worked as a journalist, research scientist, medical assistant, and math/biology tutor before starting my master’s program. I was a health sciences person trying to transition into technical work, and I had never written a thesis before this program.

Let’s start with a little bit of data from my class. On a scale from 1 to 5, where 1 is like eating cake and 5 is the most stressful academic event ever – how stressful was it to establish the thesis project?

If you enter the program without a semblance of what your thesis might be about (no worries, that was me ), take the time to explore anything that is interesting to you. As someone coming from a non-technical background, I had to do a lot of work to explore and understand which technical areas I could work in. A couple of ways to do this from the first year is to pay attention to all those Facebook events in order to:

• Attend conferences
• Keep an eye out for companies that are doing work that align with your passions and values (also via LinkedIn, job fairs, conferences, etc.)
• Talk to people! – your professors, classmates, students in other programs, alumni, strangers at networking events
• Attend events at KI, SU, and nearby schools like the Royal Institute of Technology (KTH)

I asked students who responded to my survey which program courses contributed to their thesis project the most.

I preferred to work with a company rather than a research group because I was confident that I want to work in industry rather than academia. When the third semester of school started, I was late to start actively applying to projects. This led to a lot of anxiety and frenzied weeks during November and December. To find a project I did the following:

• applied to master’s thesis internship positions online
• attended a career fair at KTH
• contacted research groups from various schools and organizations
• talked to speakers from companies to get connections to their technical/informatics colleagues
• looked at theses from previous students

Various issues arose: one company could only take one student that semester and chose someone else; two research groups were interested but they would not have data available until the spring or summer; a German company only accepted German-speaking students; and others simply rejected me.

By the end of December, I had interviewed at two places that were doing amazing work and wanted me to join them! I made my decision based on finances, location, and growth-opportunity. I found the company by reading a thesis by a former student that seemed intriguing. I wanted to see what she was doing now that she had graduated. She happened to be working at the company, so I applied there and found my thesis company.

I was advised at the beginning of my thesis semester to focus on what I wanted to learn during this time, and not become too overwhelmed with having the perfect or most interesting topic. I outlined which skills I wanted to learn, though I still think my topic is very interesting (I am investigating different dimensionality reduction techniques to manage electronic health record data to improve predictions of readmission and mortality rates). I have learned the skills I aimed to learn, but to be transparent, I also ended up taking an extension and I submitted my thesis at the end of August.

Now let’s get to that data! Tableau visuals cannot be embedded on wordpress.com but they can be accessed here and here .

Of the 43 students who were registered for their degree project during the spring 2019 semester, 29 presented their thesis defense in May 2019. The following are responses from 20 students completing the degree project, including myself. Of the respondents, 14 completed their theses with KI, while 6 completed theirs with SU. Almost all the respondents completed their theses in Sweden, except for two who conducted their work in the United Kingdom and Taiwan.

Though people thought of their thesis ideas over various spans of time, everyone established their project between November and January.

Nine students chose their supervisors while 11 were assigned theirs.

There is a lot of variability in the details of the respondents theses, but most students completed an independent thesis.

Finally, I leave you with some pieces advice from the students who responded to the survey. The most consistent word of advice is to start early! Good luck and always ask for help when you need it.

“It will be good if they start thinking about thesis after one year of masters where they get concrete idea on what field they are good at working. Then start networking in Linked in until you find desired. My thesis hunt was challenging as well as interesting to get a chance to talk with as many people as possible. I enjoyed.”

“Choose a topic that you really like. read papers. don’t stress :)”

“Choose relevant topics based on personal interests and/or previous experience, and start in the third semester to search companies that work in the same area, contact them and pitch a couple of extra ideas that you could deploy with them using their existing projects. Most companies are willing to receive students when they have a decent plan that benefits equally both the company with new solutions and students with hands-on experience.”

“start looking early and make connections with other organizations or professors. the projects offered are very few, for swedish speakers or just plain boring. be prepared to be working mostly alone as feedback from swedish supervisors is often useless and promises to help withy finding participants are often not kept.”

“be well stocked on coffee an anti depressants”

” 1. Use the last course, current research and trends, as a springboard for your thesis. 2. Ask research groups if they have thesis projects available.”

“Start contacting a third party at least 6 months before submitting thesis proposal if you want to do thesis outside KI/SU”

“Start writing early. Allow adequate time for analysis of results. When you loose confidence in yourself, find a way to be inspired again e.g. by contacting your supervisor.”

“Have a clear idea what you want to do and pick a topic that you think is fun and interesting. Don’t be afraid to do your thesis alone, in my opinion it is much easier :)”

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Research Topics & Ideas: Healthcare

F inding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Topics & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

Need a helping hand?

Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

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19 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you give me research titles that i can conduct as a school nurse

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

I have been racking my brain for a while on what topic will be suitable for my PhD in health informatics. I want a qualitative topic as this is my strong area.

Hi, may I please be assisted with research topics in the medical laboratory sciences

How do i frame a qualitative topic that will be suitable for the use of calibrated drape among midwifes. this is a thesis for my master programme in midwifery education.

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90+ Informatics in Nursing Essay Topic Ideas & Examples

90+ Informatics in Nursing Essay Topic Ideas & Examples

Informatics in nursing refers to the use of technology and data to improve patient care outcomes and streamline healthcare processes. With the increasing use of electronic health records (EHRs) and other technological tools, informatics has become an essential component of nursing practice. In this post, we will provide several topic ideas and examples of informatics in nursing and why they are important.

Informatics in nursing is important for several reasons. First, it allows nurses to access patient information quickly and easily, leading to more efficient and effective care. Second, it promotes patient safety by reducing the risk of errors and ensuring that patients receive the right medications and treatments. Third, it can help to reduce healthcare costs by identifying areas for improvement and streamlining processes. Finally, it can improve the overall quality of care by providing nurses with the information they need to make informed decisions.

What You'll Learn

Tips for Students Writing an Essay on Informatics in Nursing

• Start with a clear and concise thesis statement that outlines the main points of your essay.
• Provide a brief overview of the history and evolution of informatics in nursing.
• Discuss the benefits of informatics in nursing, including improved patient outcomes and increased efficiency.
• Provide examples of informatics tools used in nursing practice, such as EHRs and clinical decision support systems.
• Discuss the challenges associated with implementing informatics in nursing practice, such as resistance to change and concerns about privacy and security.
• Analyze the impact of informatics on the nursing profession and healthcare as a whole.
• Conclude with a summary of your main points and a call to action for further research and implementation of informatics in nursing practice.

Informatics in nursing is an essential component of nursing practice that can improve patient outcomes, increase efficiency, and reduce healthcare costs. By using technology and data to inform decision-making and streamline processes, nurses can provide better care for their patients. When writing an essay on informatics in nursing, it is important to provide a clear thesis statement, discuss the benefits and challenges of informatics in nursing practice, and provide examples of informatics tools used in nursing practice.

Informatics in Nursing Essay Topics/Ideas:

• The Impact of Artificial Intelligence on Nursing Practice and Patient Outcomes
• The Use of Mobile Health Applications in Nursing Practice: Opportunities and Challenges
• The Role of Social Media in Promoting Health Literacy and Patient Engagement
• The Impact of Data Analytics on Nursing Research and Evidence-Based Practice
• The Use of Telemonitoring in Chronic Disease Management: A Nursing Perspective
• The Impact of Health Information Technology on Interprofessional Collaboration in Healthcare
• The Use of Patient Portals in Nursing Practice: Promoting Patient-Centered Care
• The Role of Informatics in Nursing Education: Preparing Future Nurses for the Digital Age
• The Impact of Informatics on Nursing Documentation and Workflow
• The Use of Virtual Reality in Nursing Education and Training
• The Role of Nursing Informaticians in Healthcare System Development and Implementation
• The Impact of Informatics on Nursing Leadership and Management
• The Use of Clinical Decision Support Systems in Nursing: Improving Patient Outcomes
• The Impact of Wearable Technology on Nursing Practice and Patient Care
• The Role of Nursing Informatics in Promoting Health Equity and Addressing Healthcare Disparities
• The Use of Artificial Intelligence in Nursing Education and Training
• The Impact of Informatics on Patient Safety and Quality of Care in Nursing Practice
• The Use of Robotics in Nursing Practice: Opportunities and Challenges
• The Role of Informatics in Promoting Evidence-Based Practice in Nursing
• The Impact of Telehealth on Nursing Practice and Healthcare Delivery
• The Use of Blockchain Technology in Nursing Practice: Enhancing Security and Privacy
• The Role of Nursing Informatics in Promoting Patient-Centered Care and Shared Decision-Making
• The Impact of Informatics on Nursing Research Methodologies and Approaches
• The Use of Machine Learning in Nursing Practice: Improving Diagnosis and Treatment
• The Role of Informatics in Nursing Professional Development and Lifelong Learning
• The Impact of Informatics on Nursing Workforce Diversity and Cultural Competence
• The Use of Chatbots in Nursing Practice: Enhancing Patient Communication and Engagement
• The Role of Nursing Informatics in Addressing Ethical and Legal Issues in Healthcare
• The Impact of Informatics on Nursing Practice in Rural and Underserved Communities
• The Use of Augmented Reality in Nursing Education and Simulation Training
• The Role of Nursing Informatics in Promoting Interprofessional Education and Collaboration
• The Impact of Informatics on Nursing Practice and Patient Outcomes in Developing Countries
• The Use of Data Visualization in Nursing Practice: Enhancing Data Interpretation and Communication
• The Role of Nursing Informatics in Promoting Health Information Exchange and Interoperability
• The Impact of Informatics on Nursing Practice and Patient Outcomes in Disaster and Emergency Situations

Controversial Informatics in Nursing Essay Topics:

• The Ethics of Using Artificial Intelligence in Nursing Practice
• The Controversy Surrounding the Use of Social Media in Nursing Practice
• The Impact of Health Information Technology on Nursing Job Satisfaction and Burnout
• The Controversy Surrounding the Use of Telehealth in Nursing Practice
• The Ethics of Using Patient Data for Research and Quality Improvement Purposes
• The Controversy Surrounding the Use of Wearable Technology in Nursing Practice
• The Impact of Health Information Technology on Nursing Workforce Diversity and Inclusion
• The Controversy Surrounding the Use of Clinical Decision Support Systems in Nursing Practice
• The Ethics of Using Chatbots in Nursing Practice
• The Controversy Surrounding the Use of Blockchain Technology in Nursing Practice
• The Impact of Health Information Technology on Nursing Education and Training
• The Controversy Surrounding the Use of Augmented Reality in Nursing Education and Training
• The Ethics of Using Machine Learning in Nursing Practice
• The Impact of Health Information Technology on Nursing Professionalism
• The Controversy Surrounding the Use of Data Visualization in Nursing Practice
• The Ethics of Using Robotics in Nursing Practice
• The Controversy Surrounding the Use of Virtual Reality in Nursing Education and Training
• The Impact of Health Information Technology on Nursing Autonomy
• The Controversy Surrounding the Use of Telemonitoring in Nursing Practice
• The Ethics of Using Artificial Intelligence in Nursing Education and Training
• The Controversy Surrounding the Use of Machine Learning in Nursing Research
• The Impact of Health Information Technology on Nursing Scope of Practice
• The Controversy Surrounding the Use of Chatbots in Nursing Education and Training
• The Ethics of Using Augmented Reality in Nursing Practice
• The Controversy Surrounding the Use of Data Analytics in Nursing Research

Latest Informatics in Nursing Essay Topics to Write About:

• The Impact of Artificial Intelligence on Nursing Documentation: Opportunities and Challenges
• The Use of Electronic Health Records in Nursing Practice: Enhancing Patient Safety and Quality of Care
• The Role of Nursing Informatics in Addressing Health Disparities: A Global Perspective
• The Impact of Health Information Exchange on Interprofessional Collaboration in Healthcare
• The Use of Telehealth in Nursing Practice: Challenges and Solutions
• The Impact of Health Information Technology on Nursing Education and Training: Emerging Trends and Future Directions
• The Use of Data Analytics in Nursing Research: Opportunities and Challenges
• The Role of Nursing Informatics in Promoting Health Equity and Social Justice
• The Impact of Wearable Technology on Nursing Practice and Patient Outcomes: A Systematic Review
• The Use of Augmented Reality in Nursing Education and Training: A Scoping Review
• The Role of Nursing Informatics in Promoting Interprofessional Education and Practice
• The Impact of Health Information Technology on Nursing Workforce Development and Retention
• The Use of Clinical Decision Support Systems in Nursing Practice: Improving Clinical Outcomes and Quality of Care
• The Role of Nursing Informatics in Promoting Evidence-Based Practice: From Research to Implementation
• The Impact of Telemonitoring on Chronic Disease Management: A Nursing Perspective
• The Use of Artificial Intelligence in Nursing Education and Training: Current Trends and Future Directions
• The Role of Nursing Informatics in Promoting Health Information Privacy and Security
• The Impact of Health Information Technology on Nursing Professional Development and Lifelong Learning
• The Use of Digital Health Technologies in Nursing Practice: Opportunities and Challenges

Related Article: Importance of Nursing Informatics Essay

Informatics in Nursing Research Questions:

• How does the use of electronic health records impact nursing workflow and efficiency?
• What are the key challenges associated with implementing telehealth in nursing practice, and how can they be addressed?
• How can nursing informatics promote interprofessional collaboration and teamwork in healthcare settings?
• What is the impact of health information exchange on patient safety and care coordination in nursing practice?
• How can wearable technology be used to improve patient outcomes and quality of care in nursing practice?
• What are the ethical considerations associated with using artificial intelligence in nursing practice, and how can they be addressed?
• How can nursing informatics promote health equity and social justice in healthcare settings?
• What is the role of nursing informatics in addressing healthcare disparities and promoting health equity on a global scale?
• What are the key challenges associated with using clinical decision support systems in nursing practice, and how can they be addressed?
• What is the impact of health information technology on nursing education and training, and how can it be optimized?
• What are the key benefits and challenges associated with using telemonitoring in chronic disease management, and how can they be addressed?
• What is the role of nursing informatics in promoting evidence-based practice and improving patient outcomes?
• How can nursing informatics promote health information privacy and security in healthcare settings?
• What is the impact of health information technology on nursing job satisfaction and burnout, and how can it be addressed?
• What is the role of nursing informatics in promoting patient-centered care and shared decision-making in healthcare settings?

How can nursing informatics promote lifelong learning and professional development among nurses?

• What are the key opportunities and challenges associated with using data analytics in nursing research?
• What is the impact of augmented reality on nursing education and training, and how can it be optimized?
• What is the role of nursing informatics in promoting interprofessional education and practice in healthcare settings?
• How can digital health technologies be used to enhance nursing practice and improve patient outcomes?

FAQs Related to Informatics in Nursing:

What is informatics in nursing.

Informatics in nursing refers to the use of technology and data to improve patient care outcomes and streamline healthcare processes.

How does informatics improve nursing practice?

Informatics improves nursing practice by providing nurses with access to patient information, promoting patient safety and quality of care, and streamlining healthcare processes to increase efficiency.

What are some examples of informatics tools used in nursing practice?

Examples of informatics tools used in nursing practice include electronic health records (EHRs), clinical decision support systems, telehealth technologies, wearable devices, and data analytics software.

How does informatics impact nursing education?

Informatics impacts nursing education by preparing future nurses for the digital age, promoting lifelong learning and professional development, and enhancing nursing research methodologies and approaches.

What are the challenges associated with implementing informatics in nursing practice?

Challenges associated with implementing informatics in nursing practice include resistance to change, concerns about privacy and security, lack of informatics competencies among healthcare professionals, and the need for ongoing support and training.

How can nursing informatics promote interprofessional collaboration in healthcare?

Nursing informatics can promote interprofessional collaboration in healthcare by providing a common language and framework for data exchange, promoting shared decision-making and teamwork, and enhancing communication and coordination among healthcare professionals.

What is the role of nursing informatics in promoting evidence-based practice?

The role of nursing informatics in promoting evidence-based practice involves using data and technology to inform clinical decision-making, promoting research and quality improvement initiatives, and enhancing patient outcomes and quality of care.

How can nursing informatics promote health equity and address healthcare disparities?

Nursing informatics can promote health equity and address healthcare disparities by promoting the use of data to identify and address health inequities, enhancing cultural competence and diversity in healthcare settings, and promoting patient-centered care and shared decision-making.

What are the ethical considerations associated with using informatics in nursing practice?

Ethical considerations associated with using informatics in nursing practice include maintaining patient privacy and confidentiality, ensuring data security and integrity, avoiding bias and discrimination, and promoting informed consent and patient autonomy.

Nursing informatics can promote lifelong learning and professional development among nurses by providing ongoing education and training opportunities, promoting collaboration and knowledge-sharing among healthcare professionals, and facilitating the use of technology and data to enhance nursing practice.

Conclusion:

In conclusion, informatics in nursing is an essential component of nursing practice that can improve patient outcomes, increase efficiency, and reduce healthcare costs. It is important for nurses to be knowledgeable about informatics tools and competencies in order to provide effective and high-quality care. Nursing informatics can also promote interprofessional collaboration, evidence-based practice, health equity, and lifelong learning among nurses. By embracing informatics, nurses can enhance their practice and contribute to the advancement of healthcare.

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Introduction to Health Informatics

Course Director: Marianne Sharko MD, MS  

3 credits  

Health informatics is the body of knowledge that concerns the acquisition, storage, management and use of information in, about and for human health, and the design and management of related information systems to advance the understanding and practice of healthcare, public health, consumer health and biomedical research. The discipline of health informatics sits at the intersection of several fields of research – including health and biomedical science, information and computer science, and sociotechnical and cognitive sciences. In recent years we have witnessed how the collection, storage and usage of digital health data has exponentially grown. Increases in the complexity of health information systems have driven growth in demand for a specialized workforce. This course introduces the field of health informatics and provides students with the basic knowledge and skills to pursue a professional career in this field and apply informatics methods and tools in their health professional practice.  

Weill Cornell Medicine Graduate School of Medical Sciences 1300 York Ave. Box 65 New York, NY 10065 Phone: (212) 746-6565 Fax: (212) 746-8906

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Home > Colleges and Schools > Health Sciences (College of) > Health Informatics & Administration > CHS_HEALTHINFO_ETD

Health Informatics & Administration Theses and Dissertations

Theses/dissertations from 2022 2022.

ABAHUSSAIN, MOHAMMED ABDULRAHMAN M, Emergency Preparedness in Nursing Homes: The Association Between Emergency Preparedness Standards Compliance and the COVID-19 Pandemic

Theses/Dissertations from 2020 2020

Alzughaibi, Saleh, Disparities in Anti-Vaccine Views: Twitter Contents Analysis During World Immunization Week

Gaddis, Tyler Michael, Machine-Learning-based Prediction of Sepsis Events from Vertical Clinical Trial Data: a Naïve Approach

Kolarkar, Swapna, Modelling of Internet of Things (IoT) for Healthcare

Theses/Dissertations from 2019 2019

Xiong, Peggy, Engaging Hmong Americans Long-term use of Healthcare Technology Using Culturally Revised Social Cognitive Theory Model

Xiong, Peggy, Engaging Hmong Americans Long-term Use of Healthcare Technology Using Culturally Revised Social Cognitive Theory Model

Theses/Dissertations from 2016 2016

Bassi, Zeanab Hassan, Longitudinal Patient Records: A Re-Examination of the Possibility

Theses/Dissertations from 2015 2015

Almulhem, Jwaher Abdullah, Importance of Medical Informatics in Medical Students' Curricula in Saudi Arabia

Theses/Dissertations from 2014 2014

Klosterman, Eric James, Text Mining of Patient Demographics and Diagnoses from Psychiatric Assessments

Theses/Dissertations from 2013 2013

Kay, Brian Charles, Alcohol Biomarkers as Predictive Factors of Rearrest in High Risk Repeat Offense Drunk Drivers

Theses/Dissertations from 2012 2012

Salari Far, Zeinab, Health Care Informatics Support of a Simulated Study

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UCL Institute of Health Informatics

• Postgraduate taught

Dissertation in Health Informatics

All MSc students complete a dissertation or project looking at an aspect of informatics, normally related to their work. This gives students the opportunity to frame their own research questions and carry out a significant piece of research within a real clinical environment. The aim of this course is to develop the student’s ability to undertake independent research particularly in relation to:

• Critical reviewing the relevant literature
• Planning and application of one or more appropriate research techniques
• Managing time and resources to meet a deadline
• Addressing ethics issues where appropriate
• Data analysis
• Evaluation of the results
• Effective presentation of research findings

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Module code

Ucl credits, course length.

2020: 20 October (Supervisor Fair), 17 November & 15 December.

2021: 19 January, 16 February. 16 March, 20 April, 18 May, 15 June & 13 July.

Assessment Dates

Project proposal submission: 25 January 2021, 4:30pm. Journal paper submission: 01 September 2021, 4:30pm

Module Organiser

Ms Pippa Bark  for further information contact [email protected]

Who can study this course?

MSc Health Informatics students

Admission requirements

Open to all UCL MSc Health Informatics students who have or are in the process of completing the eight taught modules.

Independent research project

Proposal (20%). Journal paper (80%)

Selected reading list

Dependent on project area

Master of Public Health

A thesis is a substantive and original body of work that allows the student to synthesize and integrate knowledge from their public health course work and practicum experiences, apply it to a particular topic area, and communicate their ideas and findings through a scholarly written product. The thesis represents the culmination of the student’s educational experience in the Vanderbilt MPH Program.

The thesis may take on different formats, depending on the student’s track focus and interests. Regardless of the format chosen, the student must apply critical thought, systematic analysis, and clear presentation.

Each student is responsible for identifying a topic and appropriate format for their thesis with the assistance and guidance of faculty advisers and faculty thesis readers.

The practicum product must be distinct from the thesis. Although the practicum and thesis can be related, the student must be able to articulate how the two projects are independent from one another. The practicum is a practice experience that allows students to apply and develop skills in public health concepts. The thesis is the synthesis and integration of knowledge acquired in coursework and through the practicum and results in an original scholarly work.

View selection of published theses

Additionally, students have the option to pursue publishing their thesis products in scholarly journals.

2024 Thesis Topics

Anjola Ajayi, M.B.B.S.		Use of Hydroxyprogesterone in Pregnancy and the Risk of Recurrent Preterm Birth: A Nested Case-Control Study
Bashir Al Hussein Al Awamlh, M.D.		Health Literacy and All-Cause Mortality among Cancer Patients
Nicole Andersen		Weight Loss in Prenatally Opioid Exposed Neonates with Additional Withdrawal Exacerbating Exposures
Nick Baker		Variability in Hospital Organ Donation Performance in the United States
Camden Castagna-McLeod		The Effect of Infector’s Age and Gender on Influenza Transmission Risk
Cara Charnogursky, M.D.		Pandemic Social Distancing and Declines in Nasopharyngeal Carriage of Pneumococcus and Related-Antimicrobial Resistance Genes: Evidence from Household-Based Cohort Studies in Lima, Peru
Genevieve Delano		COVID-19 Vaccination Among People Living with Diagnosed HIV in Tennessee
Gianna Ferrara		Associations between household secondhand smoke exposure in the first year of life and subsequent recurrent wheezing and asthma diagnosis in childhood
Katherine Griffin		Evaluating the Association of SGLT2i on Amputation, Stent Placement, or Vascular Surgery Compared to DPP4 as an Add-On Therapy: A Cohort Study in Veterans with Diabetes
Olla Hamdan		Influenza-Specific Antiviral Use in Hospitalized Children Before and During the COVID-19 Pandemic, New Vaccine Surveillance Network (2016–2023)
Corianne Johnson		The Influence of Residential Segregation, Urbanicity, and Population Density on Hepatocellular Carcinoma Incidence among a Low Socioeconomic Population
Erica Koch, M.D.		Effect of Rurality on NSAID-related Adverse Events within Veteran Emergency Departments and Urgent Cares
Brittany Lehrer, M.D.		A Statewide Assessment of the Appropriateness of Pediatric Outpatient Antibiotics
Alexandra “Lexie” Lipham		The Impact of State Abortion Restrictions Implemented between 2010 and 2020 on State-Level Food Insecurity
Mariam Saad, M.D.		Surgical Revision Rates Following Breast Reconstruction for Breast Cancer Across Payor Type
Megan Shroder, M.D.		Making a Difficult Decision Easy: Patient Reported Outcome Measures in Recurrent Diverticulitis
Jacen Wilder		Criminal Justice Involvement Risk and Protective Factors for LGB Young Adults
Kaleb Wolfe, M.D.		Assessing Antimicrobial Susceptibility Test Breakpoint Use in Tennessee
Joshua Woods		Information needs of rural and Black Tennesseans eligible for inherited cancer genetic testing: Qualitatively informed policy
David Xiao, M.D.		Assessing the Transportability of Radiomic Features for Pulmonary Nodule Diagnostic Models
Lauren Zaylskie		Differences in Healthcare Usage, Access, and Quality Between English and Spanish-speaking Children

2023 Thesis Topics

Taylor Carty		Medical mistrust and HIV testing among South Africans who consulted a traditional healer
Rohini Chakravarthy, M.D.		Leveraging the Pediatric Health Information System Database to Characterize Hospital Readmissions Following Pediatric Allogeneic Stem Cell Transplantation
Ryan Dalforno		The Jackson Water Crisis: A Complex Systems Approach
Robert Dambrino, M.D.		The 21st Century Cures Act Information Blocking Rule Affect on Unsolicited Patient Complaints
Meredith Denney		Mobile Flu Fighter!: Development and implementation of a mobile vaccination initiative to reduce pediatric influenza vaccination disparities in Nashville, Tennessee
Laura Ernst		Unwinding without Unraveling: State Approaches to Medicaid Redetermination When Continuous Enrollment Ends
Kelsey Gastineau, M.D.		One Step Closer to Safer: Counseling Outcomes from AAP Firearm Safe Storage Education Training
Kevin Gibas, M.D.		Association of delayed HIV diagnosis with demographic disparities based on geographic residence: A target for innovative screening interventions
Caroline Godfrey, M.D.		Creation of a Clinically Useful High-Risk Lung Nodule Calculator
Kyle Hart		Prescriptions for Non-Opioid Medications in Combination with Opioids on the Development of Persistent Opioid Use among Patients Hospitalized for Long Bone Fracture
Layan Ibrahim		Childhood Epilepsy in Northern Nigeria: Comparing Epilepsy Knowledge and Trust in Providers Among Children Enrolled in the BRIDGE Trial
Sofia Ludwig		Improving Relationship Empathy Among HIV+ Seroconcordant Couples in Rural Mozambique: A cluster-randomized study on the Homens Para a Saúde+ (HoPS+) program
Ellen McMahon, M.D.		The Relationship Between Resilience and Positive Child Health Behaviors in a Large, Nationally Representative Dataset
Maria Padilla Azain, M.D.		A nested case-control study of opioid analgesics and antidepressant prescriptions during pregnancy and the risk for preterm birth
Chelsea Rick, D.O.		Frailty as a Predictor of Catatonia in the Critically Ill Patient
Elsa Rodriguez, M.D.		Antibiotic treatment compliance among Fracture related infections in Orthopaedic trauma
Barrett Smith		Assessing Bedside Nurse Pain Management Recommendations and Their Associations with Inpatient Opioid Use in Women who Have Undergone a Cesarean Birth
Allison Stranick		Lung Cancer Screening Eligibility Among United States Veterans: Results from a National Smoking History Survey Jennifer Lewis, M.D., M.P.H.
Claire Umstead		Comparing ICU Admission between Influenza- and SARS-CoV-2-Positive Pregnant Women in Middle Tennessee

2022 Thesis Topics

Noor Ali		The Effect of Biased Language in Emergency Transfers
James Antoon, M.D., Ph.D.		Factors Associated with Guideline Concordant Antiviral Use in Children at High Risk for Poor Influenza Outcomes
Katherine Black		Pediatric CYP2D6 Metabolizer Status and Post-Tonsillectomy Nausea and Vomiting After Ondansetron Administration
Christina Boncyk		The Impact of Increased Prescribing on ICU Survivors
Miaya Blasingame		The Combined Effects of Social Determinants of Health on Childhood Overweight and Obesity
Alison Carroll		Decreasing Pre-Procedural Fasting Times in Hospitalized Children
Augustine Chung		The effect of movement-based disorders on long term care informal caregiver burden
Tavia Gonzalez Pena, M.D.		Legal Outcomes among Postpartum Women with Opioid Use Disorder
Sarah Grossarth		Infant Mortality Associated with Prenatal Opioid Exposure in Tennessee
Rachael Jameson		Equity Implications of the Tennessee Fetal Assault Law
Shani Jones, M.D.		Access Equity: Trust and Telemedicine Use in Diverse Pediatric Primary Care Populations
Emily Kack		Incidence of Invasive Group B Strep by Census Tract Level Socioeconomic Status Among the Adult Population in TN
Rebecca Lee		The Impact of Timely Access to Care on Breast Cancer Survival Among Young Black Women
Kevin Liu, M.D.		A Retrospective Analysis on the Impact of an Integrated Palliative Care Approach during the COVID-19 Pandemic
Kristyne Mansilla		HIV Knowledge among Postpartum Women in South Africa
Cooper March		Lung Cancer Screening Eligibility Among United States Veterans: Results from a National Smoking History Survey Michael Ward, M.D.,Ph.D, MBA
Hannah Marmor, M.D.		Comparing ICU Admission between Influenza- and SARS-CoV-2-Positive Pregnant Women in Middle Tennessee
Marshae Nickelberry		Prenatal Omega-3 Fatty Acids and Child Asthma
Alexandra Odenthal		Post Discharge Opioid Prescribing and Use after Vaginal Birth
Laura Rausch, M.D.		Surgical Resident Involvement in Renal Transplantation, Evaluating Anastomosis Time and Outcomes
Isaac Schlotterbeck		Disparities in Loss to Follow-Up/Mortality Before vs. After Registry Linkage in Brazil, Mexico, and Peru
Daniel Tilden, M.D.		Prolonged Lapses in Care Associated with Pediatric to Adult Care Transfer are Associated with Rise in HbA1c Among Patients with Type 1 Diabetes
Avirath Vaidya		Effects of Mixed-Income Redevelopment on Low-Income Families: Evidence from Envision Cayce
Sarah Welch, D.O.		The Age-Friendly Initiative: Outcomes from Vanderbilt Acute Care for Elders Unit
Anna Wisotzkey		Obstetric Provider Opioid Prescribing Perspectives after Childbirth in Tennessee, June-July 2019
Jacy Weems		Federal Nursing Home Civil Monetary Penalties, 2009-2019

2021 Thesis Topics

Bentley Akoko, M.D.		HIV-related stigma and psychological distress in a cohort of patients receiving anti retroviral therapy in Nigeria
Lin Ammar		Third trimester electronic cigarette use and the risk of pre-term birth, low birthweight and small-for-gestational age
Laura Baum, M.D.		Post-Traumatic Stress Symptoms, Financial Toxicity, and Health-Related Quality-of-Life in Caregivers and Young Adult Patients with New Cancer Diagnoses
Wubishet Belay, M.D.		Secondary Prophylaxis for Rheumatic Heart Disease in Ethiopia
Ryan Belcher, M.D.		The Demographics and Trends of Patients with Cleft Lip and Palate Born in the State of Tennessee from 2000-2017
Mary-Margaret Fill, M.D.		The Impact of Electronic Laboratory Reporting on Public Health Communicable Disease Surveillance in Tennessee
Chloe Hurley		Advanced Practice Providers Improve Quality: Accountable Care Organizations Enrolled in the Medicare Shared Savings Program
Wali Johnson, M.D.		The Impact of Social Determinants on Abdominal Solid Organ Transplant Wait-Lists
Ali Manouchehri, M.D.		Cardiovascular toxicities associated with Ponatinib: a pharmacovigilance study
Mina Nordness, M.D.		The Impact of Surgery and Anesthesia on the Development of Alzheimer’s Disease or Related Dementia (ADRD) after Injury
Allan Peetz, M.D.		Resuscitating the Dying Donation: A Qualitative Analysis of Trauma Surgeons’ Resuscitation Practices
India Pungarcher		A Descriptive Analysis of Caseworker Status Among People Experiencing Homelessness in Nashville, Tennessee
Milner Staub, M.D.		Veteran satisfaction and expectations for antibiotics in outpatient upper respiratory tract infections
Lindsay Sternad, M.D.		Parental Primary Language, Access to Care, and Developmental Delays in Neonates
Bo Stubblefield, M.D.		COVID-19 Surveillance Among Frontline Healthcare Personnel
Teris Taylor		Prenatal Care Use Among Women in the 2017-2019 National Survey of Family Growth
Victoria Umutoni		The association between smoking and anal human papillomavirus in the HPV in Men Study
Jasmine Walker, M.D., M.A.T.		Early Impact of MISSION Act on Utilization of Veterans Affairs Transplant Centers
Ni Ketut Wilmayani, M.D., M.B.B.S.		Inappropriate Antibiotic Prescriptions in United States Hospital Emergency Departments, 2011-2018

2020 Thesis Topics

Amanda Abraham		Impact of Food Insecurity on Engagement in HIV Care for Female vs. Male Head of Household
Justin Banerdt		Delirium Prevalence and Outcomes at a Resourced-Limited Referral Hospital in Lusaka, Zambia
Edson Bernardo, M.D.		Estimation of Levels and Patterns of Migration among People Living with HIV in the District of Manhiça, Southern Rural Mozambique
Sean Bloos		Retrospective Multi-Center Cohort Study Comparing Timeliness of Emergency Department Care in Younger Versus Older Patients with ST-Elevation Myocardial Infarction
Evan Butler		The Impact of Rural Hospital Closures on Local Economies
Keerti Dantuluri, M.D.		Prevalence and Factors Associated with Inappropriate Antibiotic Prescription among Children Enrolled in Tennessee Medicaid
Gretchen Edwards, M.D.		Assessing Quality of Colorectal Cancer Care in a National VA Cohort
Lei Fan, Ph.D., M.D.		Magnesium Intake and Opioid Use in the National Health and Nutrition Examination (NHANES) 2005-2016
Mary-Margaret Fill, M.D.		The Impact of Electronic Laboratory Reporting on Public Health Communicable Disease Surveillance in Tennessee
Carleigh Frazier		Measuring Trust in Biomedical Research: Trust Survey Pilot Study and Validation
Hannah Griffith		Changes in Time to First Occurrence of Otitis Media in Young Children in Tennessee and Associated Antibiotic Prescriptions Following the Introduction of the 13-valent Pneumococcal Conjugate Vaccine
Heather Grome, M.D.		Association of STI Diagnosis with Incident HIV Diagnosis: A Target for PrEP Intervention
Diane Haddad, M.D.		Vertical Integration and Post Acute Care Use after Major Surgery
Sarah Homann, M.D.		Select Medication Exposure and Risk of Hip Fracture in Veterans with Rheumatoid Arthritis (RA)
Arlyn Horn, Pharm.D.		Initial Postpartum Opioid Exposure and Risk of Death Among TN Medicaid Opioid Naive Women: A Retrospective Cohort Study
Peter Hsu, M.D.		Provider Network Breadth under the Affordable Care Act Between Marketplace Insurance Plans Versus Medicaid Managed Care Plans
Tamee Livermont		The Effect of Substance Use on Postpartum Contraception
Alexandria Luu		Traditional Healers as a Treatment Partner for PLHIV in Rural Mozambique
Muna Muday		Engaging with the Community: Exploring Community Development and Program Evaluation in the Context of Health Promotion
Harriett Myers		Improving Child Diet Quality through a Family-Based Behavioral Intervention for Childhood Obesity
Madelynne Myers		Antipsychotic Usage and Prescribing Patterns amongst the Med-SHEDS Population Diagnosed with Dementia
Katelyn Neely, M.D.		Genotype and Adverse Events During Citalopram, Escitalopram and Sertraline Treatment in Children and Adolescents
Allan Peetz, M.D.		Resuscitating the Dead: A Qualitative Analysis of Trauma Surgeons’ Resuscitation Decisions for Organ Preservation
Varvara Probst, M.D.		AdV Detection Alone vs. AdV Co-detected with Other Respiratory Viruses in Children with Acute Respiratory Illnesses
Sarah Rachal		A Longitudinal Analysis of Relationships between Neighborhood Context and Underserved Children’s Sedentary Behavior in a Rapidly Growing City
Sonya Reid, M.B.B.S.		The Role of Tumor Biology in Bridging the Survival Disparity Gap in Young Black Women with Breast Cancer
Emmanuel Sackey, M.B.Ch.B.		Cervical Cancer Screening History of Davidson County Women, 2008 – 2018
Emily Sedillo		Contraception and Unplanned Pregnancies in Migori County, Kenya
Sadie Sommer		Comparative Review of Maternal Mortality
Fatima Yadudu		Prevalence of Febrile Seizures in children between 6 and 60 months from Northern Nigeria

2019 Thesis Topics

Ben Acheampong, M.B.Ch.B		Evaluation of a Miniaturized Handheld Device for Ventricular Structure and Function in Children: A Pilot Study
Jim Barclay		Predictors of Increased Post-Training Knowledge among Current and Prospective Members of the HIV Clinical Workforce in the Southeast United States
Morgan Batey		A Systematic Review of NCAA Concussion Management Plans
Celso Give		If Ebola Were to Happen Tomorrow in Mozambique, Would We be Ready for the Various Ethical Issues Raised in the Ebola Outbreak in West Africa in 2014-2015?
Selorm Dei-Tutu, M.D.		Correlating Maternal Iodine Status with Infant Thyroid Function in Two Hospital Settings in Ghana
Jennifer Erves Ph.D.		Factors Influencing Parental HPV Vaccine Hesitancy from the Provider and Clinic Level: A Cross-Sectional Study
Djamila Ghafuri, M.D.		Severe Acute Malnutrition in Children with Sickle Cell Anemia in Northern Nigeria
David Isaacs, M.D.		Longitudinal Outcomes for Deep Brain Stimulation in Parkinson’s Disease
Sophie Katz, M.D.		An Assessment of Pediatric Outpatient Antibiotic Prescriptions Across Tennessee
Tom Klink		Predicting Severe Illness using WHO Severe Acute Respiratory Infections (SARI) Criteria in a Jordanian Cohort
Delaney Lackey		Predictors of late presentation to antenatal care among pregnant women living with HIV in Johannesburg, South Africa
Jennifer Lewis, M.D.		A Difference-In-Difference Study of Low-Dose CT Utilization in the VA
Taylor Matherly		Development and Assessment of a Mentoring Curriculum for Junior Faculty in Health Sciences at the University of Zambia
Lindsey McKernan, Ph.D.		Patient-Centered Treatment for Interstitial Cystitis/Bladder Pain Syndrome
Andrew Medvecz, M.D.		Long Term Outcomes Following Obstruction from Small Bowel Adhesive Disease: Longitudinal Analysis of a Statewide Database
Kelsey Minix		What are the Determinants of Breastfeeding Initiation and Duration in a Group of Pregnant Hispanic Women Participating in a Research Study from 10/1/14 – 9/30/16?
Sarah Moroz		The Effectiveness of a Brief ACEs Educational Intervention on Low-Income Parents at Risk for Exposing their Children to Harmful Stress
Miller Morris, M.A.		Prevalence and Predictors of Interpersonal Violence Against Women in Migori County, Kenya
Didier Mugabe, M.D.		Determinants of Self-Report not Receiving HIV Test Results after HIV Testing in Mozambique: Results from a Nationally Representative Survey
Sylvie Muhimpundu		Racial Differences in Liver Cancer Risk
Meghana Parikh, V.M.D.		Temporal and Genotypic Associations of Sporadic Acute Norovirus Gastroenteritis in an Active Surveillance System Compared to Reported Norovirus Outbreaks in Middle Tennessee
Mariah Pettapiece-Phillips		Multidimensional Poverty in Migori County, Kenya: Analysis from a Population-based Household Survey
Nicole Quinones		Contraception Choice of Postpartum Women in the 2011-2015 National Survey of Family Growth
Jennifer Robles, M.D.		Variation in Urology Post-Operative Opioid Prescription Patterns using a National Veterans Health Administration Cohort
Laura Sartori, M.D.		Pneumonia Severity in Children: Reducing Variation in Management Through Analysis of Procalcitonin
Shailja Shah, M.D.		The Association of Calcium, Magnesium, and Calcium Magnesium Intakes with Incident Gastric Cancer, a Prospective Cohort Study of the NIH-AARP Diet and Health Study
Emily Smith, R.N.		The Prevalence of Opioid Use and Factors Contributing to Opioid Therapy Among a Hospitalized Elderly Population
Maggie Smith		Gender Differences in Research Participation and the Association with Perceived Health Competence
Kayla Somerville		Long-term Effects of Antiretroviral Therapy on Pediatric Cohort in Latin America
Lucy Spalluto, M.D.		Assessing the Impact of a Community Health Worker on Hispanic/Latina Women’s Reported Measures of Processes of Care in the Screening Mammography Setting
Jeremy Stelmack		Identifying Risk Factors for Opioid Misuse in Employed Populations

2018 Thesis Topics

Rachel Apple, M.D.		Relationship Between Weight Trajectory and Health-Related Quality of Life Among a General Adult Population
Sade Arinze, M.D.		Immunodeficiency at the Start of Combination Antiretroviral Therapy: Data from Zambézia Province, Mozambique
Beto Arriola Vigo, M.D.		Qualitative Analysis: Community Involvement in the new model of care during Mental Health Reform in Peru
Shawna Bellew, M.D.		Prospective Evaluation of Indications for Obtaining Pneumococcal and Legionella Urinary Antigen Tests in Adults with Community-acquired Pneumonia
Sydney Broadhead		High Competition and Low Premiums—Key Components of the ACA’s Narrow Physician Networks
Emily Castellanos, M.D.		Health Literacy and Healthcare Use in the Southern Community Cohort Study
Heather Ewing		Knowledge of Tuberculosis is Associated with Greater Expression of Stigma in Brazil
Erin Gillaspie, M.D.		Tumor Response in Patients with Advanced Stage Lung Cancer Treated with Immunotherapy
Birdie Hutton		Evaluation of behavioral, environmental and genetic risk factors for gastric cancer: a population-based study in Central America
Chelsea Isom, M.D.		Does Increased Arachidonic Acid Levels Lead to an Increased Risk for Colorectal Adenoma?
Justin Liberman, M.D.		Post-Discharge Opioid Prescriptions and Their Association with Healthcare Utilization in the VICS Cohort
Salesio Macuacua, M.D.		Assessment of the Determinants of Non-adherence to Antiretroviral Therapy during Pregnancy in the District of Manhiça, Mozambique
Adoma Manful		Latent TB Among Refugees in Middle Tennessee
Cassie Oliver		Substance Use and Post-Partum Retention in Care among Women with Human Immunodeficiency Virus (HIV) Infection in Prenatal Care at the Vanderbilt Comprehensive Care Clinic, 1999-2016
Mindy Pike		Effects of Social Support on Physical and Mental Quality of Life in Heart Failure Patients: The Vanderbilt Inpatient Cohort Study (VICS)
Juanita Prieto Garcia, M.D.		Determinants of Full Immunization in Children under Five Years Old in the Rongo Sub-County of Migori County, Kenya
J.W. Randolph		Addressing Parenting Related Adverse Childhood Experiences (‘PRACES’) in the Pediatric Primary Care Setting
Lauren Sanlorenzo, M.D.		Identifying Severe Neonatal Abstinence Syndrome Among Polysubstance Exposed Infants
Joey Starnes		Reduction in Under-Five Mortality in the Rongo Sub-County of Migori County, Kenya: Experience of the Lwala Community Alliance 2007-2017 with Evidence from a Cross-Sectional Survey
Rui Wang, M.Ed.		Risk Factors for Depression among Women in Rural Western Kenya and Implications for Designing Future Surveys
Hannah Weber		Food Insecurity Among Older Adults

2017 Thesis Topics

Julia Allen		Diabetes Services Utilization under the Affordable Care Act Medicaid Expansion: Evidence from the Behavioral Risk Factor Surveillance System
Frances Anderson		Evaluation of the Minnesota TB Screening Program: Immigrants and Refugees with TB Class conditions Arriving in the State of Minnesota, 2012-2014
Jimmy Carlucci, M.D.		Prevalence and Risk Factors for Malaria among Children in Zambezia Province, Mozambique
Alaina Davis, M.D.		Depression and Medication Non-Adherence in Childhood-onset Systemic Lupus Erythematosus
Cherie Fathy		Ophthalmologist Age and Patient Complaints
Grace Fletcher		Maternal Conception of Gestational Weight Gain Among Latinas: A Qualitative Study
Sarah Greenberg		Evaluation of the Home Health Market: Impact of Chain Status on Quality Care
Aamer Imdad, M.B.B.S.		Pathogenic Escherichia coli (E. coli) As Cause Of Acute, Moderate To Severe Gastroenteritis In A Geographically Defined Pediatric Population In Colombia, South America. A Case Control Study
Kailey Lewis		Variation in Tennessee Outpatient Antibiotic Prescribing by County of Practice and Provider Specialty in 2013
Katie McGinnis		An Exploratory Investigation Into Parent/Caregiver and Hospital Staff Perceptions About Children and Families’ Psychosocial Needs and Hospital Experiences in Two Kenyan Children’s Hospitals
Rany Octaria, M.D.		Using Administrative and Surveillance Data to Target Carbapenem Resistant Enterobacteriaceae Response and Prevention Strategies in Tennessee
Ezequiel Ossemane		Assessment of Guardians’ One-Day Recall of Elements of Informed Consent to a Mozambican Study of Pediatric Bacteremia
Caroline Presley, M.D.		Validation of an Algorithm to Identify Heart Failure Hospitalization and Retrospective Assessment of Frailty Status
Jason Pryor, M.D.		Pregnancy Intention and Maternal Alcohol Consumption
Markus Renno, M.D.		Toward High-Value Utilization of Pediatric Echocardiography: Foundations for a Robust Quality Improvement Initiative
Kidane Amare Sarko		Influence of HIV Status Disclosure on Facility-based Delivery and Postpartum Retention of Mothers in a Prevention Clinical Trial in Rural Nigeria
Cassie Smith		Evaluating the Frequency and Dispersion of ACOs with Multiple Payer Contracts
Shanel Tage		Determinants of Breastfeeding Self Efficacy Among Mexican Immigrant Women
Grace Umutesi		Evaluation of the Impact of the 2014 Ebola Outbreak on the Acute Flaccid Paralysis (AFP) Surveillance Programs of Guinea and Liberia
Christopher Wahlfeld, Ph.D.		HIV Rapid Diagnostic Test Inventories in Zambézia Province, Mozambique: A Tale of Two Test Kits
Katherine Watson, M.D.		Measuring Health Literacy in Parents of Young Children

2016 Thesis Topics

Lealani Acosta, M.D.		Error Frequency in Category Fluency in Mild Cognitive Impairment
Jillian Balser		Impact of Adverse Childhood Experiences on Long-term Outcomes in Vulnerable Populations: Retrospective Analysis
Mary Bayham		Predictors of Healthcare Utilization Among Children 6-59 months in Zambezia Province, Mozambique
Angela Boehmer, R.N.		Patient and Clinician Satisfaction with Task Shifting of Prevention of Mother-to-Child HIV Transmission (PMTCT) Services in rural North-Central Nigeria
Mariu Carlo, M.D.		Executive Function, Depression, and Mental Health-Related Quality of Life in Survivors of Critical Illness
Erin Graves, R.N.		Prevention of mother-to-child transmission (PMTCT) outcomes in Zambézia, Mozambique
Erin Hamilton		Evaluation of a School Nutrition Education and Fruit Delivery Intervention in Santiago, Chile
Bryan Harris, M.D.		Preventing Infection-Related Ventilator-Associated Complications
Jessica Hinshaw		Food Security and Dietary Diversity of a Peri-urban Community in Nicaragua
Savannah Hurt		Pediatric Perioperative Mortality Rates in a Sample of Urban Kenyan Hospitals
Mary Allyson Lowry, M.D.		An Innovative Mucosal Impedance Device Differentiates Active Eosinophilic Esophagitis From Inactive Disease, Nerd, and Controls
Joseph Maloney		Microenterprise in Croix-des-bouquets, Haiti: Program Evaluation to Evaluate Affects on Poverty and Health
Brett Norman, M.D.		30-day Readmission Rates Associated with Survivors of Severe Sepsis
Bhinnata Piya		An Early Impact Assessment of Health Systems Strengthening Initiatives on Tuberculosis Outcomes: A 6 Month Prospective Cohort Study in Southeast Liberia
Nicholas Richardson, D.O.		Adverse Health Outcomes of Contemporary Survivors of Childhood & Adolescent Hodgkin Lymphoma
Caitlin Ridgewell		Prematurity as a mitigating factor in the relationship of adverse family events and adolescent depression: Analysis of the 2011/2012 National Survey of Children’s Health
Althea Robinson-Shelton, M.D.		Problem Behaviors in Pediatric Narcolepsy
Emily Sheldon		Strategic Planning with the Turner Family Center for Social Ventures at Vanderbilt University
Shellese Shemwell		Vaccine and Vitamin A Compliance in Children Ages 12-13 months in Zambezia Province
Thomas Spain, Jr, M.D.		History of Physician Complaints and Risk of Hospital Readmission
Krystal Tsosie, M.A.		Epidemiology of Essential Hypertension and Uterine Fibroids
Zachary Willis, M.D.		Risk Factors for Persistent and Recurrent Clostridium difficile Infection among Pediatric Oncology Patients
Jo Ellen Wilson, M.D.		Catatonic Signs in Patients with Delirium in the ICU: A nested prospective cohort study
Kathleene Wooldridge, M.D.		Social Isolation and Hospital Length of Stay in Acute Decompensated Heart Failure

2015 Thesis Topics

Amma Bosompem, M.S.		Evaluation of Treatment Completion Rates for Latent Tuberculosis Infection in Refugees in Davidson County
Mary DeAgostino-Kelly		Analysis of Sex Differences within the Nutritional Support for Africans Starting Antiretroviral Therapy Study Results
Annabelle de St. Maurice, M.D.		Invasive Pneumococcal Disease in Tennessee: Regional Differences in Rates, Racial Distribution and Antibiotic Susceptibility
Jay Doss, M.D.		A Study of Rheumatoid Arthritis by Serotype in a Clinical Electronic Health Record
Najibah Galadanci, M.B.B.S.		Acceptability and Safety of Hydroxyurea for Primary Prevention of Stroke in Children with Sickle Cell Disease in Nigeria
Dupree Hatch, M.D.		Endotracheal Intubation Safety and Outcomes in the Neonatal Intensive Care Unit
Caleb Hayes		A Focus Group Study on the Barriers to Type 2 Diabetes Self-management among Latinos in Middle Tennessee
Colleen Kiernan, M.D.		Utilization of Radioiodine After Thyroid Lobectomy In Patients with Differentiated Thyroid Cancer: Does it Change Outcomes?
Sahar Kohanim, M.D.		Risk Factors and Patterns of Unsolicited Patient Complaints in Ophthalmology: an Analysis of a Large National Patient Complaint Registry
Kristy Kummerow, M.D.		Inter-hospital Transfer for Acute Surgical Care: Does Delay Matter?
Paula McIntyre, M.S.		Multidimensional Poverty in Dominican Bateyes: A Metric for Targeting Public Health Interventions
Alicia Morgans, M.D.		Patient-Centered Treatment Decision-Making in Advanced Prostate Cancer
Thomas O’Lynnger, M.D.		Standardizing the Initial and ICU Management of Pediatric Traumatic Brain Injury Improves Outcomes at Discharge: A Pre- and Post-Implementation Comparison Study
Cristin Quinn		Changes in the Comprehensiveness of Care Provided at HIV Care and Treatment Programs in the IeDEA Collaboration from 2009 to 2014
Scott Revey, M.A.		Women’s Agency in Rural Mozambique: Multidimensional Poverty and The Decision to Bear Children
Katie Rizzone, M.D.		Development of a Survey to Study Sports Specialization and Injury Risk in College Athletes
Elizabeth Rose, M.Ed.		Determinants of undernutrition among children aged 6 to 59 months in rural Zambézia Province, Mozambique: Results of a population-based cross-sectional survey
Jay Shah, D.O.		Association Between Disease Activity and Fatigue in Adolescents with Crohn’s Disease
Ebele Umeukeje, M.B.B.S.		Increasing Autonomous Motivation in End Stage Renal Disease to Enhance Phosphate Binder Adherence
Andrew Wu		Incidence and Risk Factors for Respiratory Syncytial Virus and Human Metapneumovirus Infections Among Children in the Remote Highlands of Peru

2014 Thesis Topics

Jay Bala		Diagnostic trends in rural health clinics in Southern, Zambia, 2003-2009: Informatics for clinic data management
Imani Brown		Positive prevention in Zambézia province, Mozambique: How effective/useful is the messaging?
Charlotte Buehler, M.S.		Using Geographic Information Systems (GIS) to examine spatial patterns and clustering of HIV knowledge withing three districts of Zambézia Province, Mozambique
Lanla Conteh, M.D.		Radiologic-Histologic concordance for hepatocellular carcinoma: comparing lesions treated with locoregional therapy versus untreated lesions
Liz Dancel, M.D.		Acculturation and Infant Feeding Styles in a Latino Population: Results from an Ongoing Randomized Controlled Trial of Obesity Prevention
Eileen Duggan, M.D.		Patterns of Care, Outcomes and Healthcare Utilization for Patients with Perforated Appendicitis at Children’s Hospitals
Laura Edwards		Evaluation of a health management mentoring program in rural Mozambique: successes and challenges of year one of implementation
Ditah Fausta, M.D.		Pharmacogenomics of Anti-Retroviral Drug-Induced Hepatoxicity
Monique Foster, M.D.		Prevalence of Enterotoxigenic Escherichia coli and Analysis of Classical and Non-Classical Virulence Factors
Oliver Gunter, M.D.		Teaching Status is Associated with Early Postoperative Complications in Emergency Abdominal Operations
Bill Heerman, M.D.		Parent Health Literacy and Injury Prevention Behaviors for Infants
Angela Horton-Henderson, M.D.		Predictors of Acute Care Transfers from Inpatient Rehabilitation
Jessica Islam		Knowledge, Attitudes and Perceptions of Cervical Cancer and the HPV Vaccine in a Cohort of Bangladeshi Women
Yaa Kumah-Crystal, M.D., M.A.		Technology Use for Self-Management Problem Solving in Adolescent Diabetes and its Relationship to Hba1C
Chrispine Moyo, M.B.Ch.B.		WHO 2007 Policy Recommendation to Initiate Anti-Retroviral Therapy with Tenofovir instead of Stavudine: Implementation Status in Zambia and 12-months Outcome Evaluation
Elizabeth Murphy		Youth Violence Prevention in the Sierra Region of Chiapas, Mexico; Identifying Relevant Positive Youth Development Approaches to Promote Healthy Relationships
Christopher Nyirenda, M.B.Ch.B.		Plasma Polyunsaturated Fatty Acids in Zambian Adults with HIV/AIDS: Relation to Dietary Intake and Cardiovascular Risk Factors
Colby Passaro		MSM HIV/Syphilis Testing and Sexual Risk Behaviors at a Lima CBO: A Cross-Sectional Retrospective Study
Heather Paulin, M.D.		Antenatal Care Uptake in Zambézia Province, Mozambique
Matthew Resnick, M.D.		Self-referral for Advanced Imaging in Urolithiasis: Implications for Utilization and Quality of Care
Cecelia Theobald, M.D.		Improving Quality of Care for Patients Transferred to VUH: Targeting Provider Communication
Christopher Tolleson, M.D.		Motor Timing in Parkinson’s Disease Patients with Freezing of Gait
Yuri van der Heijden, M.D.		Missed Opportunities for Tuberculosis Screening in Pediatric Primary Care
Ellen Zheng, PhD, M.S.		HIV infection and related risk factors among men who have sex with men (MSM) with commercial sex activities in China

2013 Thesis Topics

Dwayne Dove, M.D., Ph.D.		Neuroimaging Young School-Age Children: Brain Connectivity and Pre-Reading Skills in Kindergarten
Leigh Howard, M.D.		A Phase I Study in Healthy Adults to Assess the Safety, Reactogenicity, and Immunogenicity of Influenza A/H5N1 Virus Vaccine Administered With and Without Adjuvant System 03
Eiman Jahangir, M.D.		The Socioeconomic and Sociodemographic Determinants to Awareness, Treatment, and Control of Hypertension in the Southern Cone
Ashley Karpinos, M.D.		Prevalence of Hypertension Among Collegiate Male Athletes
Pat Keegan, M.D.		Patterns of Care Regarding Active Surveillance for Prostate Cancer
Dzifaa Lotsu, M.D.		Role of Omega Fatty Acids in Colorectal Cancer
Andre Marshall, M.D.		Socioeconomic Disparities of 30-day Readmissions Following Surgical Treatment of Appendicitis in Children
Leigh Anne Dageforde, M.D.		Health Literacy Assessment in Dyads of Primary Support Persons and Patients being Evaluated for Kidney Transplantation
Rebecca Snyder, M.D.		Patterns of Care in Perioperative Therapy for Resectable Gastric Cancer
Jose Tique, M.D.		Assessing Literacy and Numeracy in Patients with HIV Infection in Mozambique: Validation of the HIV Literacy Test
Eduard Vasilevskis, M.D.		Developing a Daily Prediction Model for Acute Brain Dysfunction in Older Patients: A New Tool for Quality Measurement and Improvement
Joshua Warolin, D.O.		Factors in Adolescent Weight Gain, a Prospective Cohort
Candice Williams, M.D.		Rural Residence and Access to Mental Health Care for Children and Adolescents after a Suicide Attempt
Elizabeth Williams, M.D.		Educational Intervention to Improve Acceptance of the Recommended Childhood Vaccine Schedule in Vaccine Hesitant Parents
Jessica Young, M.D.		Severe Dysmenorrhea in Adolescence and its Association with Somatization, Mood Symptoms, and Chronic Pain

2012 Thesis Topics

Alex Diamond, D.O.		Determining the effects of participation in organized physical activity as a youth on a variety of short as well as long-term patient and societal-oriented outcome measures
Richard Epstein, Ph.D.		Sudden cardiac death risk and psychotropic drug use in young women
Jennifer Esbenshade, M.D.		Surveillance of influenza shedding in healthcare workers in a pediatric intensive care unit
Sara Horst, M.D.		Evaluating a cohort of patients diagnosed with different chronic abdominal pain syndromes as children or adolescents now being evaluated as young adults
Tera Howard, M.D.		Health literacy defined as the degree to which patients can obtain, process and understand basic health information and services they need to make appropriate health decisions
Matthew Landman, M.D.		Effects of organ allocation strategies in liver transplantation
Christopher Lee, M.D.		Development of muscle imaging as a biomarker in amyotropic lateral sclerosis
Alessandro Morandi, M.D.		The role of pre-hospital use of statins on delirium and long-term cognitive impairment prevention in critically ill patients
Wesley Self, M.D.		Comparing the results of a real-time polymerase chair reaction (PCR) test targeting Methicillin-Resistant Staphylococcus aureus (MRSA) and culture results from purulent material isolated from skin and soft tissue (SST) abscesses
Julia Shelton, M.D.		Effects of wound classification on the incidence of abdominal wall incisional hernias
Anees Siddiqui, M.B.B.S.		Preventing HIV/AIDS transmission among female sex workers (FSWs)in Nawabshah, Sindh by assessing prevalence of sexually transmitted infections (STIs)and knowledge regarding HIV/AIDS transmission

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September 17, 2024

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Q&A: Researcher discusses autism in young adulthood

by Karolinska Institutet

Our understanding of autism has changed significantly in the past years. Previously viewed as a rare childhood disorder with a focus on deficits and pathology, autism is now recognized as a common, lifelong and heterogenous condition characterized by a broad spectrum of strengths and challenges. With increasing numbers of autistic adults and in particular females, a better understanding of autism in young adulthood for autistic females and males is warranted.

In her thesis, Miriam Martini, Ph.D. student at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, aimed to gain a better understanding of the factors that contribute to autism continuing into adulthood. She also aimed to identify which mental and physical health problems autistic females and males might be struggling with around the timing of autism diagnosis and during the challenging transition to adulthood, and how mental and physical health problems influence each other. By comparing autistic individuals to nonautistic individuals and exploring how autistic females and males differ from each other, the thesis aimed to better support the needs of the autistic community.

In this interview, she discusses her findings.

What are the most important results in your thesis?

We see that genetic factors might be important across development. Autism is highly heritable from childhood into adulthood, with genetic factors contributing to its stability over time. Interestingly, while some genetic influences remain stable over time, new ones can emerge as individuals age. Importantly, the thesis highlights complex health challenges in autistic individuals, particularly with regards to mental health problems, as they transition to adulthood.

As a group, autistic individuals are at a higher risk to be diagnosed with or hospitalized for psychiatric difficulties compared to nonautistic individuals between ages 16 and 25. We also show associations between childhood somatic conditions and psychiatric conditions between 16 and 25, as well as associations between childhood psychiatric conditions and adult somatic conditions in autistic individuals. Regarding sex differences, we found autistic females to be particularly at risk. Compared to autistic males, they show higher rates of psychiatric diagnoses before autism diagnosis that seem more persistent and show an increased risk for psychiatric diagnoses and hospitalizations in young adulthood.

Why did you become interested in this topic?

My interest in this topic stems from my background in psychology and an internship in autism research during my studies, where I became particularly interested in autism beyond childhood and its strong association with mental health. As I learned more about the gender health data gap, I recognized the unique opportunity large register data in Sweden provides for epidemiological research, especially in examining sex differences.

I am very passionate about improving mental health outcomes, particularly for those who face significant challenges in this area, and I hope my work contributes to better mental health care and support for autistic individuals, and particularly autistic females, who are often overlooked or excluded from services because of various reasons.

What do you think should be done in future research?

There is a critical need to expand mental health services for autistic individuals, particularly during the transition to adulthood . Additionally, care must be tailored to address the specific needs of both autistic females and males, ultimately improving their long-term health and quality of life.

To achieve this, health care providers require more education on autism and neurodevelopmental conditions to better recognize the unique manifestations of mental and physical health issues in autistic individuals, which will improve differential diagnosis and treatment of these co-occurring conditions.

Collaboration with the autistic community, caregivers, and health care professionals is essential to ensure research translates into practical, person-centered care strategies, meeting the complex needs of autistic individuals across their lifespans.

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Four Ways Climate Information is Helping Health Programs Adapt to Meet the Climate Challenge

As the world grapples with the realities of climate change, its far-reaching impacts are becoming impossible to ignore. Rising temperatures, shifting weather patterns, and the increasing frequency of extreme weather events are not just environmental concerns—they are public health emergencies. These changes are forcing us to reshape our health programs to ensure they remain effective and resilient in the face of these new challenges.

Climate change affects health in numerous ways, from heat stress and the exacerbation of respiratory diseases due to worsening air quality, to altering the spread of infectious diseases like malaria and dengue fever as warmer climates, where mosquitoes thrive, expand. The impacts are widespread and often disproportionately affect the most vulnerable populations, including those in low-income regions where health systems and infrastructures may already be under strain.

Traditional approaches to health programming are no longer sufficient in this rapidly changing climate. We must now account for the environmental factors that affect health outcomes, increase demand for health services, and impact the availability of health resources. This means integrating climate considerations into every aspect of our health programs, from planning and resource allocation to service delivery and emergency response.

A key strategy of this integration is the use of Climate Information Services (CIS). CIS involves collecting and analyzing climate data to predict and address the impacts of climate change on health. By using CIS, we can anticipate potential health crises and adjust our programs accordingly. Below are four real-life examples of how health programs are shifting to better respond to our changing climate. 

Climate-Informed Early Warning and Response Systems for Malaria in Ethiopia

Ethiopia is implementing a tool that integrates malaria surveillance and climate data to generate forecasts and produce malaria early warning reports with up to 8-12 weeks lead time. Investing in a climate-informed early detection system built flexibility into malaria control programs, allowing them to adapt to changing climate conditions. Additionally, targeted and concentrated surveillance can create opportunities to control outbreaks as they happen while also reducing the risk of novel outbreaks.

Anticipatory Action to Reduce the Impact of Extreme Weather Events on Health  

This approach, spearheaded by the International Federation of the Red Cross and Red Crescent Societies (IFRC), represents a significant pivot in disaster risk management and health systems strengthening by emphasizing preparedness while also strengthening response and relief systems. It includes preparing for and mitigating the health threats of climate change through anticipatory action: IFRC links locally led humanitarian action with regional- and global-scale responses and surge support through forecast-based financing from the Disaster Response Emergency Fund.

PEPFAR’s El Nino Response: Lessons Learned from Food Security and HIV/AIDS Crisis Funding  

The 2015-2016 El Niño exacerbated food insecurity in Southern Africa, severely impacting vulnerable populations, including those living with HIV/AIDS. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) response included a $20 million grant to the World Food Programme to combat malnutrition and support HIV-affected households, reaching over 349,000 people. This case study underscores the importance of integrating CIS and fostering inter-agency collaboration to strengthen health systems and improve outcomes in future climate-related emergencies.

A Health Early Warning System to Reduce Extreme Heat Impacts in Senegal

As climate change intensifies, early warning systems are essential to address the increasing frequency and severity of heatwaves, particularly in vulnerable regions like the Sahel. Improved monitoring, accurate forecasting, and strong community engagement are critical components of these systems, helping to protect health and strengthen resilience. This pilot program, supported by the National Oceanic and Atmospheric Administration, enhances regional preparedness through heat-health early warning systems, highlighting the need for improved monitoring, forecasting, and community engagement to mitigate these growing threats.

These approaches are looking beyond immediate risks to anticipate future threats and needs. By integrating climate considerations, we can ensure that our efforts to improve health outcomes worldwide are sustainable and effective in the long term.

Watch this space for the forthcoming technical report, learning materials, and webinars that will showcase USAID’s work on climate and health systems strengthening moving forward.

Strategic Objective

Fernanda zermoglio.

Fernanda Zermoglio is a Senior Advisor in the Center for Resilience, Bureau for Resilience, Environment, and Food Security. She works to support missions and programs to integrate climate risks into programs and activities. She has over 25 years of experience providing strategic and technical leadership in integrating climate adaptation and resilience into development policy and practice.

Maggie Barnes

Maggie Barnes is the Program and Communications Coordinator for the USAID Office of Health Systems’ Strategic Communications, Analytics, Learning and Evidence (SCALE) team. In her current role, she supports OHS' communications and messaging and is part of the AOR team that manages the $1.15 billion WHO Consolidated Portfolio. Maggie also serves as the Country Team Coordinator for Burkina Faso. She has her Masters of Public Health from George Washington University.

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Pagers Explode Across Lebanon in Apparent Attack on Hezbollah

The attack killed 11 people, including a young girl. Officials briefed on the operation say Israeli operatives planted explosives in pagers Hezbollah bought from a Taiwanese company. Israel declined to comment.

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Patrick Kingsley Euan Ward and Ronen Bergman

Here are the latest developments.

Hundreds of pagers blew up at the same time across Lebanon on Tuesday in an apparently coordinated attack that targeted members of Hezbollah, an Iranian-backed militant group in the region, Lebanese and Hezbollah officials said.

The Israeli military declined to comment, but American and other officials briefed on the operation said Israel was responsible for the attack and had executed it by hiding small amounts of explosive material in each pager within a new batch of pagers made in Taiwan and imported into Lebanon.

The attack came a day after Israeli leaders had warned that they were considering stepping up their military campaign against Hezbollah, which has been firing on northern Israel since last year in solidarity with Hamas and its war with Israel in Gaza.

Hezbollah accused Israel of orchestrating the attack on Tuesday and vowed to retaliate for what it called “blatant aggression.”

The wave of explosions left many people in Beirut, the Lebanese capital, in a state of confusion and shock. Witnesses reported smoke coming from people’s pockets, followed by small blasts that sounded like fireworks or gunshots. Amateur footage broadcast on Lebanese television showed chaotic scenes at hospitals, as wounded patients with mangled hands and mutilated faces sought treatment. Sirens blared throughout the city.

Lebanon’s prime minister, Najib Mikati, characterized the attack as “criminal Israeli aggression” and called it “a serious violation of Lebanese sovereignty.” Here is what else to know:

Thousands injured: Officials said that the death toll had risen to 11 people. Hezbollah said at least eight of its fighters had been killed. Lebanon’s Ministry of Health said that a young girl was also among those killed and that more than 2,700 others were injured. Lebanon’s health minister, Dr. Firass Abiad, said many of the victims had injuries to their faces, particularly the eyes, as well as to their hands and stomachs. Iran’s ambassador to Lebanon, Mojtaba Amini , suffered injuries to his hand and face when a pager he was carrying exploded, according to Iranian state news media reports.

Hezbollah’s pagers targeted : Three officials briefed on the attack said that the operation had targeted hundreds of pagers belonging to Hezbollah operatives who have used such devices for years to make it harder for their messages to be intercepted. The use of pagers had became even more widespread after the Oct. 7 attacks, when Hezbollah’s chief warned that Israeli intelligence had penetrated the cellphone network, security experts said. The devices were programmed to beep for several seconds before exploding, according to the officials, who spoke on the condition of anonymity because of the sensitivity of the matter.

Escalating conflict : The blasts appeared to be the latest salvo in an 11-month conflict between Israel and Hezbollah that began last October, after Hezbollah, an Iranian-backed militia, began firing into Israeli territory in solidarity with its ally, Hamas, which is also backed by Iran. The conflict has largely remained contained to exchanges of missiles and rockets, but for months, leaders on either side have warned that it could expand into a war involving ground forces.

Assassination attempt : On Tuesday afternoon, before the pager explosions in Lebanon, the Israeli military had accused Hezbollah of attempting to assassinate a retired senior member of the country’s security services with an explosive device that could be remotely detonated from Lebanon. The same operatives were behind a similar attempted attack in Tel Aviv last year, the military said.

Syrian attacks: In Syria, at least 14 people were injured by pager explosions in the apparently coordinated attack on Hezbollah, according to the Syrian Observatory for Human Rights, a Britain-based monitor.

Pager danger: Lebanon’s health ministry has put all hospitals in Lebanon on “maximum alert,” and has requested citizens to discard their pagers.

Johnatan Reiss and Gabby Sobelman contributed reporting.

Anushka Patil

Lebanon’s health minister, Dr. Firass Abiad, said on Tuesday evening that health officials were beginning to direct the injured to medical facilities outside of Beirut and its southern suburbs, where hospitals are overwhelmed, state news media reported.

One of those hospitals, the American University of Beirut Medical Center, said earlier Tuesday that it had received more than 160 “seriously injured” people in the span of three hours and that more were on their way.

The World Health Organization said it was assisting hospitals in Lebanon and providing supplies because many health facilities were at capacity with injured patients. The U.N.’s public health agency described the situation as an “emergency,” according to a statement.

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Sheera Frenkel and Ronen Bergman

Israel planted explosives inside new beepers sold to Hezbollah, officials say.

Israel carried out its operation against Hezbollah on Tuesday by hiding explosive material within a new batch of Taiwanese-made pagers imported into Lebanon, according to American and other officials briefed on the operation.

The pagers, which Hezbollah had ordered from Gold Apollo in Taiwan, had been tampered with before they reached Lebanon, according to some of the officials. Most were the company’s AR924 model, though three other Gold Apollo models were also included in the shipment.

The explosive material, as little as one to two ounces, was implanted next to the battery in each pager, two of the officials said. A switch was also embedded that could be triggered remotely to detonate the explosives.

At 3:30 p.m. in Lebanon, the pagers received a message that appeared as though it was coming from Hezbollah’s leadership, two of the officials said. Instead, the message activated the explosives. Lebanon’s health minister told state media at least 11 people were killed and more than 2,700 injured.

The devices were programmed to beep for several seconds before exploding, according to three of the officials.

Hezbollah has accused Israel of orchestrating the attack but has described limited details of its understanding of the operation. Israel has not commented on the attack, nor said it was behind it.

The American and other officials spoke on the condition of anonymity given the sensitive nature of the operation.

Independent cybersecurity experts who have studied footage of the attacks said it was clear that the strength and speed of the explosions were caused by a type of explosive material.

“These pagers were likely modified in some way to cause these types of explosions — the size and strength of the explosion indicates it was not just the battery,” said Mikko Hypponen, a research specialist at the software company WithSecure and a cybercrime adviser to Europol.

Keren Elazari, an Israeli cybersecurity analyst and researcher at Tel Aviv University, said the attacks had targeted Hezbollah where they were most vulnerable.

Earlier this year, Hezbollah’s leader, Hassan Nasrallah, strictly limited the use of cellphones, which he saw as increasingly vulnerable to Israeli surveillance, according to some of the officials as well as security experts.

“This attack hit them in their Achilles’ heel because they took out a central means of communication,” Ms. Elazari said. “We have seen these types of devices, pagers, targeted before but not in an attack this sophisticated.”

Over 3,000 pagers were ordered from the Gold Apollo company in Taiwan, said several of the officials. Hezbollah distributed the pagers to their members throughout Lebanon, with some reaching Hezbollah allies in Iran and Syria. Israel’s attack affected the pagers that were switched on and receiving messages.

It remained unclear on Tuesday precisely when the pagers were ordered and when they arrived in Lebanon.

As people gathered to donate blood at Red Cross centers across Lebanon on Tuesday, various medical professional groups called on their members, including oral surgeons, pharmacists and veterinarians, to report to local hospitals and provide what help they could, state media reported.

Hwaida Saad

Hezbollah told The New York Times that six of the nine people killed in the coordinated pager explosions were Hezbollah fighters.

The death toll has risen to at least nine killed, according to the U.N.’s special coordinator for Lebanon, Jeanine Hennis-Plasschaert. “The developments today mark an extremely concerning escalation,” she said in a statement.

A doctor who visited hospitals in Sidon where some of the wounded were taken said so many people have suffered wounds to their eyes that there is a shortage of eye surgeons. The doctor, Abdulrahman al Bizri, said the hospitals he visited were flooded with people who have injured eyes, faces and hands, and the medical staffs are struggling to treat them all. “The eye injuries won’t be easy and need long treatment,” he said.

At least 14 people in Syria were injured by pager explosions in the apparently coordinated attack on Hezbollah, according to the Syrian Observatory for Human Rights, a Britain-based monitor.

Laurence Tan

Medics collected blood donations in Sidon and Beirut’s southern suburbs on Tuesday after hundreds of pagers blew up at the same time in an apparently coordinated attack across Lebanon.

Schools across Lebanon will be closed on Wednesday, Lebanese state media said, citing a statement from the country’s minister of education, Abbas Al-Halabi.

Farnaz Fassihi

Iran’s ambassador to Lebanon is injured in the apparent attack, state media reports.

Iran’s ambassador to Lebanon, Mojtaba Amini, lost one eye and severely injured his other eye when a pager he was carrying exploded in a simultaneous wave of blasts targeting wireless electronic devices, according to two members of Iran’s Revolutionary Guards Corps briefed on the attack.

The Guards members, who had knowledge of the attacks and spoke on the condition of anonymity because they were not authorized to speak publicly, said Mr. Amini’s injuries were more serious than Iran initially reported and that he would be medevacked to Tehran for treatment.

Hossein Soleimani, the editor in chief of Mashregh, the main Revolutionary Guards news website, confirmed the extent of Mr. Amini’s injuries in a post on X . “Unfortunately the injuries sustained by Iran’s ambassador were extremely severe and in his eyes,” Mr. Soleimani wrote.

A video of Mr. Amini being transported to the hospital, published by Iranian news media outlets, shows him on a chaotic Beirut street with his eyes covered by bandages and the front of his white shirt covered in blood.

Iran’s foreign minister, Abbas Araghchi, condemned the attack in a call with Lebanon’s foreign minister and said Iran was ready to medevac the ambassador and other injured people to Iran for medical treatment if needed, according to a statement released by his office. He spoke to Mr. Amini’s wife in Beirut and wished the ambassador a speedy recovery, the statement said.

The attacks appeared to mostly target members of Hezbollah, a political and militia group backed and supported by Iran. Hezbollah and Israel have engaged in intense clashes across their borders since the Hamas-led Oct. 7 attacks on Israel last year. Hezbollah accused Israel, which did not comment, of responsibility for the blasts.

Narges Ghadirian, the ambassador’s wife, said in a post on X earlier on Tuesday that her husband “is slightly injured but thank God he is all right and the danger has passed.”

Iranian media reported that two of the ambassador’s bodyguards were also injured because they were carrying pagers that exploded. Tasnim News agency, which is affiliated with the Revolutionary Guards, said similar devices also exploded in Syria.

One of the Guards members said the pagers, including the one used by the ambassador, beeped for about 10 seconds before exploding, prompting some victims to hold the devices close to their eyes and faces to check for a message. The two Guards members said the pagers were used only by Hezbollah members and operatives and not widely distrusted among ordinary citizens.

Iran appoints its ambassadors in Lebanon, Syria, Iraq and Yemen — allied countries that are known regionally as the “axis of resistance’— from the senior ranks of the Revolutionary Guards because they also serve as liaisons with militant groups backed by Iran.

The news of the explosions rattled many Iranian supporters of the government who took to social media to express what they feared was Israel’s ability to cause widespread harm remotely. They also said the explosions had outed Hezbollah members, whose identities are typically secret, because video footage of the blasts and their aftermath went viral and victims were seen being injured and seeking medical treatment at hospitals.

A former vice president of Iran, Mohammad Ali Abtahi, called the means of attack “a new phase in technological warfare replacing conventional war” on Telegram. Mr. Abtahi, a politician from the reformist faction, was stationed in Lebanon in the 1980s.

Israel has carried out a series of covert operations in Iran as part of the shadow war between the two countries. Israel assassinated Iran’s top nuclear scientist and deputy defense minister, Mohsen Fakhrizadeh , in 2020 using an A.I.-assisted robot controlled remotely via satellite. In February, Israel blew up two major gas pipelines in Iran, disrupting service to several cities, and, in 2021, an Israeli hack of Iran’s oil ministry servers disrupted gasoline distribution nationwide.

Tensions are already high between Iran and Israel after the assassination of Hamas’s political leader, Ismail Haniyeh, in Tehran in July. Iran pledged to retaliate against Israel but so far has refrained from doing so after diplomatic efforts warned Tehran that responding risked an Israeli retaliation and wider war.

Some conservative Iranian pundits on Tuesday called on the government to act on its pledge of retaliation against Israel, saying not doing so could embolden Israel to carry out more strikes.

Matthew Miller, the State Department spokesman, told reporters, “we would urge Iran not to take advantage of any incident, any instability, to try to add further instability and to further increase tensions in the region.”

Michael Crowley contributed reporting from Washington.

Hiba Yazbek and Anushka Patil

Israel attacks central Gaza, and civil officials say at least five were killed.

Israeli airstrikes on homes near the Bureij neighborhood in central Gaza on Tuesday morning killed at least five people, including a child, and dozens remained trapped under the rubble at nightfall, the local emergency services said.

The Palestinian Civil Defense said that it had received dozens of calls for help from people who were wounded and trapped and that more than 50 people, including several families, were believed to be inside the buildings when they were hit.

Emergency crews on the scene could hear injured survivors screaming for help, but were forced to retreat after being targeted by Israeli aircraft, according to Mahmoud Basal, a Civil Defense spokesman. Unless medics and rescuers were granted safe access to the site and allowed to bring heavy equipment, including excavators, the scale of the tragedy could rise dramatically, he warned.

The Israeli military said that it had targeted sites near the Bureij neighborhood, where it said fighters were preparing to fire anti-tank missiles and rifles at Israeli troops. The military said it was reviewing reports of civilians being harmed, and it did not respond to the accusation that rescue workers were being prevented from reaching the victims.

Photos from several news agencies at the scene showed extensive destruction, with bloodied limbs of people visible in the rubble. Clothing and household items, including chairs and blankets, could be seen in one building whose facade had been blown off, and children and other residents of the camp were walking through the streets with their meager belongings in hand. At the al-Awda hospital in central Gaza, where some of the victims were taken, photos showed families bent in grief over the bodies of their relatives.

Hamas, the armed group that controlled Gaza before Israel’s invasion last year in response to the Oct. 7 attacks, said in a statement that the intensive bombardment had killed and wounded dozens of people in their homes and accused Israel of deliberately targeting Palestinian civilians.

Israel has repeatedly denied that its forces purposely target civilians and has accused Hamas of hiding its fighters and weapons among noncombatants.

Other Israeli strikes across Gaza on Tuesday, including several in Gaza City, killed at least 13 other people, including women and at least one child, Mr. Basal said. The Gaza Health Ministry said on Tuesday afternoon that at least 26 Palestinians had been killed in Israeli strikes over the past 24 hours.

Iran has offered to send a plane to evacuate some of the wounded to Tehran for treatment, particularly those with severe eye injuries, said Lebanon’s foreign minister, Abdallah Bou Habib.

Aaron Boxerman

Matthew Miller, the State Department spokesman, said the United States was “not involved” in the apparently coordinated attack in Lebanon, nor had it received any advance notice about it. “At this point, we are gathering information,” Miller said. Miller also said that he had “no assessment” to offer about whether Israel might be responsible for the explosions.

It was too soon to say how the attack could impact negotiations for a cease-fire in Gaza, Miller said. The United States was continuing to tell Israel and "other parties" that they should seek a “diplomatic resolution” to the ongoing war, he added.

Lebanon’s foreign minister, Abdallah Bou Habib, said the country was bracing for a major retaliation by Hezbollah. “If Israel thinks by this that they’re going to return their displaced people from the north of Israel, they are mistaken. This escalates this war,” Bou Habib said in a phone call with The New York Times.

He added that the Lebanese government was now preparing to lodge a complaint at the U.N. Security Council. “Hezbollah are definitely going to retaliate in a big way. How? Where? I don’t know,” he said after speaking Tuesday with Hezbollah officials.

The son of a Hezbollah lawmaker, Ali Ammar, was among those killed in the blasts. Lebanon’s prime minister, Najib Mikati, visited Beirut’s southern suburbs on Tuesday to pay condolences to the parliamentarian.

Johnatan Reiss

The Israeli chief of staff, Lt. Gen. Herzi Halevi, held a security briefing with other senior generals Tuesday evening, the military said in a statement. The officers reviewed “preparation for defensive and offensive operations on all fronts,” according to the statement.

While no new guidelines have been issued for Israeli civilians, the military said Israelis should continue exercising “alertness.”

A graphic video from social media , recorded in Bahman Hospital in Beirut and verified by The New York Times, shows scores of injured individuals bleeding on stretchers and beds. The injuries vary in severity. Some people appear to be missing parts of their hands.

Three minutes from inside the hospital in Lebanon showing how overwhelmed the hospital with Hezbollah’s member after the cyberattack. pic.twitter.com/77aHBUcIRW — Asaad Sam Hanna (@AsaadHannaa) September 17, 2024

Matthew Mpoke Bigg

Hezbollah started using paging devices more widely after Oct. 7, experts say.

Senior members of Hezbollah have used pagers for years but the practice became more widespread after the Oct. 7 attacks, when the group’s leader warned members that Israeli intelligence had penetrated the cellphone network, security experts said Tuesday.

As a result, thousands of rank-and-file members of Hezbollah — and not just fighters — switched to a new system of wireless paging devices, said Amer Al Sabaileh, a regional security expert and university professor based in Amman, Jordan. He said his information was based on extensive contacts in Lebanese political and security circles.

It was not immediately clear how those devices were distributed, but large numbers of pagers exploded at approximately the same time on Tuesday in Lebanon, causing thousands of injuries, according to Lebanese health authorities.

Since the advent of cellphones and smartphones, pagers have fallen out of use, though they remain in use by some people for quick and private contact.

Hezbollah has been security conscious about telecommunications for years, Mr. Al Sabaileh said, and has long banned its operatives from using cellphones while they are traveling in the south of the country near the Israel border. Cellphones can be used to locate the person carrying them.

But, he said, that became more urgent after Oct. 7, when some of the Hezbollah’s senior members were assassinated in airstrikes. In February, Hezbollah’s chief, Hassan Nasrallah, warned members during a speech that their phones were dangerous and could be spied on by Israeli forces, saying they should break or bury them.

Iran, whose government has for decades supplied Hezbollah with arms, technology and other forms of military aid, and would have been pivotal both to any decision to switch to the system and in the delivery of the technology, the experts said.

Experts said that they did not know the precise arrangement for the distribution of the paging devices to Hezbollah members, nor how they had been compromised, but a key element of the new paging system was that it did not use the technology that is the basis of most conventional cellphone networks, and therefore were harder to track electronically.

David Wood, a senior Lebanon analyst with the International Crisis Group think tank, described it as a “limited, closed network.”

He said that in the short term, Hezbollah would likely resort to other methods of communication, potentially one that avoided electronic means altogether.

“It will obviously make coordination more difficult and more risky and without a doubt this is a serious blow to Hezbollah’s operational capacity,” he said.

Mr. Sabaileh said the explosions would be a psychological blow for Hezbollah because it showed the capacity of Israel to strike not just fighters but anyone connected with the group as they went about their daily business.

“It’s like doing an operation in every part of Hezbollah’s territory,” Mr. Sabaileh said, adding that the group would likely see it as a prelude to an Israeli escalation of the conflict, potentially on the ground. “The way they are targeted and the timing looks like a movie — making devices explode all at the same time everywhere is shocking.”

U.N. spokesman Stéphane Dujarric said the developments in Lebanon were “extremely concerning” given the volatile situation in the region. “We deplore the civilian casualties that we have seen,” Dujarric said, adding that the U.N. was following events closely. “We cannot underscore enough the risks of escalation in Lebanon and in the region.”

Sanjana Varghese

Video from social media, verified by The New York Times, shows two injured people on a busy street in Beirut after explosions across the city.

Hezbollah accused Israel of responsibility for the blasts in a second statement, adding that there would be “punishment for this blatant aggression.”

Residents in Lebanon are scared to answer calls. One resident, Khadijeh Fouani, was preparing winter food supplies when she answered her phone by crying out, "Please hang up, hang up!"

The office of Lebanon’s prime minister, Najib Mikati, labeled the incident “criminal Israeli aggression” in a statement, adding that it was “a serious violation of Lebanese sovereignty.”

Ahmad Ayoud, a butcher from the Basta neighborhood in Beirut, said he was in his shop when he heard explosions. Then he saw a man in his 20s fall off a motorbike. He appeared to be bleeding. “We all thought he got wounded from a random shooting,” Ayoud said. “Then, a few minutes later, we started hearing of other cases. All were carrying pagers.”

Here is a look at Hezbollah and what a wider war would mean for Lebanon.

For months, concerns have grown that the war in Gaza might ignite a second conflict between Israel and Hezbollah, the well-armed militia that is loosely allied with Hamas and based just across Israel’s northern border with Lebanon.

The two sides have repeatedly traded strikes since the Gaza war began in October, killing civilians and combatants in Lebanon and Israel, with most of the civilian casualties in Lebanon. The hostilities have also forced more than 150,000 people on both sides of the border to leave their homes for temporary shelters. That has put pressure on the Israeli government to make the north of the country safe for residents again by pushing Hezbollah back from the border region.

The pagers that exploded across Lebanon on Tuesday came a day after Israeli leaders warned that they were considering stepping up their military campaign against Hezbollah. Israel hasn’t commented on whether it was behind the attacks, but tensions between the two countries were already rising.

Here’s a look at Hezbollah and what a wider war would mean for Lebanon.

What is Hezbollah?

Hezbollah has opposed Israel since the group’s very beginnings. It was founded in the 1980s, after Israel, responding to attacks, invaded and occupied southern Lebanon, intending to root out the Palestine Liberation Organization, which was then based in the country.

But Israel soon ran into a new enemy, one whose guerrilla fighters quickly grew effective at bedeviling the far-better-equipped Israeli forces: Hezbollah, a Shiite Muslim popular movement that made driving Israel out of Lebanon a major goal.

By 2000, Israel had withdrawn from Lebanon, making Hezbollah a hero to many Lebanese. It fought Israel again in 2006, launching a military operation into its southern neighbor that led to a fierce counterattack. In that war, Israel rained bombs on southern Lebanon and Beirut, the capital; the fighting killed more than 1,000 Lebanese.

Yet, the Israeli military never managed to overwhelm Hezbollah in 34 days of war, allowing the group and its leader, Hassan Nasrallah, to emerge as stars in an Arab world wearily accustomed to being defeated by Israel.

Hezbollah soon allied with Iran, and they became close partners.

Though the group retains a large and loyal following among Shiite Muslims because of the social services and political power it offers them — as well as the authoritarian tactics it uses to quell any dissent — many Lebanese see the group as an obstacle to progress that keeps threatening to drag the country into an unwanted war.

Hezbollah, considered a terrorist group by the United States and other countries, has evolved from a fighting force into a dominant political one, accruing significant influence in Lebanon’s government.

What would a wider war mean for Lebanon?

Lebanon can hardly afford a new conflict with Israel.

The country is reeling from years of an economic crisis that has left countless Lebanese in poverty and a political one that has stripped citizens of many basic services. The strikes at the border have displaced about 100,000 Lebanese civilians, depriving many of their income and their homes, and have cost the country billions of dollars in lost tourism and agricultural revenue, Lebanese officials say.

Even some of Hezbollah’s traditionally loyal Shiite Muslim constituents in southern Lebanon are questioning the price of the current fighting. As a result, analysts say, Mr. Nasrallah knows he has to step carefully. He has said that Hezbollah does not want a broader conflict, while warning that his fighters are prepared for one — and that Israel will face serious consequences if it comes.

A Hezbollah-Israel war could also metastasize into a larger regional war that would dwarf the ongoing fighting. Such a conflict could draw in Iran, as well as the United States, which has been working to avert further escalation.

Though jitters have grown with the frequency and deadliness of each side’s strikes, Israel, Hezbollah and Iran do not want a full-fledged war , analysts and U.S. officials say. Yet, the only near-certain way to avoid one, they say, is to end the fighting in Gaza with a cease-fire deal between Israel and Hamas, whose Oct. 7 attack led to the war in the enclave.

How strong is Hezbollah?

Through propaganda videos and calibrated strikes, Hezbollah has repeatedly displayed signs of a bulked-up arsenal that analysts say is capable of inflicting heavy damage on Israeli cities. Its forces are also battle-tested after years of fighting against rebels in Syria, where Hezbollah sent thousands of fighters during that country’s civil war to help prop up the government of President Bashar al-Assad, a close ally of Iran and Hezbollah.

Estimates vary about just how many missiles Hezbollah has and just how sophisticated its systems are. The Central Intelligence Agency’s World Factbook says the group may have more than 150,000 missiles and rockets of various types and ranges. It also estimated that the group had up to 45,000 fighters, though Mr. Nasrallah has claimed to have 100,000.

But analysts and Israeli officials say Hezbollah’s arsenal is considerably more dangerous than Hamas’s because of its precision-guided missiles, which could target critical Israeli infrastructure and military assets.

Hezbollah has also displayed exploding drones that can elude Israel’s Iron Dome, the detect-and-shoot-down system designed to protect the country from incoming rockets and missiles. The group also appears to have anti-tank missiles that fly too fast and too low for the Iron Dome to intercept.

Euan Ward contributed reporting.

Lebanon's health minister, Dr. Firass Abiad, said in a news conference that eight people were killed by exploding paging devices and more than 2,700 were wounded, including approximately 200 in serious condition.

Dr. Abiad said many of the victims had injuries to their faces, particularly the eyes, as well as to their hands and stomachs. One of those killed was an 8-year-old girl, he said.

The wave of explosions left many people in Beirut in a state of confusion and shock. "It is complete chaos," said Um Saleh, a homemaker who lives in the southern suburbs of the city. "I cannot find an explanation to what happened this afternoon.”

Anjana Sankar

Here’s a look at some of the key events in the conflict in the Middle East.

Wireless devices were exploding across Lebanon, the day after Israel warned it would escalate its campaign against the powerful Iran-backed militia.

Tensions have been high for months in the wake of high-profile assassinations of senior leaders of the militant groups Hamas and Hezbollah. Those killings in July intensified the longstanding conflict between Israel and Iran, which backs Hamas and Hezbollah.

They also fueled alarm among global leaders, including in the United States, where the Biden administration has urged restraint to prevent a broader war from engulfing the region.

Here are some of the key developments in recent months.

Jan. 2: A Hamas leader’s killing in Beirut

Hamas accused Israel of killing Saleh al-Arouri, a senior leader, along with two commanders from its military wing in an explosion in a suburb of Beirut, Lebanon’s capital. Previously, Beirut had been far from the cross-border violence between Israel and Hezbollah, the powerful Lebanese militia that, like Hamas, is aligned with Iran. Mr. al-Arouri was the first high-level Hamas official to be killed outside the West Bank and Gaza in recent years. Israeli officials declined to comment, but Lebanese and U.S. officials attributed the attack to Israel.

Jan. 6: Hezbollah’s retaliation against Israel

In response to Mr. al-Arouri’s assassination, Hezbollah fired a volley of rockets at a small military base in northern Israel. Though Hezbollah said it caused casualties, the Israeli military reported no injuries and responded with its own strikes in Lebanon. Analysts viewed Hezbollah’s response as a symbolic act rather than a significant escalation, with the group firing about 40 rockets toward Mount Meron, an area housing a military radar station.

April 1: Airstrikes in Damascus

Israel carried out airstrikes that hit part of the Iranian Embassy complex in Damascus, Syria, killing three senior Iranian commanders and four officers involved in Iran’s covert operations. The attack, one of the deadliest in the yearslong shadow war between Israel and Iran, increased regional tensions, which were already strained over the war in Gaza and hostilities involving Iran-backed groups. Israeli officials, speaking anonymously, confirmed the strike but denied that the targeted building had diplomatic status.

April 14: A barrage of missiles and drones against Israel

Iran retaliated for the Damascus strikes by launching more than 300 drones and missiles against Israel , its first open attack on Israel from Iranian soil. The strikes, aimed at military targets, caused minor damage and injured a young girl. Israel intercepted most of the projectiles and others were shot down by U.S. and Jordanian defenses. The calibrated attack, telegraphed well in advance, demonstrated Iran’s effort to avoid mass casualties or direct war, analysts said.

July 13: An airstrike in a designated humanitarian zone of Gaza

Israel tried to kill Muhammad Deif, a top Hamas military commander in Gaza, in an airstrike that the territory’s health ministry said killed 90 people and injured 300 others. The strike hit a strip of coastal land known as Mawasi, which Israel had designated as a humanitarian zone, and where thousands of displaced Palestinians were living. Mr. Deif, believed to be a mastermind behind the Oct. 7 attack on Israel, had long been a high-priority target, and after weeks of uncertainty about his condition, Israeli authorities said in August that he had been killed . Hamas has not explicitly confirmed or denied Israel’s claim.

July 27: Rocket strikes in the Israeli-controlled Golan Heights

A rocket from Lebanon struck a soccer field in the Druse town of Majdal Shams in the Israeli-controlled Golan Heights, killing 12 teenagers and children, according to the Israeli military. It was the deadliest single attack from across Israel’s northern border in months of hostilities. Israel accused Hezbollah, but the group denied responsibility.

July 30: A second strike in Beirut

Israel targeted Fuad Shukr, a senior Hezbollah leader and close adviser to the organization’s leader, Hassan Nasrallah, in a deadly strike in Beirut . Israeli officials described the attack as a response to the Golan Heights rocket strike, but the assault quickly raised concerns in the region about Israel’s willingness to strike deep within Lebanese territory.

July 31: A top Hamas official is killed in Tehran

Hours after the strike in Beirut, Ismail Haniyeh, one of the most senior Hamas leaders and a key figure in the stalled cease-fire talks, was assassinated in Iran , where he had gone for the inauguration of that country’s new president. Iran and Hamas said Israel had carried out the killing, and they vowed to retaliate. Mr. Haniyeh, who had led Hamas’s political office and helped manage negotiations for a cease-fire, was killed by an explosive device covertly smuggled into the guesthouse in Tehran where he was staying, according to seven Middle Eastern officials, including two Iranians, as well as an American official.

Aug. 25: Israel says it thwarted a major attack

The Israeli military said it had launched airstrikes against Hezbollah forces that had been preparing an “extensive” attack against Israel, destroying what it said were thousands of rocket launch barrels. Hezbollah later said it had retaliated for Mr. Shukr’s killing by launching hundreds of rockets at Israeli military positions — believed to be one of its largest barrages in months — though Israel said there had been “very little damage.”

The strikes came after cross-border strikes between Israeli forces and Hezbollah militants in Lebanon had escalated sharply. A week earlier, an Israeli airstrike hit a factory in a small town in southern Lebanon, killing at least 10 civilians , according to Lebanese officials. It was one of the largest death tolls in a single strike in Lebanon since the war in Gaza began.