Transitioning to Digital Systems: The Role of World Health Organization's Digital Adaptation Kits in Operationalizing Recommendations and Interoperability Standards.
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SUBMITTER: Tamrat T
PROVIDER: S-EPMC8885357 | biostudies-literature | 2022 Feb
REPOSITORIES: biostudies-literature
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Transitioning to Digital Systems: The Role of World Health Organization's Digital Adaptation Kits in Operationalizing Recommendations and Interoperability Standards.
Tamrat Tigest T Ratanaprayul Natschja N Barreix Maria M Tunçalp Özge Ö Lowrance David D Thompson Jenny J Rosenblum Leona L Kidula Nancy N Chahar Ram R Gaffield Mary E ME Festin Mario M Kiarie James J Taliesin Brian B Leitner Carl C Wong Sylvia S Wi Teodora T Kipruto Hillary H Adegboyega Ayotunde A Muneene Derrick D Say Lale L Mehl Garrett G
Global health, science and practice 20220228 1
<h4>Introduction</h4>The transition from paper to digital systems requires quality assurance of the underlying content and application of data standards for interoperability. The World Health Organization (WHO) developed digital adaptation kits (DAKs) as an operational and software-neutral mechanism to translate WHO guidelines into a standardized format that can be more easily incorporated into digital systems.<h4>Methods</h4>WHO convened health program area and digital leads, reviewed existing ...[more]
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Project description:BackgroundOne of the key mandates of the World Health Organization (WHO) is to develop guidelines, defined as "a document containing recommendations for clinical practice or public health policy." Guidelines represent the global standard for information sources shaping clinical practice and public health policies. Despite the rigorous development process and the value of guidelines for setting standards, implementing such standards within local contexts and at the point of care is a well-documented challenge. Digital technologies enable agile information management and may facilitate the adaptation of guidelines to diverse settings of health services delivery.ObjectiveThe objective of this paper is to detail the systematic and iterative process involved in transforming the WHO Antenatal Care (ANC) guidelines into a digital decision-support and patient-record application for routine use in primary health care settings, known as the WHO digital ANC module.MethodsThe WHO convened a team of clinical and digital health experts to develop the WHO digital ANC module as a tool to assist health care professionals in the implementation of WHO evidence-based recommendations for pregnant women. The WHO digital ANC module's creation included the following steps: defining a minimum viable product (MVP), developing clinical workflows and algorithms, algorithm testing, developing a data dictionary, and the creation of a user interface or application development. The overall process of development took approximately 1 year to reach a stable prototype and to finalize the underlying content requirements of the data dictionary and decision support algorithms.ResultsThe first output is a reference software reflecting the generic WHO ANC guideline content, known as the WHO digital ANC module. Within it, all actionable ANC recommendations have related data fields and algorithms to confirm whether the associated task was performed. WHO recommendations that are not carried out by the health care worker are saved as pending tasks on a woman's health record, and those that are adequately fulfilled trigger messages with positive reinforcement. The second output consists of the structured documentation of the different components which contributed to the development of the WHO digital ANC module, such as the data dictionary and clinical decision support workflows.ConclusionsThis is a novel approach to facilitate the adoption and adaptation of recommendations through digital systems at the health service delivery level. It is expected that the WHO digital ANC module will support the implementation of evidence-based practices and provide information for monitoring and surveillance; however, further evidence is needed to understand how the WHO digital ANC module impacts the implementation of WHO recommendations. Further, the module's implementation will inform the WHO's ongoing efforts to create a pathway to adaptive and integrated (Smart) Guidelines in Digital Systems to improve health system quality, coverage, and accountability.
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Project description:In this article, we present a joint effort of the wheat research community, along with data and ontology experts, to develop wheat data interoperability guidelines. Interoperability is the ability of two or more systems and devices to cooperate and exchange data, and interpret that shared information. Interoperability is a growing concern to the wheat scientific community, and agriculture in general, as the need to interpret the deluge of data obtained through high-throughput technologies grows. Agreeing on common data formats, metadata, and vocabulary standards is an important step to obtain the required data interoperability level in order to add value by encouraging data sharing, and subsequently facilitate the extraction of new information from existing and new datasets. During a period of more than 18 months, the RDA Wheat Data Interoperability Working Group (WDI-WG) surveyed the wheat research community about the use of data standards, then discussed and selected a set of recommendations based on consensual criteria. The recommendations promote standards for data types identified by the wheat research community as the most important for the coming years: nucleotide sequence variants, genome annotations, phenotypes, germplasm data, gene expression experiments, and physical maps. For each of these data types, the guidelines recommend best practices in terms of use of data formats, metadata standards and ontologies. In addition to the best practices, the guidelines provide examples of tools and implementations that are likely to facilitate the adoption of the recommendations. To maximize the adoption of the recommendations, the WDI-WG used a community-driven approach that involved the wheat research community from the start, took into account their needs and practices, and provided them with a framework to keep the recommendations up to date. We also report this approach's potential to be generalizable to other (agricultural) domains.
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Project description:Physical inactivity is a major risk-factor of non-communicable diseases. The World Health Organization has set physical activity recommendations for adults to reduce physical inactivity and its consequences. However, 1.4 billion adults are non-adherent to the recommendation worldwide. The prevalence of non-adherence to this recommendation and its predictors has not been assessed in urban Ethiopia. This study aimed to determine the prevalence of non-adherence to physical activity recommendations and identify its associated factors among healthy adults in urban centers of Southwest Ethiopia. A community-based cross-sectional study was employed from May to June 2021, involving 1191 adults in urban centers of Southwest Ethiopia. Data was collected using Global Physical Activity Questionnaire. Multivariable logistic regression was used to identify factors associated with non-adherence to physical activity recommendations using 95% confidence interval of adjusted odds ratio at P-value of < 0.05.Overall, 61.2% of participants were non-adherent to physical activity recommendations. Older age (AOR = 6.6; 95%CI (2.3-19)), female sex (AOR = 6.1; 95%CI (3.5-10.5)), lower educational status (AOR = 0.5; 95%CI (.28-0.93)), less community engagement (AOR = 2.7;95% CI (1.3-5.5)), lower level of happiness (AOR = 4.7; 95%CI (1.3-16.8)) and physical inactivity of family members (AOR = 2.5; 95%CI (1.4-4.3)) were associated with non-adherence. The prevalence of non-adherence to physical activity recommendations in the study area is high. Age, sex, educational status, community engagement, level of happiness and physical inactivity of family members were predictors of non-adherence to the recommendations. Interventions have to target females and older adults. Community participation and family based physical activity have to be advocated to avert the consequences of physical inactivity.
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Project description:BackgroundAppropriate hand hygiene (HH) is key to reducing healthcare-acquired infections. The World Health Organization (WHO) recommends education and training to improve HH knowledge and compliance. Physicians are ranked among the worst of all healthcare workers for compliant handrubbing with its origin probably being the failure to learn this essential behavior during undergraduate medical studies. This study evaluated if the use of Ultraviolet-cabinets (UVc) for fluorescent-alcohol-based handrubs (AHR) during an undergraduate medical student training improved the compliance rate to the WHO hand hygiene recommendations (completeness of AHR application and HH opportunities).MethodsThis randomized trial compared a HH training with personal feedback (using UVc) to a control group. The first year, the students (2nd degree) were convened by groups (clusters) of 6-9 for a demonstration of the correct execution of WHO procedure. Randomization by cluster was done prior HH training. In the control group, the students hand rubbed under visual supervision of a tutor. In the intervention group after the same visual supervision, completeness of fluorescent-AHR hand application was recorded under UVc and was shown to the student. The intervention group had free access to the UVc until complete application. HH practices were included in simulation sessions for the both groups. One year after (3rd degree), all the students were asked to hand rub with fluorescent-AHR. A tutor (blinded to the study group) assessed the completeness of hand application under UVc and the compliance with the WHO opportunities. Complete application of AHR was defined as fluorescence for all the surfaces of hands and wrists.Results242 students participated (140 in the intervention group and 102 in the control group). One year after the initial training, the rate of complete application of AHR was doubled in the intervention group (60.0% vs. 30.4%, p < 0.001). In a multivariate analysis which included gender, additional HH or UVc training, surgical traineeship and regular use of AHR, the hazard ratio for the intervention was 3.84 (95%CI: 2.09-7.06). The compliance with the HH WHO's opportunities was increased in the intervention group (58.1% vs. 42.4%, p < 0.018).ConclusionUsing UVc for undergraduate medical students education to hand hygiene improves their technique and compliance with WHO recommendations.
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