Incorporating NASA Earth Science Data into the DHIS2 Health Information System
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How Management and Leadership Training Can Impact a Health System: Evaluation Findings From a Public Health Management Training Program in Cambodia
In 2017, the National Institute of Public Health in Cambodia collaborated with the U.S. Centers for Disease Control and Prevention to provide management and leadership training for 20 managers and senior staff from 10 health centers. We conducted a mixed methods evaluation of the program's outcomes and impact on the graduates and health centers. From June 2018 (baseline) to January 2019 (endpoint), we collected data from a competency assessment, observational visits, and interviews. From baseline to endpoint, all 20 participants reported increased competence in seven management areas. Comparing baseline and endpoint observational visits, we found improvements in leadership and governance, health workforce, water, sanitation, and hygiene, and health centers' use of medical products and technologies. When evaluating the improvements made by participants against the World Health Organization's key components of a well-functioning health system, the program positively contributed toward building four of the six components—leadership and governance, health information systems, human resources for health, and service delivery. While these findings are specific to the context of Cambodian health centers, we hope this evaluation adds to the growing body of research around the impact of skilled public health management on health systems.
60 APPLIED LIFE SCIENCES↗
A new methodological framework for hazard detection models in health information technology systems
Not Available
96 KNOWLEDGE MANAGEMENT AND PRESERVATION↗
Prototype Input and Output Data Elements for the Occupational Health and Safety Information System
The National Aeronautics and Space Administration plans to implement a NASA-wide computerized information system for occupational health and safety. The system is necessary to administer the occupational health and safety programs and to meet the legal and regulatory reporting, recordkeeping, and surveillance requirements. Some of the potential data elements that NASA will require as input and output for the new occupational health and safety information system are illustrated. The data elements are shown on sample forms that have been compiled from various sources, including NASA Centers and industry.
Whyte, A. A.↗
Comparative Assessment of Data-driven Process Models in Health Information Technology
Process mining for conformance analysis consists of comparing a reference process model against a data-driven process model generated via log files from information technology systems. However, in the absence of a complete reference process model, we found no suggested approaches in the literature to address the need for evaluating process conformance among different healthcare facilities to assess standardization of care. Our goal is to find similarities and dissimilarities in data-driven process models among US Veterans Health Administration (VHA) facilities that can be indicative of patient safety issues. Our hypothesis was that the analysis would not produce statistically significant differences in outcome. We present a unique implementation of conformance analysis in process mining that consists of combining process mining, process mapping and statistical metrics. We illustrate our approach by applying it to the analysis of two clinical radiology order process models generated from healthcare data provided by two similar facilities in the VHA. The comparative assessment showed that about 70% of the orders completed successfully and 30% were not completed due to policy and duplications. Our analysis found a good statistical correlation between both facilities, as the Spearman’s correlation coefficient between facilities for the frequency of cases per total hours was 0.87879, for the frequency of cases by state transition was 0.79702 and for the throughput time per state transition was 0.63582. Additional statistical analyses using the Mann-Whitney U test and the root mean square error both produced values that were not significant. The foregoing approach validated our hypothesis by demonstrating a good statistical correlation of data describing the flow of clinical radiology orders absent a credible reference model. Finding good agreement between both facilities was important in confirming that the clinical orders flow in a similar manner, suggesting standardization of care.
97 MATHEMATICS AND COMPUTING↗
Forecasting disease risk for increased epidemic preparedness in public health
Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.
Disease Outbreaks↗
Software Tool for Tracking & Mapping the NASA Orion AA-2 Test Flight Ejectable Data Recorders in Real Time
On 2 July 2019, the NASA Ascent Abort 2 flight took place off the Florida coast to test the emergency systems to separate the Orion Crew Module (CM) from the future Space Launch System rocket in the event of a malfunction. During this high-altitude test, instrumentation data was recorded on twelve customized buoyant Ejectable Data Recorders (EDRs) and subsequently jettisoned from the CM in mid-air. Upon release, the EDRs activated their GPS-Iridium beacon systems and began transmitting Short Burst Data (SBD) messages via the Iridium satellite network to relay their individual location and system health information. To locate, track and retrieve each EDR from the ocean surface in real-time, multiple open-source programming tools (Python and Linux shells) were developed for parsing the incoming Iridium binary SBD messages. For this, a Linux laptop was used to receive the Iridium-generated emails containing the SBD messages and autonomously execute the parsing tools. The received SBD data contained location, timestamp and health status information that was translated, saved, and subsequently used for simultaneously generating a continuously updated color-coded tabular display summary and unique KML files used with Google Earth to track their locations. Once their locations were known, dedicated recovery vessels retrieved all EDRs from the ocean. An additional tool was also developed in order to generate 5- and 10-minute geolocation predictions for each EDR by deriving the displacement distance, elapsed time, displacement heading and velocity based on the latest known information available. The recovery vessels were also tracked with the use of a separate commercial GPS beacon system. After jettison, 67% of the EDRs transmitted valid data by the time they were retrieved from the ocean. However, the real-time information presented by the plotting tool allowed for the ready depiction of EDR dispersal patterns and reference drift trajectories, which contributed to the recovery of all twelve EDRs and the AA-2 flight data. Lastly, the available data showed that the distance between the software’s reported drift/predicted locations and the recovery locations did not exceed 38 meters, therefore demonstrating the advantages of this software tool for supporting real-time tracking and recovery efforts of beacon devices.
Moxey, Lucas↗
Health-care district management information system plan: Review of operations analysis activities during calendar year 1975 and plan for continued research and analysis activities
Operations research activities developed to identify the information required to manage both the efficiency and effectiveness of the Veterans Administration (VA) health services as these services relate to individual patient care are reported. The clinical concerns and management functions that determine this information requirement are discussed conceptually. Investigations of existing VA data for useful management information are recorded, and a diagnostic index is provided. The age-specific characteristics of diseases and lengths of stay are explored, and recommendations for future analysis activities are articulated. The effect of the introduction of new technology to health care is also discussed.
Nielson, G. J.↗
Smart Networked Elements in Support of ISHM
At the core of ISHM is the ability to extract information and knowledge from raw data. Conventional data acquisition systems sample and convert physical measurements to engineering units, which higher-level systems use to derive health and information about processes and systems. Although health management is essential at the top level, there are considerable advantages to implementing health-related functions at the sensor level. The distribution of processing to lower levels reduces bandwidth requirements, enhances data fusion, and improves the resolution for detection and isolation of failures in a system, subsystem, component, or process. The Smart Networked Element (SNE) has been developed to implement intelligent functions and algorithms at the sensor level in support of ISHM.
Oostdyk, Rebecca↗
Physics Informed Neural Nets for Systems Health Management
To facilitate and solve the prediction problem, awareness of the current health state of the system is key, since it is necessary to perform condition-based predictions. To accurately predict the future state of any system, it is required to possess knowledge of its current health state and future operational conditions. Development in data-driven algorithms in regression of complex nonlinear functions and classification tasks have generated a growing interest in artificial intelligence for industrial applications. Complex multi-physics models as well as digital twins, once purely built on physics and corresponding simplified lumped parameter iterations, can now benefit from machine learning algorithms to mitigate the lack of understanding of some complex behavior. The research work presents application of physics-informed neural nets application to a representative electric powertrain for unmanned aerial vehicles. The model is composed of physics-derived and empirical equations, integrated with connected networks that are strategically placed within the model to substitute equations that are subject to large uncertainty. Polynomial fit driven by heuristics or empirical observations can be substituted by more flexible networks that can minimize the error between model predictions and observations without being restricted to a predefined functional form. This modeling strategy allows training of networks deep inside the model and unknown parameters in a single learning stage.
Physics Informed↗
Baltimore applications project
An update is presented for the following projects: (1) asphalt pavement recycling; (2) data collection platform/water quality monitoring; (3) digital emergency traffic routing; (4) fire department communications and dispatch system; (5) health department management information system; (6) hazardous materials; (7) coal gasification; and (8) emergency vehicle proximity sensing.
Golden, T. S.↗
A Prognostics Framework Development for Swarm Satellite Formations
Prognostics is the science of predicting the failure(s) of a component or a system and understanding how the performance will change in the event of a failure or degradation mechanism. With accurate predictions of possible failures, autonomous mitigative actions can be taken to correct/repair any issues or alert human operators of a failure threshold exceedance requiring condition-based maintenance. Although there is extensive research on failure predictions for a component or a system, there are significantly more opportunities to foray into failure predictions and prognostics for a system of systems such as an airspace consisting of multiple aircraft, a fleet of unmanned aerial vehicles, and a swarm of intelligent satellite systems. Failure prediction and mitigation are particularly important in autonomous systems such as satellite swarm systems that need effective resource management and minimal human interactions. Based on NASA's decadal survey, there is a clear need to prioritize the development of satellite swarm technology for studies of space physics and Earth science. The science community will propose future missions that return in-situ measurements from a 3-D (three-dimensional) volume of space, with relative spacecraft motion and inter-satellite baselines controlled according to the mission objectives. For such multi-spacecraft missions, it is required that ground operations resources do not scale with the number of satellites, thus compromising the swarm or leading to inefficiencies in resource allocation. Swarms of tens or hundreds of small satellites will require autonomy in attitude control, navigation and failure. Although significant research has been conducted in the areas of autonomous formation flying algorithms, less attention has been given to the development of resilient systems robust to failures.The focus of this research paper is the integration of model-based prognostics into the swarm dynamics control and decision-making algorithms. We simulate swarm management strategies for a subsystem failure to demonstrate the importance of failure predictions by comparing two cases: (i) no health information is provided to the system and utilized in the decision-making process and (2) system health information is obtained using prognostics and employed by the control system. One example scenario presented is for the GPS (Global Positioning System) system of an individual satellite to perform off-nominally due to increasing estimated error. In this scenario, the keep-out zone for that satellite would become more conservative, thereby decreasing the risk of collision. This is achieved via tuning the individual artificial repulsive functions assigned to each satellite.This paper is structured as follows. First we provide an overview of current swarm technology development, where we specifically use the term swarm to define multiple satellites flying in formation in similar orbits, with cross-link communication and station-keeping capabilities. Second, we give an introduction to the Swarm Orbital Dynamics Advisor (SODA), a tool that accepts high-level configuration commands and provides the orbital maneuvers required to achieve the prescribed formation configuration. Third, we provide the details of the model-based prognostics algorithm implementation in SODA. Finally, we present different case studies for potential component/subsystem failures and the swarm responses based with and without failure prediction information.
prognostics↗
Evaluation of a Pilot Surveillance System: Health and Environment Linked for Information Exchange in Atlanta (HELIX-Atlanta)
CDC and its partners established the Health and Environment Linked for Information Exchange, Atlanta (HELIX-Atlanta) demonstration project, to develop linking and analysis methods that could be used by the National Environmental Public Health Tracking (EPHT) Network. Initiated in October 2003, the Metropolitan Atlanta-based collaborative conducted four projects: asthma and particulate air pollution, birth defects and ozone and particulate air pollution, childhood leukemia and traffic emissions, and children's blood lead testing and neighborhood risk factors for lead poisoning. This report provides an overview of the HELIX-Atlanta projects' goals, methods and outcomes. We discuss priority attributes and common issues and challenges and offer recommendations for implementation of the nascent national environmental public health tracking network.
Meyer, P.↗
The Challenges of Releasing Human Data for Analysis
The NASA Johnson Space Center s (NASA JSC) Committee for the Protection of Human Subjects (CPHS) recently approved the formation of two human data repositories: the Lifetime Surveillance of Astronaut Health Repository (LSAH-R) for clinical data and the Life Sciences Data Archive Repository (LSDA-R) for research data. The establishment of these repositories forms the foundation for the release of data and information beyond the scope for which the data was originally collected. The release of clinical and research data and information is primarily managed by two NASA groups: the Evidence Base Working Group (EBWG), consisting of members of both repositories, and the LSAH Policy Board. The goal of unifying these repositories and their processes is to provide a mutually supportive approach to handling medical and research data, to enhance the use of medical and research data to reduce risk, and to promote the understanding of space physiology, countermeasures and other mitigation strategies. Over the past year, both repositories have received over 100 data and information requests from a wide variety of requesters. The disposition of these requests has highlighted the challenges faced when attempting to make data collected on a unique set of subjects available beyond the original intent for which the data were collected. As the EBWG works through each request, many considerations must be factored into account when deciding what data can be shared and how - from the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act (HIPAA), to NASA s Health Information Management System (10HIMS) and Human Experimental and Research Data Records (10HERD) access requirements. Additional considerations include the presence of the data in the repositories and vetting requesters for legitimacy of their use of the data. Additionally, fair access must be ensured for intramural, as well as extramural investigators. All of this must be considered in the formulation of the charters, policies and workflows for the human data repositories at NASA.
Fitts, Mary↗
Integration of Data Analytics with Plant System Health Program
This report summarizes the R&D activities of the Plant Health Management (PHM) project during fiscal year 2020 (FY20). This project focuses on the development of methods that integrate component health data and propagate such information at the system level to evaluate system sources of risk. This project development lives in cooperation with the Risk Informed Asset Management (RIAM) project. The RIAM project, in fact, uses the reliability models and data generated by the PHM project to optimize plant operations (e.g., maintenance/replacement schedule, optimal maintenance posture). This year’s activities for the PHM project focused mainly on the development of two classes of models. The first one includes a series of component reliability models which include aging, testing and maintenance. The second class includes a series of system reliability models which focus on the secondary side of exiting U.S. reactors. These models are based on fault tree logic structures such that they can be used by existing plant PRA software. We also started to focus on the management of health data and we tackled this issue in two directions. The first one focuses on the integration of monitor data with simulation models to assess component health. This approach is moving from a classical data based to a model+data based approach with the goal of improving higher component health information. The second direction focuses on linking equipment reliability data (e.g., maintenance/failure reports, component monitoring data) directly to system reliability models using a safety margin based language rather than a probability based language. The main advantage of a safety margin based language is that it can provide to system engineers more tangible information on system/component health and how it propagates to the system level.
97 MATHEMATICS AND COMPUTING↗
Integration of Condition-Based, Diagnostic, Prognostic, And Anomaly Detection Data into Reliability Models to Support a Predictive Maintenance Context
Reliability data employed in plant reliability models are an approximated integral representation of the past industrywide operational experience, and they neglect the present asset health status (available, for example, from online monitoring data and diagnostic assessments) and forecasted health projection (when available from prognostic models). Ideally, in a predictive maintenance context, system reliability models should support decision making by propagating actual health information from the asset to the system level in order to provide a quantitative snapshot of system health and identify the most critical assets. Asset health should be informed solely by that specific asset’s current and historical performance data and should not be an approximated integral representation of the past industrywide operational experience (as currently performed by system reliability models through Bayesian updating processes). This paper proposes a reliability modeling approach that relies on asset diagnostic and prognostic assessments, along with monitoring data to measure asset health. We show how state-of-the art condition-based, diagnostic, prognostic, and anomaly detection models can be linked to system reliability models not in probability terms, but in terms of margin where margin is defined as the “distance” between the present status and an undesired event (e.g., failure or unacceptable performance). Then, we show how the propagation of margin data from the asset to the system level is performed through classical reliability models such as fault trees or reliability block diagrams. The described method is in fact able to propagate heterogenous health data from the asset to the system level in order to analytically assess system health.
97 MATHEMATICS AND COMPUTING↗
Development of an Information Fusion System for Engine Diagnostics and Health Management
Aircraft gas-turbine engine data are available from a variety of sources including on-board sensor measurements, maintenance histories, and component models. An ultimate goal of Propulsion Health Management (PHM) is to maximize the amount of meaningful information that can be extracted from disparate data sources to obtain comprehensive diagnostic and prognostic knowledge regarding the health of the engine. Data Fusion is the integration of data or information from multiple sources, to achieve improved accuracy and more specific inferences than can be obtained from the use of a single sensor alone. The basic tenet underlying the data/information fusion concept is to leverage all available information to enhance diagnostic visibility, increase diagnostic reliability and reduce the number of diagnostic false alarms. This paper describes a basic PHM Data Fusion architecture being developed in alignment with the NASA C17 Propulsion Health Management (PHM) Flight Test program. The challenge of how to maximize the meaningful information extracted from disparate data sources to obtain enhanced diagnostic and prognostic information regarding the health and condition of the engine is the primary goal of this endeavor. To address this challenge, NASA Glenn Research Center (GRC), NASA Dryden Flight Research Center (DFRC) and Pratt & Whitney (P&W) have formed a team with several small innovative technology companies to plan and conduct a research project in the area of data fusion as applied to PHM. Methodologies being developed and evaluated have been drawn from a wide range of areas including artificial intelligence, pattern recognition, statistical estimation, and fuzzy logic. This paper will provide a broad overview of this work, discuss some of the methodologies employed and give some illustrative examples.
Volponi, Allan J.↗
Use of Event-Time Embeddings via RNN to Discern Novel Event Sequences in EHRs
In highly configurable health information technology (HIT) systems, such as VistA of the Veterans Health Administration, the variations in how the system is used among different healthcare facilities and how the data are recorded can be significant. Despite the successful standardization of care efforts, some of these variations can be indicative of HIT hazards and demand further investigation. In this work, we implemented a recurrent neural network (RNN) architecture to learn clinical provider order sequences and their temporal dynamics while predicting the orders' terminal state. We demonstrate model performance and provide a use case for the model discerning novel event sequences. This model is proposed to find novel event sequences in an operational environment.
Ozmen, Ozgur↗