Research Institute on Population and Social Policies

Electronic health record and Telemedicine

Last June 29, the researcher Fabrizio Pecoraro of the Health and Society group of IRPPS participated in the 𝐜𝐚𝐫𝐚. The conference was an opportunity to discuss the opportunities opened up by decree of 28 September 2023 for the innovation of the National Health Service, guided by the transition towards new technological infrastructures dedicated both to Telemedicine, i.e. the set of health services that can be carried out remotely thanks to the use of innovative technologies, and to the File, which allows the collection digital of the patient's clinical history. 

Pecoraro's contribution focused precisely on the Electronic Health Record, underlining the need to develop a tool that contains structured information and that is interoperable with other health information systems. Furthermore, the Dossier will have to play a role not only in supporting treatment, i.e. facilitating patient care and diagnosis and treatment operations between different professionals and healthcare facilities, but also providing data to decision makers and the research world for studies of an epidemiological and government nature.  

It's possible listen to the speech again here of the researcher.  

The latest article is dedicated to the experience of users of a Telemedicine service tested at the San Giovanni Addolorata Hospital in Rome. Working paper of IRPPS to which the Health and Society group contributed. You can read it here.  

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The HIN project becomes a brand

To facilitate collaborations in academia and clinical practice, HIN (Health Issue Network) – project born within the group Health and Society of IRPPS -has recently been registered as a trademark.

Hin is a method which facilitates the clinical reasoning and improves the training of students and professionals in the healthcare sector (both in human and veterinary medicine). 

Fabrizio Pecoraro (CNR-IRPPS) traces the salient points of the project in a audio-abstract.

Find out more on the site https://www.healthissuenetwork.org/ita/home

And on the working papers:

  • Antonio D'Uffizi, Fabrizio L. Ricci, Fabrizio Pecoraro, Oscar Tamburis (2023). The flexibility of a clinical case (a HINe diagram) Rome: National Research Council Institute for Research on Population and Social Policies, (IRPPS Working papers n. 14 2 202 4, p. 2 0

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Call for Paper – Welfare & Ergonomics

The new call for paper of the magazine Welfare & Ergonomia, edited by Alberto Pesce and Veronica Valenti, is dedicated to “Investing in the social reintegration of prisoners: trends and new perspectives of Italian welfare” .

You can submit your proposal by 29 March 2024, sending an abstract of approximately 3000 characters (including spaces).

All information is available in call document.

Welfare & Ergonomics is a magazine in Class A (Anvur), published by Franco Angeli editore, on the editorial project and direction of IRPPS (thanks to the researcher Antonella Ciocia).

 By way of example, contributions for the edition in question may concern:

  • the socio-health aspects resulting from overcrowding both at a collective and individual level;
  • the importance of caring for loved ones in prison to gather suggestions with a view to reform;
  • the reciprocal relationship between forms of restorative justice and social reintegration;
  • the importance of prison education and professional training courses;
  • the analysis of best practices Italian or European and aimed at promoting training, placement and job hiring;
  • the analysis of traditional welfare models and their implementation towards people deprived of liberty, with attention also to new models or which concern prisoners or former prisoners;
  • the analysis of legislation and jurisprudence regarding the social and work reintegration of prisoners;
  • the critical analysis of the role of local authorities and private social organizations in guaranteeing training, placement and employment;
  • the analysis of best practices territorial or tested in individual penitentiary institutions;
  • the analysis of the factors that lead to relapse: 
  • the analysis of state and regional spending aimed at promoting social and work inclusion paths;
  • the treatment of resigning prisoners who have reached the end of their sentences;
  • the impact of new technologies, such as artificial intelligence, or neuroscience on the social and work reintegration of detained people.

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Real World Data and Causal Artificial Intelligence

9 October 2023 – h. 10.00

Sala Europa, IRPPS via Palestro 32 – Rome

Abstract

Artificial Intelligence (AI) is transforming people's lives in unprecedented ways. AI models have human or superhuman abilities in multiple tasks, eg, gaming, driving, conversation, and content organization. In biomedical research, however, AI demonstrated as much promise, eg, in molecular drug design, as much disappointment, eg, in clinical drug repurposing or public health intervention. One of the reasons is that the datasets AI feeds on – sourced from real world databases such electronic health records (EHR) – are often littered with bias. Such bias might be irrelevant to predict the happening of health conditions, but it influences any strategy to prevent such conditions from happening. In this talk, we will take a dive into the promises and perils of AI in healthcare, and its troubled relationship with data, bias, and causality. We will explore novel causal AI methodologies able to both provide accurate individual health predictions as well as interventions. Finally, we will present use cases of causal AI on large, integrated EHR data, and an eagle's view of EHR consortia in the USA.

Short biographies

Mattia Prosperi, PhD, FAMIA, is Professor in the Department of Epidemiology, and Associate Dean of AI and Innovation in the College of Public Health and Health Profession at University of Florida. His background is in computer science engineering, with expertise in machine learning, bio-health informatics, and epidemiology. His research leverages technology and data intelligence to develop prediction and intervention models for improving future health and lives. In his administrative role di lui, his mission di lui is to expand AI infrastructure, training, research and expertise capacity in public health and health professions.

Yi Guo, PhD, is Associate Professor in the Department of Health Outcomes, Policy and Biomedical Informatics, College of Medicine, University of Florida. He has a multi-disciplinary background in the analysis of real-world data, including electronic health records and administrative claims, experimental and observational study design, predictive modeling (eg, statistical and machine learning), causal modeling, and analysis of patient-reported outcomes in clinical and public health applications, and among various populations, especially vulnerable populations.

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Interviews

Interviews

The work done in the project Our lucky stars continues to stimulate interest and “curiosity” on the important topics covered in the research and in particular on Educational Poverty.

on May 20, 2022, the doctor Antonella Ciocia was interviewed:

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EPICOST

EPICOST

In most advanced countries, expenditure on cancer commits an increasing portion of resources, due to changes in risk factors, the availability of more advanced diagnostic procedures and specific treatments, and the aging of the population. In Italy, 2% of the population lives with a diagnosis of cancer and this percentage is destined to increase. It is important to be able to measure and project the impact both in terms of people and public spending, in order to plan interventions. The Epicost project, funded by the Ministry of Health (CCM 2014), aims to: 1. describe the diagnostic-therapeutic-assistance paths and the economic resources allocated to cancer patients in some areas covered by population cancer registries (RT); 2. make forecasts on the number of patients and related costs, according to different scenarios; 3. assess, at a regional level, the expected variation in healthcare expenditure in relation to specific preventive (eg screening programs) and therapeutic interventions (eg use of new high-cost biological drugs) and demographic dynamics.

Clinical and demographic information on cancer patients provided by 8 Population Cancer Registries are linked on an individual level with economic information from administrative sources (hospital admissions, specialist services, drugs).

The distribution of patients and their associated economic resources is estimated along the entire path of the disease, identified by three clinically relevant phases: initial phase (one year after diagnosis), intermediate phase (between initial and final), final phase (one year before death) and specific expense profiles are constructed for all the variables that can influence the treatment path.

Dynamic micro-simulation models are used which make it possible to project, both geographically and temporally, the estimates of expenditure.

A software is developed aimed at managing the linkage between RT data and administrative data; identification of the diagnosis and treatment profiles; estimate of the number of prevalent cases and of the expenditure profiles by disease phase.

Research products:

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Health at Home

Health at Home

The project intends to create assistance to citizens based on a network of integrated health and social services and interoperable devices / systems with the general aim of improving the "quality of life" of people / families both with "aspects of difficulty" and without particular problems, through solutions that guarantee the greatest possible autonomy within one's own environment. The information system will be developed according to the paradigms of cloud computing aimed at connecting the companies and bodies that offer the services with the users who will use them.

Within the project, the activities in which the IRPPS research group will participate concern:

definition of the conceptual model that combines the main concepts of the three contexts studied in the project (health, social and home automation);

identify and define the types and areas of services to be offered through the H @ H information system;

description of business processes based on specific types of users (young people, athletes, the elderly, temporarily frail, patients with chronic diseases, etc.);

definition of the extension model of the Electronic Health Record (FSE) with the information provided by the devices in the user's home and integrated into the H @ H system;

analysis of the ethical-legal aspects relating to the new forms of regulation in the field of health data management.

The project, funded by MIUR as part of the Smart Cities and Communities call of the PON Research and Competitiveness 2007-2013, started in January 2014 and is in full implementation phase. Coordinated by the La Sapienza University of Rome, the project involves numerous partners including the Polytechnic University of Marche, the University of Genoa, Telecom Italia Spa, HomeLab. Closer collaborations of the research group within the project were with: Dedalus Spa and Don Carlo Gnocchi Foundation. The CNR research group is represented not only by the IRPPS but also by the Antonio Ruberti Institute of Systems Analysis and Information Technology in Rome.

Pecoraro, Fabrizio, Daniela Luzi, Eleheh Pourabbas, Fabrizio L. Ricci. A methodology to identify health and social care web services on the basis of case stories. E-Health and Bioengineering Conference (EHB), 2017. IEEE, 2017.

Fabrizio Pecoraro, Daniela Luzi, Eleheh Pourabbas, Fabrizio L. Ricci. A conceptual model for integrating social and health care services at home: the H @ H project. Proceedings of the 18th International conference on E-Health, Networking, Application and Services, 2016.

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CHILD PREV

CHILD PREV

 

Patients recovered from childhood tumors represent an emblematic group and particularly suitable for the study of clinical follow-up and psycho-physical, social and work rehabilitation paths: the quality of the diagnosis is generally very good and well documented, the treatment is for mostly done in specialized structures and on the basis of carefully tested and continuously updated protocols; this makes it easier to study the pathways following the treatment phase. However, due to the length of the observation period required, there are only scattered data globally on the prevalence in the general population of adult childhood cancer survivors of all ages and many pediatric cancer survivors are now adults (long- survivors) who enter the age groups at risk of incidence for chronic degenerative diseases.

The CHILDPREV project, funded by the Ministry of Health (CCM 2012), aims, among others, to provide an overall epidemiological picture of the prevalence, incidence and trends of childhood cancers in order to evaluate their future evolution.

With this in mind, the extent of the prevalent adults of all ages who survived a tumor in pediatric age was estimated, through the use of ad hoc statistical methods. In particular, the Childprev method (Simonetti, Gigli, Capocaccia, Mariotto, 2008) was applied to the data of the Cancer Registries that had at least 15 years of incidence and follow-up data of the state in life, to obtain the estimate of the complete prevalence in adulthood (15+) for all cancers together, and for the most frequent prevalent sites among children who get cancer: Hodgkin's lymphomas, acute lymphatic leukemia and central nervous system tumors

Francisci, Guzzinati, Dal Maso, Priest, Buzzoni, Gigli (2017). Living after cancer diagnosis during childhood: A population-based estimation in Italy. International Journal of Cancer http://onlinelibrary.wiley.com/doi/10.1002/ijc.30665/full

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Territorial welfare

Territorial welfare

Goals:

Implement the territorial welfare network; develop tools for the detection of social demand, monitor and evaluate social policies; build the "statistical data" to guide the planning of an inclusive and effective welfare.

Interactive (research-action) to stimulate reflection and multidisciplinary work using qualitative, quantitative and formative tools; development of tools for monographic surveys.

 - Young adults aged 35 to 45 to detect the skills learned in the growth path with particular reference to responsibility, autonomy and participation in community life.

- Seniors aged 65 and over to detect lifestyle with particular reference to well-being, health and life expectancy

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