JMIR Medical Informatics

Clinical informatics, decision support for health professionals, electronic health records, and ehealth infrastructures

Editor-in-Chief:

Christian Lovis, MD, MPH, FACMI, Division of Medical Information Sciences, University Hospitals of Geneva (HUG), University of Geneva (UNIGE), Switzerland


Impact Factor 3.23

JMIR Medical Informatics (JMI, ISSN 2291-9694; Impact Factor: 3.23) (Editor-in-chief: Christian Lovis MD MPH FACMI) is a PubMed/SCIE-indexed journal that focuses on clinical informatics, big data in health and health care, decision support for health professionals, electronic health records, ehealth infrastructures and implementation. In June 2022, the journal received a Journal Impact Factor of 3.23 (5-Year Impact Factor: 3.56) (2021 Journal Impact Factor, Journal Citation Reports, (Clarivate, 2022)).

Published by JMIR Publications, JMIR Medical Informatics has a focus on applied, translational research, with a broad readership including clinicians, CIOs, engineers, industry and health informatics professionals.

JMIR Medical Informatics adheres to rigorous quality standards, involving a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs (ready for deposit in PubMed Central/PubMed).

Recent Articles

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Viewpoints on and Experiences with Digital Technologies in Health

The Health Insurance Portability and Accountability Act (HIPAA) was an important milestone in protecting the privacy of patient data; however, the HIPAA provisions specific to geographic data remain vague and hinder the ways in which epidemiologists and geographers use and share spatial health data. The literature on spatial health and select legal and official guidance documents present scholars with ambiguous guidelines that have led to the use and propagation of multiple interpretations of a single HIPAA safe harbor provision specific to geographic data. Misinterpretation of this standard has resulted in many entities sharing data at overly conservative levels, whereas others offer definitions of safe harbors that potentially put patient data at risk. To promote understanding of, and adherence to, the safe harbor rule, this paper reviews the HIPAA law from its creation to the present day, elucidating common misconceptions and presenting straightforward guidance to scholars. We focus on the 20,000-person population threshold and the 3-digit zip code stipulation of safe harbors, which are central to the confusion surrounding how patient location data can be shared. A comprehensive examination of these 2 stipulations, which integrates various expert perspectives and relevant studies, reveals how alternative methods for safe harbors can offer researchers better data and better data protection. Much has changed in the 20 years since the introduction of the safe harbor provision; however, it continues to be the primary source of guidance (and frustration) for researchers trying to share maps, leaving many waiting for these rules to be revised in accordance with the times.

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Theme Issue 2022: Health Natural Language Processing and Applications (CHIP)

The ever-increasing volume of medical literature necessitates the classification of medical literature. Medical relation extraction is a typical method of classifying a large volume of medical literature. With the development of arithmetic power, medical relation extraction models have evolved from rule-based models to neural network models. The single neural network model discards the shallow syntactic information while discarding the traditional rules. Therefore, we propose a syntactic information–based classification model that complements and equalizes syntactic information to enhance the model.

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Machine Learning

Deep neural networks are showing impressive results in different medical image classification tasks. However, for real-world applications, there is a need to estimate the network’s uncertainty together with its prediction.

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Decision Support for Health Professionals

The management of diagnostic uncertainty is part of every primary care physician’s role. e–Safety-netting tools help health care professionals to manage diagnostic uncertainty. Using software in addition to verbal or paper based safety-netting methods could make diagnostic delays and errors less likely. There are an increasing number of software products that have been identified as e–safety-netting tools, particularly since the start of the COVID-19 pandemic. e–Safety-netting tools can have a variety of functions, such as sending clinician alerts, facilitating administrative tasking, providing decision support, and sending reminder text messages to patients. However, these tools have not been evaluated by using robust research designs for patient safety interventions. We present an emergent framework of criteria for effective e–safety-netting tools that can be used to support the development of software. The framework is based on validated frameworks for electronic health record development and patient safety. There are currently no tools available that meet all of the criteria in the framework. We hope that the framework will stimulate clinical and public conversations about e–safety-netting tools. In the future, a validated framework would drive audits and improvements. We outline key areas for future research both in primary care and within integrated care systems.

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Clinical Communication, Electronic Consultation and Telehealth

Telemedicine as a mode of health care work has grown dramatically during the COVID-19 pandemic; the impact of this transition on clinicians’ after-hours electronic health record (EHR)–based clinical and administrative work is unclear.

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Theme Issue 2022: Health Natural Language Processing and Applications (CHIP)

Falls may cause elderly people to be bedridden, requiring professional intervention; thus, fall prevention is crucial. The use of electronic health records (EHRs) is expected to provide highly accurate risk assessment and length-of-stay data related to falls, which may be used to estimate the costs and benefits of prevention. However, no studies to date have investigated the extent to which hospital stays could be shortened through fall avoidance resulting from the use of prediction tools.

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Clinical Communication, Electronic Consultation and Telehealth

Approximately 1.1 million people living with HIV live in the United States, and the incidence is highest in Southeastern United States. Electronic patient portal prevalence is increasing and can improve engagement in primary medical care. Retention in care and viral suppression—measures of engagement in HIV care—are associated with decreased HIV transmission, morbidity, and mortality.

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Clinical Communication, Electronic Consultation and Telehealth

Web-based medical services have become an effective supplement to traditional services in hospitals and an essential part of medical services. Studies have shown that web-based medical services are useful for shortening the delayed admission time and for enhancing the treatment effect from the service continuity perspective. However, the specific measures that patients and physicians should take to improve service continuity remain unknown.

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Machine Learning

Twitter provides a valuable platform for the surveillance and monitoring of public health topics; however, manually categorizing large quantities of Twitter data is labor intensive and presents barriers to identify major trends and sentiments. Additionally, while machine and deep learning approaches have been proposed with high accuracy, they require large, annotated data sets. Public pretrained deep learning classification models, such as BERTweet, produce higher-quality models while using smaller annotated training sets.

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Machine Learning

Emergency department (ED) overcrowding is a concerning global health care issue, which is mainly caused by the uncertainty of patient arrivals, especially during the pandemic. Accurate forecasting of patient arrivals can allow health resource allocation in advance to reduce overcrowding. Currently, traditional data, such as historical patient visits, weather, holiday, and calendar, are primarily used to create forecasting models. However, data from an internet search engine (eg, Google) is less studied, although they can provide pivotal real-time surveillance information. The internet data can be employed to improve forecasting performance and provide early warning, especially during the epidemic. Moreover, possible nonlinearities between patient arrivals and these variables are often ignored.

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Machine Learning

Intervening in and preventing diabetes distress requires an understanding of its causes and, in particular, from a patient’s perspective. Social media data provide direct access to how patients see and understand their disease and consequently show the causes of diabetes distress.

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Reviews

The standard Fast Healthcare Interoperability Resources (FHIR) is widely used in health information technology. However, its use as a standard for health research is still less prevalent. To use existing data sources more efficiently for health research, data interoperability becomes increasingly important. FHIR provides solutions by offering resource domains such as “Public Health & Research” and “Evidence-Based Medicine” while using already established web technologies. Therefore, FHIR could help standardize data across different data sources and improve interoperability in health research.

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Preprints Open for Peer-Review

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Open Peer Review Period:

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