Factors associated with the impact of quality improvement collaboratives in mental healthcare: an exploratory study.

NARCIS (Netherlands)

Versteeg, M.H.; Laurant, M.G.H.; Franx, G.C.; Jacobs, A.J.M; Wensing, M.J.P.

2012-01-01

BACKGROUND: Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and

[Development method of healthcare information system integration based on business collaboration model].

Science.gov (United States)

Li, Shasha; Nie, Hongchao; Lu, Xudong; Duan, Huilong

2015-02-01

Integration of heterogeneous systems is the key to hospital information construction due to complexity of the healthcare environment. Currently, during the process of healthcare information system integration, people participating in integration project usually communicate by free-format document, which impairs the efficiency and adaptability of integration. A method utilizing business process model and notation (BPMN) to model integration requirement and automatically transforming it to executable integration configuration was proposed in this paper. Based on the method, a tool was developed to model integration requirement and transform it to integration configuration. In addition, an integration case in radiology scenario was used to verify the method.

Views of the United States healthcare system: Findings from documentary analysis of an interprofessional education course.

Science.gov (United States)

Bultas, Margaret W; Ruebling, Irma; Breitbach, Anthony; Carlson, Judy

2016-11-01

As the healthcare system of the United States becomes more complex, collaboration among health professionals is becoming an essential aspect in improving the health of individuals and populations. An interprofessional education course entitled "Health Care System and Health Promotion" was developed to allow health profession students to work and learn together about issues related to healthcare delivery, health promotion, and the effect of policy issues on key stakeholders in the system. A qualitative document analysis research design was used to evaluate the effect of this interprofessional course on students' views of the current healthcare system of the United States. Fifty-nine student articles were analysed using document analysis. Health professions represented in the sample included occupational therapy, physical therapy, athletic training, nursing, and radiation therapy, nuclear medicine technology, and magnetic resonance imaging. Eight themes were identified including: increased personal awareness, the need for a system change, concern for access, affordability of healthcare, vision for future practice role, need for quality care, the value of interprofessional collaboration (IPC), and the importance of disease prevention. The results of the study suggest that healthcare education can benefit from the integration of Interprofessional Education (IPE) courses into their curriculum especially when teaching content common to all healthcare professions such as healthcare systems and health promotion.

E-health and healthcare enterprise information system leveraging service-oriented architecture.

Science.gov (United States)

Hsieh, Sung-Huai; Hsieh, Sheau-Ling; Cheng, Po-Hsun; Lai, Feipei

2012-04-01

To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail. The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms. The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH. The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility

Secure and Privacy-Preserving Data Sharing and Collaboration in Mobile Healthcare Social Networks of Smart Cities

Directory of Open Access Journals (Sweden)

Qinlong Huang

2017-01-01

Full Text Available Mobile healthcare social networks (MHSN integrated with connected medical sensors and cloud-based health data storage provide preventive and curative health services in smart cities. The fusion of social data together with real-time health data facilitates a novel paradigm of healthcare big data analysis. However, the collaboration of healthcare and social network service providers may pose a series of security and privacy issues. In this paper, we propose a secure health and social data sharing and collaboration scheme in MHSN. To preserve the data privacy, we realize secure and fine-grained health data and social data sharing with attribute-based encryption and identity-based broadcast encryption techniques, respectively, which allows patients to share their private personal data securely. In order to achieve enhanced data collaboration, we allow the healthcare analyzers to access both the reencrypted health data and the social data with authorization from the data owner based on proxy reencryption. Specifically, most of the health data encryption and decryption computations are outsourced from resource-constrained mobile devices to a health cloud, and the decryption of the healthcare analyzer incurs a low cost. The security and performance analysis results show the security and efficiency of our scheme.

Multi-Stakeholder Collaboration in the Redesign of Family-Centered Rounds Process

Science.gov (United States)

Xie, Anping; Carayon, Pascale; Cartmill, Randi; Li, Yaqiong; Cox, Elizabeth D.; Plotkin, Julie A.; Kelly, Michelle M.

2014-01-01

A human factors approach to healthcare system redesign emphasizes the involvement of multiple healthcare stakeholders (e.g., patients and families, healthcare providers) in the redesign process. This study explores the experience of multiple stakeholders with collaboration in a healthcare system redesign project. Interviews were conducted with ten stakeholder representatives who participated in the redesign of the family-centered rounds process in a pediatric hospital. Qualitative interview data were analyzed using a phenomenological approach. A model of collaborative healthcare system redesign was developed, which defined four phases (i.e., setup of the redesign team, preparation for meetings, collaboration in meetings, follow-up after meetings) and two outcomes (i.e., team outcomes, redesign outcomes) of the collaborative process. Challenges to multi-stakeholder collaboration in healthcare system redesign, such as need to represent all relevant stakeholders, scheduling of meetings and managing different perspectives, were identified. PMID:25124394

Professionals learning together with patients: An exploratory study of a collaborative learning Fellowship programme for healthcare improvement.

Science.gov (United States)

Myron, Rowan; French, Catherine; Sullivan, Paul; Sathyamoorthy, Ganesh; Barlow, James; Pomeroy, Linda

2018-05-01

Improving the quality of healthcare involves collaboration between many different stakeholders. Collaborative learning theory suggests that teaching different professional groups alongside each other may enable them to develop skills in how to collaborate effectively, but there is little literature on how this works in practice. Further, though it is recognised that patients play a fundamental role in quality improvement, there are few examples of where they learn together with professionals. To contribute to addressing this gap, we review a collaborative fellowship in Northwest London, designed to build capacity to improve healthcare, which enabled patients and professionals to learn together. Using the lens of collaborative learning, we conducted an exploratory study of six cohorts of the year long programme (71 participants). Data were collected using open text responses from an online survey (n = 31) and semi-structured interviews (n = 34) and analysed using an inductive open coding approach. The collaborative design of the Fellowship, which included bringing multiple perspectives to discussions of real world problems, was valued by participants who reflected on the safe, egalitarian space created by the programme. Participants (healthcare professionals and patients) found this way of learning initially challenging yet ultimately productive. Despite the pedagogical and practical challenges of developing a collaborative programme, this study indicates that opening up previously restricted learning opportunities as widely as possible, to include patients and carers, is an effective mechanism to develop collaborative skills for quality improvement.

Collaborative user-centred textile design research for healthcare: improving wellbeing and increasing performance

OpenAIRE

McLaren, A; Stevenson, F; Valentine, L

2017-01-01

It has been widely acknowledged that collaboration across disciplines is required in order to develop innovative, sustainable textile solutions that address complex societal problems (Kane & Philpott, 2013; Igoe, 2010). Potential to develop life-changing innovations in the field of advanced textiles for medical and healthcare has been identified as a key growth sector within Scotland, with collaborative cross- disciplinary user-focused design approaches recognised as central to developing new...

3D medical collaboration technology to enhance emergency healthcare

DEFF Research Database (Denmark)

Welch, Gregory F; Sonnenwald, Diane H.; Fuchs, Henry

2009-01-01

Two-dimensional (2D) videoconferencing has been explored widely in the past 15-20 years to support collaboration in healthcare. Two issues that arise in most evaluations of 2D videoconferencing in telemedicine are the difficulty obtaining optimal camera views and poor depth perception. To address...... these problems, we are exploring the use of a small array of cameras to reconstruct dynamic three-dimensional (3D) views of a remote environment and of events taking place within. The 3D views could be sent across wired or wireless networks to remote healthcare professionals equipped with fixed displays...... or with mobile devices such as personal digital assistants (PDAs). The remote professionals' viewpoints could be specified manually or automatically (continuously) via user head or PDA tracking, giving the remote viewers head-slaved or hand-slaved virtual cameras for monoscopic or stereoscopic viewing...

Dynamic analysis of interhospital collaboration and competition: empirical evidence from an Italian regional health system.

Science.gov (United States)

Mascia, Daniele; Di Vincenzo, Fausto; Cicchetti, Americo

2012-05-01

Policymakers stimulate competition in universalistic health-care systems while encouraging the formation of service provision networks among hospital organizations. This article addresses a gap in the extant literature by empirically analyzing simultaneous collaboration and competition between hospitals within the Italian National Health Service, where important procompetition reforms have been implemented. To explore how rising competition between hospitals relates to their propensity to collaborate with other local providers. Longitudinal data on interhospital collaboration and competition collected in an Italian region from 2003 to 2007 are analyzed. Social network analysis techniques are applied to study the structure and dynamics of interhospital collaboration. Negative binomial regressions are employed to explore how interhospital competition relates to the collaborative network over time. Competition among providers does not hinder interhospital collaboration. Collaboration is primarily local, with resource complementarity and differentials in the volume of activity and hospital performance explaining the propensity to collaborate. Formation of collaborative networks among hospitals is not hampered by reforms aimed at fostering market forces. Because procompetition reforms elicit peculiar forms of managed competition in universalistic health systems, studies are needed to clarify whether the positive association between interhospital competition and collaboration can be generalized to other health-care settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The International Charter for Human Values in Healthcare: an interprofessional global collaboration to enhance values and communication in healthcare.

Science.gov (United States)

Rider, Elizabeth A; Kurtz, Suzanne; Slade, Diana; Longmaid, H Esterbrook; Ho, Ming-Jung; Pun, Jack Kwok-hung; Eggins, Suzanne; Branch, William T

2014-09-01

The human dimensions of healthcare--core values and skilled communication necessary for every healthcare interaction--are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe the development of the International Charter for Human Values in Healthcare which delineates core values, articulate the role of skilled communication in enacting these values, and provide examples showing translation of the Charter's values into action. We describe development of the Charter using combined qualitative research methods and the international, interprofessional collaboration of institutions and individuals worldwide. We identified five fundamental categories of human values for every healthcare interaction--Compassion, Respect for Persons, Commitment to Integrity and Ethical Practice, Commitment to Excellence, and Justice in Healthcare--and delineated subvalues within each category. We have disseminated the Charter internationally and incorporated it into education/training. Diverse healthcare partners have joined in this work. We chronicle the development and dissemination of the International Charter for Human Values in Healthcare, the role of skilled communication in demonstrating values, and provide examples of educational and clinical programs integrating these values. The Charter identifies and promotes core values clinicians and educators can demonstrate through skilled communication and use to advance humanistic educational programs and practice. Copyright © 2014. Published by Elsevier Ireland Ltd.

Collaborating to embrace evidence-informed management practices within Canada's health system.

Science.gov (United States)

Strelioff, Wayne; Lavoie-Tremblay, Mélanie; Barton, Melissa

2007-01-01

In late 2005, 11 major national health organizations decided to work together to build healthier workplaces for healthcare providers. To do so, they created a pan-Canadian collaborative of 45 experts and asked them to develop an action strategy to improve healthcare workplaces. One of the first steps taken by members of the collaborative was to adopt the following shared belief statements to guide their thinking: "We believe it is unacceptable to fund, govern, manage, work in or receive care in an unhealthy health workplace," and, "A fundamental way to better healthcare is through healthier healthcare workplaces." This commentary provides an overview of the Quality Worklife-Quality Healthcare Collaborative action strategy. This strategy embraces the thinking set out by the lead papers (by Shamian and El-Jardali and by Clements, Dault and Priest) and brings to life evidence-informed management practices.

Using ESB and BPEL for Evolving Healthcare Systems Towards Pervasive, Grid-Enabled SOA

Science.gov (United States)

Koufi, V.; Malamateniou, F.; Papakonstantinou, D.; Vassilacopoulos, G.

Healthcare organizations often face the challenge of integrating diverse and geographically disparate information technology systems to respond to changing requirements and to exploit the capabilities of modern technologies. Hence, systems evolution, through modification and extension of the existing information technology infrastructure, becomes a necessity. Moreover, the availability of these systems at the point of care when needed is a vital issue for the quality of healthcare provided to patients. This chapter takes a process perspective of healthcare delivery within and across organizational boundaries and presents a disciplined approach for evolving healthcare systems towards a pervasive, grid-enabled service-oriented architecture using the enterprise system bus middleware technology for resolving integration issues, the business process execution language for supporting collaboration requirements and grid middleware technology for both addressing common SOA scalability requirements and complementing existing system functionality. In such an environment, appropriate security mechanisms must ensure authorized access to integrated healthcare services and data. To this end, a security framework addressing security aspects such as authorization and access control is also presented.

Healthcare provider education: from institutional boxes to dynamic networks.

Science.gov (United States)

Eisler, George

2009-01-01

The world recognizes the need for close collaboration in planning between the healthcare system and the post-secondary education system; this has also been advocated in the lead article. Forums and mechanisms to facilitate this collaboration are being implemented from local to global environments. Beyond the focus on competency gaps, there are important functional co-dependencies between healthcare and post-secondary education, including the need for a more formalized continuous quality improvement approach at the inter-organizational system level. The case for this close and continuous collaborative relationship is based on the following: (1) a close functional relationship, (2) joint responsibility for healthcare provider education, (3) the urgent need to address the workforce and education strategies for almost all healthcare services areas and (4) the factors that characterize successful and sustained quality improvement in complex adaptive systems. A go-forward vision consisting of an integrated web of academic health networks is proposed, each with its particular shared vision and aligned with an overall vision for healthcare in each provincial jurisdiction, as well as with national and global healthcare objectives.

Verification of Timed Healthcare Workflows Using Component Timed-Arc Petri Nets

DEFF Research Database (Denmark)

Bertolini, Cristiano; Liu, Zhiming; Srba, Jiri

2013-01-01

Workflows in modern healthcare systems are becoming increasingly complex and their execution involves concurrency and sharing of resources. The definition, analysis and management of collaborative healthcare workflows requires abstract model notations with a precisely defined semantics and a supp......Workflows in modern healthcare systems are becoming increasingly complex and their execution involves concurrency and sharing of resources. The definition, analysis and management of collaborative healthcare workflows requires abstract model notations with a precisely defined semantics...

Enhancing Collaborative Healthcare Synergy

OpenAIRE

Noran , Ovidiu

2013-01-01

Part 15: Stimulating Collaborative Relationships; International audience; Worldwide, the constant ageing of the population brings significant challenges to the traditional style of health care systems. Rapidly spreading pandemics triggered by new disease strains, increased population mobility and displacements fuelled by conflict and climate change add another dimension to the health care predicament. In this context, proper cooperation and interoperability of the participants in the healthca...

Collaborative Environments. Considerations Concerning Some Collaborative Systems

Directory of Open Access Journals (Sweden)

Mihaela I. MUNTEAN

2009-01-01

Full Text Available It is obvious, that all collaborative environments (workgroups, communities of practice, collaborative enterprises are based on knowledge and between collaboration and knowledge management there is a strong interdependence. The evolution of information systems in these collaborative environments led to the sudden necessity to adopt, for maintaining the virtual activities and processes, the latest technologies/systems, which are capable to support integrated collaboration in business services. In these environments, portal-based IT platforms will integrate multi-agent collaborative systems, collaborative tools, different enterprise applications and other useful information systems.

Successful collaboration in healthcare a guide for physicians, nurses and clinical documentation specialists

CERN Document Server

Stukenberg, Colleen M

2010-01-01

This critically acclaimed work makes the case for collaboration and shows that it can be greatly enhanced with conscious understanding and systematic effort. As a healthcare specialist who has worn many hats from direct care giver to case manager to documentation specialist, Colleen Stukenberg is able to - Show how to build trust and communication and demonstrates specific opportunities where collaboration can make all the difference Identify ways that quality of care and financial factors overlap and the advantages that can be garnered through an understanding of this Explain how those in different roles view information through different types of knowledge and how an understanding of each perspective makes it easier to find the best source for important answers Discuss the education and ever-increasing role of the clinical documentation specialist who is often involved in all facets of a patient's progress, from intake and admission right up through discharge. As the author points out, good healthcare is d...

Are female students in general and nursing students more ready for teamwork and interprofessional collaboration in healthcare?

Directory of Open Access Journals (Sweden)

Timpka Toomas

2011-04-01

Full Text Available Abstract Background Interprofessional Education (IPE is now spreading worldwide and many universities are now including IPE in their curricula. The aim of this study was to investigate whether or not such student characteristics as gender, previous working experience in healthcare, educational progress and features of the learning environment, such as educational programmes and curriculum design, have an impact on their open-mindedness about co-operation with other professions. Methods Medical and nursing students at two Swedish universities were invited to fill in the Readiness for Interprofessional Learning Scale (RIPLS. Totally, 955 students were invited and 70.2% (n = 670 participated in the study. A factor analysis of the RIPLS revealed four item groupings (factors for our empirical data, but only one had sufficient internal consistency. This factor was labelled "Team Player". Results Regardless of the educational programme, female students were more positive to teamwork than male students. Nursing students in general displayed more positive beliefs about teamwork and collaboration than medical students. Exposure to different interprofessional curricula and previous exposure to interprofessional education were only to a minor extent associated with a positive attitude towards teamwork. Educational progress did not seem to influence these beliefs. Conclusions The establishment of interprofessional teamwork is a major challenge for modern healthcare. This study indicates some directions for more successful interprofessional education. Efforts should be directed at informing particularly male medical students about the need for teamwork in modern healthcare systems. The results also imply that study of other factors, such as the student's personality, is needed for fully understanding readiness for teamwork and interprofessional collaboration in healthcare. We also believe that the RIPL Scale still can be further adjusted.

Are female students in general and nursing students more ready for teamwork and interprofessional collaboration in healthcare?

Science.gov (United States)

Wilhelmsson, Margaretha; Ponzer, Sari; Dahlgren, Lars-Ove; Timpka, Toomas; Faresjö, Tomas

2011-04-21

Interprofessional Education (IPE) is now spreading worldwide and many universities are now including IPE in their curricula. The aim of this study was to investigate whether or not such student characteristics as gender, previous working experience in healthcare, educational progress and features of the learning environment, such as educational programmes and curriculum design, have an impact on their open-mindedness about co-operation with other professions. Medical and nursing students at two Swedish universities were invited to fill in the Readiness for Interprofessional Learning Scale (RIPLS). Totally, 955 students were invited and 70.2% (n=670) participated in the study. A factor analysis of the RIPLS revealed four item groupings (factors) for our empirical data, but only one had sufficient internal consistency. This factor was labelled "Team Player". Regardless of the educational programme, female students were more positive to teamwork than male students. Nursing students in general displayed more positive beliefs about teamwork and collaboration than medical students. Exposure to different interprofessional curricula and previous exposure to interprofessional education were only to a minor extent associated with a positive attitude towards teamwork. Educational progress did not seem to influence these beliefs. The establishment of interprofessional teamwork is a major challenge for modern healthcare. This study indicates some directions for more successful interprofessional education. Efforts should be directed at informing particularly male medical students about the need for teamwork in modern healthcare systems. The results also imply that study of other factors, such as the student's personality, is needed for fully understanding readiness for teamwork and interprofessional collaboration in healthcare. We also believe that the RIPL Scale still can be further adjusted.

The Indiana University Center for Healthcare Innovation and Implementation Science: Bridging healthcare research and delivery to build a learning healthcare system.

Science.gov (United States)

Azar, Jose; Adams, Nadia; Boustani, Malaz

2015-01-01

In the United States, it is estimated that 75,000 deaths every year could be averted if the healthcare system implemented high quality care more effectively and efficiently. Patient harm in the hospital occurs as a consequence of inadequate procedures, medications and other therapies, nosocomial infections, diagnostic evaluations and patient falls. Implementation science, a new emerging field in healthcare, is the development and study of methods and tools aimed at enhancing the implementation of new discoveries and evidence into daily healthcare delivery. The Indiana University Center for Healthcare Innovation and Implementation Science (IU-CHIIS) was launched in September 2013 with the mission to use implementation science and innovation to produce great-quality, patient-centered and cost-efficient healthcare delivery solutions for the United States of America. Within the first 24 months of its initiation, the IU-CHIIS successfully scaled up an evidence-based collaborative care model for people with dementia and/or depression, successfully expanded the Accountable Care Unit model positively impacting the efficiency and quality of care, created the first Certificate in Innovation and Implementation Science in the US and secured funding from National Institutes of Health to investigate innovations in dementia care. This article summarizes the establishment of the IU-CHIIS, its impact and outcomes and the lessons learned during the journey. Copyright © 2015. Published by Elsevier GmbH.

Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care

DEFF Research Database (Denmark)

Andersen, Anne Bendix; Frederiksen, Kirsten; Kolbæk, Raymond

2017-01-01

of intersectorial collaboration. The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order...... policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish healthcare. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the ‘Health Agreements’. Using Fairclough’s three......-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a ‘negotiated text’, appearing as an overriding document legitimising one possible discourse regarding the premises...

Understanding healthcare innovation systems: the Stockholm region case.

Science.gov (United States)

Larisch, Lisa-Marie; Amer-Wåhlin, Isis; Hidefjäll, Patrik

2016-11-21

Purpose There is an increasing interest in understanding how innovation processes can address current challenges in healthcare. The purpose of this paper is to analyze the wider socio-economic context and conditions for such innovation processes in the Stockholm region, using the functional dynamics approach to innovation systems (ISs). Design/methodology/approach The analysis is based on triangulation using data from 16 in-depth interviews, two workshops, and additional documents. Using the functional dynamics approach, critical structural and functional components of the healthcare IS were analyzed. Findings The analysis revealed several mechanisms blocking innovation processes such as fragmentation, lack of clear leadership, as well as insufficient involvement of patients and healthcare professionals. Furthermore, innovation is expected to occur linearly as a result of research. Restrictive rules for collaboration with industry, reimbursement, and procurement mechanisms limit entrepreneurial experimentation, commercialization, and spread of innovations. Research limitations/implications In this study, the authors analyzed how certain functions of the functional dynamics approach to ISs related to each other. The authors grouped knowledge creation, resource mobilization, and legitimacy as they jointly constitute conditions for needs articulation and entrepreneurial experimentation. The economic effects of entrepreneurial experimentation and needs articulation are mainly determined by the stage of market formation and existence of positive externalities. Social implications Stronger user involvement; a joint innovation strategy for healthcare, academia, and industry; and institutional reform are necessary to remove blocking mechanisms that today prevent innovation from occurring. Originality/value This study is the first to provide an analysis of the system of innovation in healthcare using a functional dynamics approach, which has evolved as a tool for public

The Systemic Products as a Source of Competitive Advantage on Healthcare Sector Example. Part II

Directory of Open Access Journals (Sweden)

Izabela SZTANGRET

2015-12-01

Full Text Available In the healthcare sector, different healthcare providers, such as home care, primary care, pharmacies and hospital clinics but also a financial institution, collaborate in order to increase values for patients, such as better health state, more complex services, high quality of services, and increased feeling of safety. By creating a value, flexible networks health care providers and additional actors create value through collaboration. The purpose of this article is to identify the specific character of systemic healthcare product, created in synergy relations of medical enntities in the area of new way of meeting customers’ needs. Critical analysis of literature in the field of studied category is conducted in the article; furthermore qualitative method of empirical studies (case study and quantitative (online questionnaire is applied for practical illustration of described processes and phenomena. The article is a second part of the stud.

The importance of moral emotions for effective collaboration in culturally diverse healthcare teams.

Science.gov (United States)

Cook, Catherine; Brunton, Margaret

2018-04-01

Moral emotions shape the effectiveness of culturally diverse teams. However, these emotions, which are integral to determining ethically responsive patient care and team relationships, typically go unrecognised. The contribution of emotions to moral deliberation is subjugated within the technorational environment of healthcare decision-making. Contemporary healthcare organisations rely on a multicultural workforce charged with the ethical care of vulnerable people. Limited extant literature examines the role of moral emotions in ethical decision-making among culturally diverse healthcare teams. Moral emotions are evident in ethnocentric moral perspectives that construct some colleagues' practices as 'other'. This article examines how moral emotions are evoked when cultural dissonance influences nurses' moral perceptions. We use a qualitative investigation of teamwork within culturally diverse healthcare organisations. We use Haidt's () account of moral emotions to examine practice-based accounts of 36 internationally educated and 17 New Zealand educated nurses practising in New Zealand. The study provides evidence that moral emotions are frequently elicited by communication and care practices considered 'foreign'. The main implication is that although safe practice in healthcare organisations is reliant on highly functioning teams, collaboration is challenged by interprofessional power relations of contested culturally shaped values. We address practice-based strategies that enable engagement with moral emotions to enhance effective teamwork. © 2017 John Wiley & Sons Ltd.

Development of a web-based pharmaceutical care plan to facilitate collaboration between healthcare providers and patients

NARCIS (Netherlands)

Geurts, Marlies M E; Ivens, Martijn; van Gelder, Egbert; de Gier, Johan J

2013-01-01

BACKGROUND: In medication therapy management there is a need for a tool to document medication reviews and pharmaceutical care plans (PCPs) as well as facilitate collaboration and sharing of patient data between different healthcare providers. Currently, pharmacists and general practitioners (GPs)

The Cuban National Healthcare System: Characterization of primary healthcare services.

Directory of Open Access Journals (Sweden)

Keli Regina DAL PRÁ

2015-10-01

Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

Romanian healthcare system at a glance

Directory of Open Access Journals (Sweden)

Christiana Balan

2013-04-01

Full Text Available The Romanian healthcare system is facing constant challenges to produce high quality care with low costs. Objectives The paper aims to analyze the efficiency of the Romanian healthcare system in terms of resources allocation. The evaluation and the dimension of healthcare system efficiency are important for identifying a balance between the resources required and the health outcomes. Prior Work Previous studies describe the Romanian healthcare system as a system in transition. This study focuses on the relationship between the inputs and outputs of the system. Approach In order to assess the efficiency of the Romanian healthcare system we use Data Envelopment Analysis approach. Both input and output healthcare indicators are observed for the period 1999-2010 and the years when healthcare inputs have been used efficiently are identified. Results The results show that human, financial, and technological resources have been used at maximum capacity in 1999, 2003, 2004, 2007 and 2010. Implications Though efficiency is defined differently by diverse stakeholders, healthcare policies should focus on rising the responsibility of communities and individuals for better treatments and services and better access to information on healthcare providers. Value The paper is an empirically based study of the healthcare resources allocation in Romania.

Complexity leadership: a healthcare imperative.

Science.gov (United States)

Weberg, Dan

2012-01-01

The healthcare system is plagued with increasing cost and poor quality outcomes. A major contributing factor for these issues is that outdated leadership practices, such as leader-centricity, linear thinking, and poor readiness for innovation, are being used in healthcare organizations. Complexity leadership theory provides a new framework with which healthcare leaders may practice leadership. Complexity leadership theory conceptualizes leadership as a continual process that stems from collaboration, complex systems thinking, and innovation mindsets. Compared to transactional and transformational leadership concepts, complexity leadership practices hold promise to improve cost and quality in health care. © 2012 Wiley Periodicals, Inc.

Healthcare Firms and the ERP Systems

Directory of Open Access Journals (Sweden)

A. Garefalakis

2016-04-01

Full Text Available With the continuous and drastic changes due to the economic crisis, along with the increasing market demands, major reforms are initiated in the healthcare sector in order to improve the quality of healthcare and operational efficiency, while reducing costs and optimizing back-end operations. ERP systems have been the basic technological infrastructure to many sectors as well as healthcare. The main objective of this study is to discuss how the adoption of ERP systems in healthcare organizations improves their functionality, simplifies their business processes, assure the quality of care services and helps their management accounting and controlling. This study presents also the stages required for the implementation of ERP system in healthcare organizations. This study utilizes a literature review in order to reach the research conclusions. Specifically, through related case studies and research, it examines how ERP systems are used to evaluate the better functionality of the healthcare organizations, addressing in parallel important problems, and possible malfunctions. The implementation of ERP systems in healthcare organizations promises to evolve and align strictly to the organizations’ corporate objectives and high-levels of healthcare quality. In order to accomplish this goal, the right decisions should be made by the managers of the healthcare organization regarding the choice of the appropriate ERP system following its installation and its application. Limited research exists on the significance ERP systems implementation in healthcare organizations, while possible dysfunctions and challenges during its installation and implementation are recorded. Therefore, new evidence in the significance of ERP systems in healthcare organization is provided.

Architecture of personal healthcare information system in ubiquitous healthcare

NARCIS (Netherlands)

Bhardwaj, S.; Sain, M.; Lee, H.-J.; Chung, W.Y.; Slezak, D.; et al., xx

2009-01-01

Due to recent development in Ubiquitous Healthcare now it’s time to build such application which can work independently and with less interference of Physician. In this paper we are try to build the whole architecture of personal Healthcare information system for ubiquitous healthcare which also

Reorganisation of healthcare services for children and families: Improving collaboration, service quality, and worker well-being.

Science.gov (United States)

Martinussen, Monica; Kaiser, Sabine; Adolfsen, Frode; Patras, Joshua; Richardsen, Astrid M

2017-07-01

This study is an evaluation of a reorganisation of different services for children and their families in a Norwegian municipality. The main aim of the reorganisation was to improve interprofessional collaboration through integrating different social services for children and their parents. The evaluation was guided by the Job Demands-Resources Model with a focus on social and healthcare workers' experiences of their work, including job demands and resources, service quality, and well-being at work. The survey of the employees was conducted at three measurement points: before (T 1 ) and after (T 2 , T 3 ) the reorganisation took place, and included between 87 and 122 employees. A secondary aim was to examine the impact of different job resources and job demands on well-being (burnout, engagement, job satisfaction), and service quality. A one-way ANOVA indicated a positive development on many scales, such as collaboration, work conflict, leadership, and perceived service quality, especially from T 1 to T 2 . No changes were detected in burnout, engagement, or job satisfaction over time. Moderated regression analyses (at T 3 ) indicated that job demands were particularly associated with burnout, and job resources with engagement and job satisfaction. Perceived service quality was predicted by both job demands and resources, in addition to the interaction between workload and collaboration. The reorganisation seems to have contributed to a positive development in how collaboration, work conflict, leadership, and service quality were evaluated, but that other changes are needed to increase worker well-being. The value of the study rests on the findings that support co-locating and merging services for children and their families, and that collaboration is an important resource for healthcare professionals.

Successful collaboration in healthcare?a guide for physicians, nurses and clinical documentation specialists

OpenAIRE

Larsen, Torben

2010-01-01

Book reviewSuccessful collaboration in healthcare-a guide for physicians, nurses and clinical documentation specialistsColleen Stukenberg New York: CRC Press, Taylor & Francis Group, 2010, pp. 136ISBN 978 1 4389 1292 1This book addresses an important topic, especially for health professionals engaged in integrated care (IC). Also, the book is easy to read with about 120 pages in a fluent language that you feel is based on first hand personal job experiences.Colleen Stukenberg is a certifi...

Factors Influencing Healthcare Service Quality

Directory of Open Access Journals (Sweden)

Ali Mohammad Mosadeghrad

2014-07-01

Full Text Available Background The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

Factors associated with the impact of quality improvement collaboratives in mental healthcare: An exploratory study

Directory of Open Access Journals (Sweden)

Versteeg Marleen H

2012-01-01

Full Text Available Abstract Background Quality improvement collaboratives (QICs bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods We studied three QICs involving 29 quality improvement (QI teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions No general conclusions about the impact of the characteristics of

Successful collaboration in healthcare-a guide for physicians, nurses and clinical documentation specialists

DEFF Research Database (Denmark)

Larsen, Torben

2010-01-01

methods of economic evaluation are relevant for a societal evaluation of the usefulness of an intervention. Sticking to DRG subtleties, only, the guidance serves private hospital profit instead of societal benefit. In all, these are serious weaknesses for a book aiming to guide the collaboration between......Book review Successful collaboration in healthcare-a guide for physicians, nurses and clinical documentation specialists Colleen Stukenberg New York: CRC Press, Taylor & Francis Group, 2010, pp. 136 ISBN 978 1 4389 1292 1 This book addresses an important topic, especially for health professionals...... engaged in integrated care (IC). Also, the book is easy to read with about 120 pages in a fluent language that you feel is based on first hand personal job experiences. Colleen Stukenberg is a certified nurse with more than 20 years' experience from a variety of hospital areas, a master's of science...

Awareness and implementation of tobacco dependence treatment guidelines in Arizona: Healthcare Systems Survey 2000

Directory of Open Access Journals (Sweden)

Menke J Michael

2008-12-01

Full Text Available Abstract Background This paper presents findings from the Tobacco Control in Arizona Healthcare Systems Survey, conducted in 2000. The purpose of the survey was to assess the status of Arizona healthcare systems' awareness and implementation of tobacco cessation and prevention measures. Methods The 20-item survey was developed by The University of Arizona HealthCare Partnership in collaboration with the Arizona Department of Health Services Bureau of Tobacco Education and Prevention. It was mailed to representatives of Arizona's 40 healthcare systems, including commercial and Medicare managed care organizations, "managed Medicaid" organizations, Veterans Affairs Health Care Systems, and Indian Health Service Medical Centers. Thirty-three healthcare systems (83% completed the survey. Results The majority of healthcare systems reported awareness of at least one tobacco cessation and prevention clinical practice guideline, but only one third reported full guideline implementation. While a majority covered some form of behavioral therapy, less than half reported covering tobacco treatment medications. "Managed Medicaid" organizations administered through the Arizona Health Care Cost Containment System were significantly less likely to offer coverage for behavioral therapy and less likely to cover pharmacotherapy than were their non-Medicaid counterparts in managed care, Veterans Affairs Health Care Systems and Indian Health Service Medical Centers. Conclusion Arizona healthcare system coverage for tobacco cessation in the year 2000 was comparable to national survey findings of the same year. The findings that only 10% of "Managed Medicaid" organizations covered tobacco treatment medication and were significantly less likely to cover behavioral therapy were important given the nearly double smoking prevalence among Medicaid patients. Throughout the years of the program, the strategic plan of the Arizona Department of Health Services Bureau of Tobacco

Healthcare Analytics: Creating a Prioritized Improvement System with Performance Benchmarking.

Science.gov (United States)

Kolker, Eugene; Kolker, Evelyne

2014-03-01

The importance of healthcare improvement is difficult to overstate. This article describes our collaborative work with experts at Seattle Children's to create a prioritized improvement system using performance benchmarking. We applied analytics and modeling approaches to compare and assess performance metrics derived from U.S. News and World Report benchmarking data. We then compared a wide range of departmental performance metrics, including patient outcomes, structural and process metrics, survival rates, clinical practices, and subspecialist quality. By applying empirically simulated transformations and imputation methods, we built a predictive model that achieves departments' average rank correlation of 0.98 and average score correlation of 0.99. The results are then translated into prioritized departmental and enterprise-wide improvements, following a data to knowledge to outcomes paradigm. These approaches, which translate data into sustainable outcomes, are essential to solving a wide array of healthcare issues, improving patient care, and reducing costs.

Collaborating with Communities and Higher Education to Address the Health-care Needs of Individuals with Disabilities in Ecuador

Directory of Open Access Journals (Sweden)

Donna J. Cech

2017-04-01

Full Text Available Individuals with disabilities experience inequities in access to health care, education, employment, and social inclusion. Causes for Change International (CCI, a non-governmental Organization (NGO, using a community-based rehabilitation approach has worked for 20 years to build self-sufficiency, improve health-care services, and education for women, children, and persons with disabilities in Ecuador. CCI initially addressed health; advocacy for individuals with disabilities; and promoted educational opportunities for children with disabilities, starting in one rural community. CCI’s outreach has expanded through Ecuador’s coastal provinces, Andean provinces, and Galapagos Islands. CCI also focused on local health-care workforce development, developing employment skills for individuals with disabilities and social inclusion for this population. CCI collaborated with local organizations, government, and universities to provide resources, managed by local leadership. Key program elements of the CCI approach include (1 develop trust between CCI, local communities, local agencies, and government; (2 empower local groups to assume leadership and sustain programs; (3 support communities and groups invested in developing self-sufficiency; and (4 strengthen collaborations and partnerships between local and international organizations, universities, and government agencies. Key lessons learned by CCI are to be supportive of cultural differences; understand that limited financial and material resources may limit the program development; recognize that it is difficult not to foster dependent relationships with communities and appreciate the importance of working with and within the host country’s governmental systems. CCI is expanding its service base to other regions of Ecuador and is focusing on development of the Ecuadorian health-care workforce and social inclusion opportunities for individuals with disability. The efforts of a small NGO have

Collaborating with Communities and Higher Education to Address the Health-care Needs of Individuals with Disabilities in Ecuador.

Science.gov (United States)

Cech, Donna J; Alvarado, Zully J

2017-01-01

Individuals with disabilities experience inequities in access to health care, education, employment, and social inclusion. Causes for Change International (CCI), a non-governmental Organization (NGO), using a community-based rehabilitation approach has worked for 20 years to build self-sufficiency, improve health-care services, and education for women, children, and persons with disabilities in Ecuador. CCI initially addressed health; advocacy for individuals with disabilities; and promoted educational opportunities for children with disabilities, starting in one rural community. CCI's outreach has expanded through Ecuador's coastal provinces, Andean provinces, and Galapagos Islands. CCI also focused on local health-care workforce development, developing employment skills for individuals with disabilities and social inclusion for this population. CCI collaborated with local organizations, government, and universities to provide resources, managed by local leadership. Key program elements of the CCI approach include (1) develop trust between CCI, local communities, local agencies, and government; (2) empower local groups to assume leadership and sustain programs; (3) support communities and groups invested in developing self-sufficiency; and (4) strengthen collaborations and partnerships between local and international organizations, universities, and government agencies. Key lessons learned by CCI are to be supportive of cultural differences; understand that limited financial and material resources may limit the program development; recognize that it is difficult not to foster dependent relationships with communities and appreciate the importance of working with and within the host country's governmental systems. CCI is expanding its service base to other regions of Ecuador and is focusing on development of the Ecuadorian health-care workforce and social inclusion opportunities for individuals with disability. The efforts of a small NGO have helped build

Pervasive mobile healthcare systems for chronic disease monitoring.

Science.gov (United States)

Huzooree, Geshwaree; Kumar Khedo, Kavi; Joonas, Noorjehan

2017-05-01

Pervasive mobile healthcare system has the potential to improve healthcare and the quality of life of chronic disease patients through continuous monitoring. Recently, many articles related to pervasive mobile healthcare system focusing on health monitoring using wireless technologies have been published. The main aim of this review is to evaluate the state-of-the-art pervasive mobile healthcare systems to identify major technical requirements and design challenges associated with the realization of a pervasive mobile healthcare system. A systematic literature review was conducted over IEEE Xplore Digital Library to evaluate 20 pervasive mobile healthcare systems out of 683 articles from 2011 to 2016. The classification of the pervasive mobile healthcare systems and other important factors are discussed. Potential opportunities and challenges are pointed out for the further deployment of effective pervasive mobile healthcare systems. This article helps researchers in health informatics to have a holistic view toward understanding pervasive mobile healthcare systems and points out new technological trends and design challenges that researchers have to consider when designing such systems for better adoption, usability, and seamless integration.

[Healthcare value chain: a model for the Brazilian healthcare system].

Science.gov (United States)

Pedroso, Marcelo Caldeira; Malik, Ana Maria

2012-10-01

This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and services; financial; and information.

Validation of Metrics for Collaborative Systems

OpenAIRE

Ion IVAN; Cristian CIUREA

2008-01-01

This paper describe the new concepts of collaborative systems metrics validation. The paper define the quality characteristics of collaborative systems. There are proposed a metric to estimate the quality level of collaborative systems. There are performed measurements of collaborative systems quality using a specially designed software.

[The five commandments for preparing the Israeli healthcare system for emergencies].

Science.gov (United States)

Adini, Bruria; Laor, Danny; Cohen, Robert; Lev, Boaz; Israeli, Avi

2010-07-01

In the last decade, the Israeli healthcare system dealt with many casualties that resulted from terrorist actions and at the same time maintained preparedness for other potential hazards such as natural disasters, toxicological, chemical, radiological and biological events. There are various models for emergency preparedness that are utilized in different countries. The aim of the article is to present the structure and the methodology of the Israeli healthcare system for emergencies. Assuring emergency preparedness for the different scenarios is based on 5 major components that include: comprehensive contingency planning; control and command of operations; central control of readiness; capacity building; coordination and collaboration among the numerous emergency agencies. CLose working relationships between the military and civilian systems characterize the operations of the emergency system. There is a mutual sharing of information, coordinated operations to achieve risk assessment and determine priorities, and consensual allocation of resources. The ability of the medical system to operate in optimal coordination with interface bodies, including the Israel Defense Forces, is derived from three main elements: the shortage of resources necessitate that all agencies work together to develop an effective response to emergencies; the Israeli society is characterized by transition of personnel from the military to the civilian system which promotes joint operations, whereas in most other countries these systems are completely separated; and also developing mechanisms for continuous and coordinated operation in routine and emergency times, such as the Supreme Health Authority. The Israeli healthcare system was put to the test several times in the Last decade, during the terror wave that occurred between 2001-2006, the 2nd Lebanon War and in operation "Cast Lead". An extensive process of learning lessons, conducted during and following each of these periods, and the

Activity System Theory Approach to Healthcare Information System

OpenAIRE

Bai, Guohua

2004-01-01

Healthcare information system is a very complex system and has to be approached from systematic perspectives. This paper presents an Activity System Theory (ATS) approach by integrating system thinking and social psychology. First part of the paper, the activity system theory is presented, especially a recursive model of human activity system is introduced. A project ‘Integrated Mobile Information System for Diabetic Healthcare (IMIS)’ is then used to demonstrate a practical application of th...

Patient-centredness in integrated healthcare delivery systems - needs, expectations and priorities for organised healthcare systems.

Science.gov (United States)

Juhnke, Christin; Mühlbacher, Axel C

2013-01-01

Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems. A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales. Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser-Meyer-Olkin of 0.914 for the patients (experts: 38.427%, Kaiser-Meyer-Olkin = 0.797). Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination. The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes.

Validation of Metrics for Collaborative Systems

Directory of Open Access Journals (Sweden)

Ion IVAN

2008-01-01

Full Text Available This paper describe the new concepts of collaborative systems metrics validation. The paper define the quality characteristics of collaborative systems. There are proposed a metric to estimate the quality level of collaborative systems. There are performed measurements of collaborative systems quality using a specially designed software.

Supply Chain Collaboration Roles of Interorganizational Systems, Trust, and Collaborative Culture

CERN Document Server

Cao, Mei

2013-01-01

To survive and thrive in the competition, firms have strived to achieve greater supply chain collaboration to leverage the resources and knowledge of suppliers and customers.  Internet based technologies, particularly interorganizational systems, further extend the firms’ opportunities to strengthen their supply chain partnerships and share real-time information to optimize their operations.  Supply Chain Collaboration: Roles of Interorganizational Systems, Trust, and Collaborative Culture explores the nature and characteristics, antecedents, and consequences of supply chain collaboration from multiple theoretical perspectives.  Supply Chain Collaboration: Roles of Interorganizational Systems, Trust, and Collaborative Culture conceptualizes supply chain collaboration as seven interconnecting elements including information sharing, incentive alignment, goal congruence, decision synchronization, resource sharing, as well as communication and joint knowledge creation. These seven components define the occur...

A Metrics Approach for Collaborative Systems

Directory of Open Access Journals (Sweden)

Cristian CIUREA

2009-01-01

Full Text Available This article presents different types of collaborative systems, their structure and classification. This paper defines the concept of virtual campus as a collaborative system. It builds architecture for virtual campus oriented on collaborative training processes. It analyses the quality characteristics of collaborative systems and propose techniques for metrics construction and validation in order to evaluate them. The article analyzes different ways to increase the efficiency and the performance level in collaborative banking systems.

Healthcare teams over the Internet: towards a certificate-based approach.

Science.gov (United States)

Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

2002-01-01

Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modem healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has therefore become a major concern for healthcare applications over the Internet. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security policy is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

Patient-centeredness in Integrated healthcare delivery systems - Needs, expectations and priorities for organized healthcare systems

Directory of Open Access Journals (Sweden)

Christin Juhnke

2013-11-01

Full Text Available Introduction: Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems. Methods: A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales. Results: Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser–Meyer–Olkinof 0.914 for the patients (experts: 38.427%, Kaiser–Meyer–Olkin = 0.797. Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination. Conclusion and Discussion: The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes.

Patient-centeredness in Integrated healthcare delivery systems - Needs, expectations and priorities for organized healthcare systems

Directory of Open Access Journals (Sweden)

Christin Juhnke

2013-11-01

Full Text Available Introduction: Patient-centred healthcare is becoming a more significant success factor in the design of integrated healthcare systems. The objective of this study is to structure a patient-relevant hierarchy of needs and expectations for the design of organised healthcare delivery systems.Methods: A questionnaire with 84 items was conducted with N = 254 healthcare experts and N = 670 patients. Factor analyses were performed using SPSS©18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's α was used to assess the internal consistency of the subscales.Results: Exploratory factor analysis led to 24 factors in the expert sample and 20 in the patient sample. After analysing the screeplots, confirmatory factor analyses were computed for 7-factor solutions accounting for 42.963% of the total variance and Kaiser–Meyer–Olkinof 0.914 for the patients (experts: 38.427%, Kaiser–Meyer–Olkin = 0.797. Cronbach's α ranged between 0.899 and 0.756. Based on the analysis, coordinated care could be differentiated into seven dimensions: access, data and information, service and infrastructure, professional care, interpersonal care, individualised care, continuity and coordination.Conclusion and Discussion: The study provides insight into patient and experts expectations towards the organisation of integrated healthcare delivery systems. If providers and payers can take into account patient needs and expectations while implementing innovative healthcare delivery systems, greater acceptance and satisfaction will be achieved. In the best case, this will lead to better adherence resulting in better clinical outcomes.

Concepts and trends in healthcare information systems

CERN Document Server

Koutsouris, Dionysios-Dimitrios

2014-01-01

​Concepts and Trends in Healthcare Information Systems covers the latest research topics in the field from leading researchers and practitioners. This book offers theory-driven research that explores the role of Information Systems in the delivery of healthcare in its diverse organizational and regulatory settings. In addition to the embedded role of Information Technology (IT) in clinical and diagnostics equipment, Information Systems are uniquely positioned to capture, store, process, and communicate timely information to decision makers for better coordination of healthcare at both the individual and population levels. For example, data mining and decision support capabilities can identify potential adverse events for an individual patient while also contributing to the population's health by providing insights into the causes of disease complications. Information systems have great potential to reduce healthcare costs and improve outcomes. The healthcare delivery systems share similar characteristics w...

The Relationship between Environmental Turbulence, Management Support, Organizational Collaboration, Information Technology Solution Realization, and Process Performance, in Healthcare Provider Organizations

Science.gov (United States)

Muglia, Victor O.

2010-01-01

The Problem: The purpose of this study was to investigate relationships between environmental turbulence, management support, organizational collaboration, information technology solution realization, and process performance in healthcare provider organizations. Method: A descriptive/correlational study of Hospital medical services process…

The role of personal resilience and personality traits of healthcare students on their attitudes towards interprofessional collaboration.

Science.gov (United States)

Avrech Bar, Michal; Katz Leurer, Michal; Warshawski, Sigalit; Itzhaki, Michal

2018-02-01

Interprofessional collaboration (IPC) improves communication between healthcare workers and healthcare delivery. Interprofessional education (IPE) is essential in preparing healthcare students for cooperating with other healthcare disciplines in a real work setting. Although higher education settings have a responsibility to provide collaborative healthcare practice to students, IPE has not yet been prompted worldwide as a formal division in health professional education and in Israel IPE among health professions students is scarce. To examine the attitudes of health professions students towards IPC in correlation with their personal resilience and personality traits. A descriptive cross-sectional design was used. Participants were fourth year nursing, occupational therapy (OT), and physical therapy students studying in an academic undergraduate program at a School of Health Professions in a central university in Israel. Attitudes were assessed with a questionnaire consisting of the Interdisciplinary Education Perception Scale, the Connor-Davidson Resilience Scale, the Big Five Inventory of personality dimensions, and a question evaluating students' experience with the PBL (Problem-Based Learning) method. Questionnaires were completed by 184 health professions students. Nursing students' perception of actual cooperation with other professions and their perceived competency and autonomy in their profession were slightly lower than those of other students. Among nursing students, positive correlations were found between competency & autonomy and resilience (p<0.01) and between competency & autonomy and agreeableness (p<0.05). Positive correlations were also found between their perception of actual cooperation with other professions and: resilience (p<0.01), agreeableness (p<0.05), conscientiousness (p<0.05), and openness (p<0.05). Only OT students were familiar with and experienced in the PBL method. This experience with PBL was found correlated with more positive

[Awareness survey of Healthcare Number System pros and cons according to medical doctors in Japan].

Science.gov (United States)

Takahashi, Yoshimitsu; Uryuhara, Yoko; Inoue, Machiko; Okamoto, Shigeru; Kashihara, Hidenori; Kito, Kumiko; Shinohara, Keiko; Mandai, Marie; Morioka, Miho; Tanaka, Shiro; Kawakami, Koji; Nakayama, Takeo

2015-01-01

After bills to launch the Social Security and Tax Number System were enacted in 2013, health and political officials have considered the Healthcare Number System (the System). However, little is known about doctors' awareness and concerns about the System. This study aimed to measure how many doctors disagree with the System, examine the doctors' characteristics, and analyze the benefits and harms of the System that they identified. A cross-sectional survey was conducted of doctors via the Internet. The participants were selected from a convenience sample of a panel of doctors based on stratified sampling including four groups: working at a hospital and content analysis. There were 562 respondents (68%). By group, 16/143 (11%), 25/138 (18%), 31/132 (23%), and 43/149 (29%) doctors, respectively, thought that the System was unnecessary. The variables that correlated with the main outcome were age (per 5 years; odds ratio [95% confidence interval], 1.14 [1.01-1.29]) and type of medical facility (working at a clinic; 1.99 [1.30-3.08]). The doctors identified that unifying information could decrease administrative duties, facilitate inter-facility collaboration, and prevent inappropriate medical consultations. This could result in decreased healthcare costs and personalized healthcare. However, the doctors also identified that integrating information and dealing with big data could increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. This could result in deteriorating healthcare. Since some information should not be integrated, the System raises ethical considerations about privacy. Among the doctors surveyed here, 10-30% thought the System was unnecessary. These respondents tended to be older and work at a clinic. The System could decrease the cost of healthcare and enable personalized healthcare but could also increase information leakage and information management, cause

Systems design for remote healthcare

CERN Document Server

Bonfiglio, Silvio

2014-01-01

This book provides a multidisciplinary overview of the design and implementation of systems for remote patient monitoring and healthcare. Readers are guided step-by-step through the components of such a system and shown how they could be integrated in a coherent framework for deployment in practice. The authors explain planning from subsystem design to complete integration and deployment, given particular application constraints. Readers will benefit from descriptions of the clinical requirements underpinning the entire application scenario, physiological parameter sensing techniques, information processing approaches and overall, application dependent system integration. Each chapter ends with a discussion of practical design challenges and two case studies are included to provide practical examples and design methods for two remote healthcare systems with different needs. ·         Provides a multi-disciplinary overview of next-generation mobile healthcare system design; ·         Includes...

Awareness of the healthcare system and rights to healthcare in the Colombian population.

Science.gov (United States)

Delgado Gallego, María Eugenia; Vázquez-Navarrete, María Luisa

2013-01-01

To analyze changes in users' awareness of the healthcare system and of their rights to healthcare in Colombia in the last 10 years, as well as the factors that influence users' awareness. We carried out a descriptive study to compare the results of two cross-sectional studies based on two surveys of users of the Colombian healthcare system. The first survey was performed in 2000 and the second in 2010. The municipalities of Tuluá (urban area) and Palmira (rural area) were surveyed. In both surveys, a stratified, multistage probability sample was selected. There were 1497 users in the first sample and 1405 in the second. Changes in awareness of the healthcare system and associated factors in each year were assessed through multivariate logistic regressions. Users' awareness of the healthcare system was limited in 2000 and was significantly lower in 2010, except for that relating to health insurers and providers. In contrast, more than 90% of users in both surveys perceived themselves as having healthcare rights. The factors consistently associated with greater awareness were belonging to a high socioeconomic stratum and having higher education. The most underprivileged users were less likely to be aware of the healthcare system, hampering their ability to make informed decisions and to exercise their health rights. To correct this situation, health institutions and the government should act decisively to reduce social inequalities. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Primary care training and the evolving healthcare system.

Science.gov (United States)

Peccoralo, Lauren A; Callahan, Kathryn; Stark, Rachel; DeCherrie, Linda V

2012-01-01

With growing numbers of patient-centered medical homes and accountable care organizations, and the potential implementation of the Patient Protection and Affordable Care Act, the provision of primary care in the United States is expanding and changing. Therefore, there is an urgent need to create more primary-care physicians and to train physicians to practice in this environment. In this article, we review the impact that the changing US healthcare system has on trainees, strategies to recruit and retain medical students and residents into primary-care internal medicine, and the preparation of trainees to work in the changing healthcare system. Recruitment methods for medical students include early preclinical exposure to patients in the primary-care setting, enhanced longitudinal patient experiences in clinical clerkships, and primary-care tracks. Recruitment methods for residents include enhanced ambulatory-care training and primary-care programs. Financial-incentive programs such as loan forgiveness may encourage trainees to enter primary care. Retaining residents in primary-care careers may be encouraged via focused postgraduate fellowships or continuing medical education to prepare primary-care physicians as both teachers and practitioners in the changing environment. Finally, to prepare primary-care trainees to effectively and efficiently practice within the changing system, educators should consider shifting ambulatory training to community-based practices, encouraging resident participation in team-based care, providing interprofessional educational experiences, and involving trainees in quality-improvement initiatives. Medical educators in primary care must think innovatively and collaboratively to effectively recruit and train the future generation of primary-care physicians. © 2012 Mount Sinai School of Medicine.

The High Value Healthcare Collaborative: Observational Analyses of Care Episodes for Hip and Knee Arthroplasty Surgery.

Science.gov (United States)

Weeks, William B; Schoellkopf, William J; Sorensen, Lyle S; Masica, Andrew L; Nesse, Robert E; Weinstein, James N

2017-03-01

Broader use of value-based reimbursement models will require providers to transparently demonstrate health care value. We sought to determine and report cost and quality data for episodes of hip and knee arthroplasty surgery among 13 members of the High Value Healthcare Collaborative (HVHC), a consortium of health care systems interested in improving health care value. We conducted a retrospective, cross-sectional observational cohort study of 30-day episodes of care for hip and knee arthroplasty in fee-for-service Medicare beneficiaries aged 65 or older who had hip or knee osteoarthritis and used 1 of 13 HVHC member systems for uncomplicated primary hip arthroplasty (N = 8853) or knee arthroplasty (N = 16,434), respectively, in 2012 or 2013. At the system level, we calculated: per-capita utilization rates; postoperative complication rates; standardized total, acute, and postacute care Medicare expenditures for 30-day episodes of care; and the modeled impact of reducing episode expenditures or per-capita utilization rates. Adjusted per-capita utilization rates varied across HVHC systems and postacute care reimbursements varied more than 3-fold for both types of arthroplasty in both years. Regression analysis confirmed that total episode and postacute care reimbursements significantly differed across HVHC members after considering patient demographic differences. Potential Medicare cost savings were greatest for knee arthroplasty surgery and when lower total reimbursement targets were achieved. The substantial variation that we found offers opportunities for learning and collaboration to collectively improve outcomes, reduce costs, and enhance value. Ceteris paribus, reducing per-episode reimbursements would achieve greater Medicare cost savings than reducing per-capita rates. Copyright © 2016 Elsevier Inc. All rights reserved.

A Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Health-care Professionals. A Call for Action.

Science.gov (United States)

Moss, Marc; Good, Vicki S; Gozal, David; Kleinpell, Ruth; Sessler, Curtis N

2016-07-01

Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients.

Behavioral Reference Model for Pervasive Healthcare Systems.

Science.gov (United States)

Tahmasbi, Arezoo; Adabi, Sahar; Rezaee, Ali

2016-12-01

The emergence of mobile healthcare systems is an important outcome of application of pervasive computing concepts for medical care purposes. These systems provide the facilities and infrastructure required for automatic and ubiquitous sharing of medical information. Healthcare systems have a dynamic structure and configuration, therefore having an architecture is essential for future development of these systems. The need for increased response rate, problem limited storage, accelerated processing and etc. the tendency toward creating a new generation of healthcare system architecture highlight the need for further focus on cloud-based solutions for transfer data and data processing challenges. Integrity and reliability of healthcare systems are of critical importance, as even the slightest error may put the patients' lives in danger; therefore acquiring a behavioral model for these systems and developing the tools required to model their behaviors are of significant importance. The high-level designs may contain some flaws, therefor the system must be fully examined for different scenarios and conditions. This paper presents a software architecture for development of healthcare systems based on pervasive computing concepts, and then models the behavior of described system. A set of solutions are then proposed to improve the design's qualitative characteristics including, availability, interoperability and performance.

The Imminent Healthcare and Emergency Care Crisis in Japan

Directory of Open Access Journals (Sweden)

Suzuki, Tetsuji

2008-05-01

Full Text Available Objectives: Japan has a universal healthcare system, and this paper describes the reality of the healthcare services provided, as well as current issues with the system.Methods: Academic, government, and press reports on Japanese healthcare systems and healthcare guidelines were reviewed.Results: The universal healthcare system of Japan is considered internationally to be both low-cost and effective because the Japanese population enjoys good health status with a long life expectancy, while healthcare spending in Japan is below the average given by the Organization for Economic Corporation and Development (OECD. However, in many regions of Japan the existing healthcare resources are seriously inadequate, especially with regard to the number of physicians and other health professionals. Because healthcare is traditionally viewed as “sacred” work in Japan, healthcare professionals are expected to make large personal sacrifices. Also, public attitudes toward medical malpractice have changed in recent decades, and medical professionals are facing legal issues without experienced support of the government or legal professionals. Administrative response to the lack of resources and collaboration among communities are beginning, and more efficient control and management of the healthcare system is under consideration.Conclusion: The Japanese healthcare system needs to adopt an efficient medical control organization to ease the strain on existing healthcare professionals and to increase the number of physicians and other healthcare resources. Rather than continuing to depend on healthcare professionals being able and willing to make personal sacrifices, the government, the public and medical societies must cooperate and support changes in the healthcare system.

The Integration of Two Healthcare Systems: A Common Healthcare Problem.

Science.gov (United States)

Cassatly, Hannah; Cassatly, Michael

2015-01-01

The change in reimbursement mandated by the Affordable Care Act is causing a rapid consolidation of the marketplace as well as the delivery of clinical care in a team-based model. This case report examines the successful joining of two clinical teams concurrent with the merger of two healthcare organizations and discusses some of the difficulties encountered. A subsequent discussion focuses on the resolution: the need for physicians to embrace the team concept of healthcare delivery and for healthcare systems to facilitate this transition with team and leadership coaching.

Healthcare teams over the Internet: programming a certificate-based approach.

Science.gov (United States)

Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

2003-07-01

Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modern healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has, therefore, become a major concern. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security model is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control (HAC) security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

Adaptive Collaboration Support Systems : Designing Collaboration Support for Dynamic Environments

NARCIS (Netherlands)

Janeiro, J.; Knoll, S.W.; Lukosch, S.G.; Kolfschoten, G.L.

2012-01-01

Today, engineering systems offer a variety of local and webbased applications to support collaboration by assisting groups in structuring activities, generating and sharing data, and improving group communication. To ensure the quality of collaboration, engineering system design needs to analyze and

Collaborative Car Pooling System

OpenAIRE

João Ferreira; Paulo Trigo; Porfírio Filipe

2009-01-01

This paper describes the architecture for a collaborative Car Pooling System based on a credits mechanism to motivate the cooperation among users. Users can spend the accumulated credits on parking facilities. For this, we propose a business model to support the collaboration between a car pooling system and parking facilities. The Portuguese Lisbon-s Metropolitan area is used as application scenario.

The collaborative work of hospital porters

DEFF Research Database (Denmark)

Bossen, Claus; Foss, Martin

2016-01-01

In this paper, we describe the collaborative work of hospital porters. The profession of hospital porter is understudied in sociology and in Computer Supported Cooperative Work, despite numerous studies of healthcare IT. We describe how a new IT system for hospital logistics provided porters...

Transcultural healthcare immersion: a unique interprofessional experience poised to influence collaborative practice in cultural settings.

Science.gov (United States)

Morton, Jennifer

2012-01-01

This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.

An evolving systems-based methodology for healthcare planning.

Science.gov (United States)

Warwick, Jon; Bell, Gary

2007-01-01

Healthcare planning seems beset with problems at all hierarchical levels. These are caused by the 'soft' nature of many of the issues present in healthcare planning and the high levels of complexity inherent in healthcare services. There has, in recent years, been a move to utilize systems thinking ideas in an effort to gain a better understanding of the forces at work within the healthcare environment and these have had some success. This paper argues that systems-based methodologies can be further enhanced by metrication and modeling which assist in exploring the changed emergent behavior of a system resulting from management intervention. The paper describes the Holon Framework as an evolving systems-based approach that has been used to help clients understand complex systems (in the education domain) that would have application in the analysis of healthcare problems.

Some perspectives on affordable healthcare systems in China.

Science.gov (United States)

Zhang, Y T; Yan, Y S; Poon, C C Y

2007-01-01

Consistent with the global population trend, China is becoming an aging society. Over one-fifth of the world's elderly population (aged 65 and over) lives in China. Statistics show that the elderly populace in China constitutes 8% of the total population in 2006 and the percentage will be tripled to become 24% in 2050. As a result, there is inevitably an increase in the prevalence of chronic disease that accounted for almost 80% of all deaths in China in 2005. On the other hand, from 1978 to 2003, the total expenditure on healthcare in China increased from 11.02 billion RMB up to 658.41 billion RMB, and in terms of GDP, it is an increase from 3.04% to 5.62%. The annual average increase (12.1%) in healthcare investment is therefore even higher than the annual rate of GDP increase (9.38%) during the last two decades. Meeting the long-term healthcare needs of this growing elderly population and escalating healthcare expenditure pose a grim challenge to the current Chinese healthcare system and the solvency of state budgets. In fact, the healthcare services in China have become less accessible since the early 1980s when its costs soared up. The rising costs have prevented many Chinese people from seeking early medical care. The phenomenon has created a wide disparity in seeking healthcare between urban and rural areas. These trends are of particular concern to the elderly, who have higher healthcare needs yet lesser means to afford the services. Furthermore, according to the 3rd National Health Service Survey, 79.1% of rural residents and 44.8% of urban citizens did not have any form of medical insurance. Such a low percentage of coverage of medical insurance indicates that many people may not be able to afford medical services when they suffer from severe diseases. Therefore, there is a great need of a more effective and low-cost healthcare system. A new system that can allow multi-level, multi-dimensional and standardized healthcare services for urban and rural

Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality.

Science.gov (United States)

Backman, Chantal; Vanderloo, Saskia; Forster, Alan John

2016-09-01

Measuring and monitoring overall health system performance is complex and challenging but is crucial to improving quality of care. Today's health care organizations are increasingly being held accountable to develop and implement actions aimed at improving the quality of care, reducing costs, and achieving better patient-centered care. This paper describes the development of the Collaborative for Excellence in Healthcare Quality (CEHQ), a 5-year initiative to achieve higher quality of patient care in university hospitals across Canada. This bottom-up initiative took place between 2010 and 2015, and was successful in engaging health care leaders in the development of a common framework and set of performance measures for reporting and benchmarking, as well as working on initiatives to improve performance. Despite its successes, future efforts are needed to provide clear national leadership on standards for measuring performance. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Strategic alliances in healthcare: opportunities for the Veterans Affairs healthcare system.

Science.gov (United States)

Halverson, P K; Kaluzny, A D; Young, G J

1997-01-01

Strategic alliances are proving to be effective strategies for responding and adapting to changing environments, and as such they offer the U.S. Department of Veterans Affairs (VA) healthcare system valuable opportunities for accomplishing the goals of its major reorganization effort. This article begins with an examination of basic strategic-alliance structures that are employed across many different types of industries. Next, consideration is given to the ways in which these basic alliance structures may be adapted to the unique organizations and individuals that serve as providers, purchasers, and consumers of health services. Finally, this article explores how models of strategic alliance in healthcare can be tailored to the specific needs and constraints of the VA healthcare system through an examination of existing and potential alliance opportunities.

Examining quality and efficiency of the U.S. healthcare system.

Science.gov (United States)

Kumar, Sameer; Ghildayal, Neha S; Shah, Ronak N

2011-01-01

The fundamental concern of this research study is to learn the quality and efficiency of U.S. healthcare services. It seeks to examine the impact of quality and efficiency on various stakeholders to achieve the best value for each dollar spent for healthcare. The study aims to offer insights on quality reformation efforts, contemporary healthcare policy and a forthcoming change shaped by the Federal healthcare fiscal policy and to recommend the improvement objective by comparing the U.S. healthcare system with those of other developed nations. The US healthcare system is examined utilizing various data on recent trends in: spending, budgetary implications, economic indicators, i.e., GDP, inflation, wage and population growth. Process maps, cause and effect diagrams and descriptive data statistics are utilized to understand the various drivers that influence the rising healthcare cost. A proposed cause and effect diagram is presented to offer potential solutions, for significant improvement in U.S. healthcare. At present, the US healthcare system is of vital interest to the nation's economy and government policy (spending). The U.S. healthcare system is characterized as the world's most expensive yet least effective compared with other nations. Growing healthcare costs have made millions of citizens vulnerable. Major drivers of the healthcare costs are institutionalized medical practices and reimbursement policies, technology-induced costs and consumer behavior. Reviewing many articles, congressional reports, internet websites and related material, a simplified process map of the US healthcare system is presented. The financial process map is also created to further understand the overall process that connects the stakeholders in the healthcare system. Factors impacting healthcare are presented by a cause and effect diagram to further simplify the complexities of healthcare. This tool can also be used as a guide to improve efficiency by removing the "waste" from the

Integration of research and practice to improve public health and healthcare delivery through a collaborative 'Health Integration Team' model - a qualitative investigation.

Science.gov (United States)

Redwood, Sabi; Brangan, Emer; Leach, Verity; Horwood, Jeremy; Donovan, Jenny L

2016-06-22

Economic considerations and the requirement to ensure the quality, safety and integration of research with health and social care provision have given rise to local developments of collaborative organisational forms and strategies to span the translational gaps. One such model - the Health Integration Team (HIT) model in Bristol in the United Kingdom (UK) - brings together National Health Service (NHS) organisations, universities, local authorities, patients and the public to facilitate the systematic application of evidence to promote integration across healthcare pathways. This study aimed to (1) provide empirical evidence documenting the evolution of the model; (2) to identify the social and organisational processes and theory of change underlying healthcare knowledge and practice; and (3) elucidate the key aspects of the HIT model for future development and translation to other localities. Contemporaneous documents were analysed, using procedures associated with Framework Analysis to produce summarised data for descriptive accounts. In-depth interviews were undertaken with key informants and analysed thematically. Comparative methods were applied to further analyse the two data sets. One hundred forty documents were analysed and 10 interviews conducted with individuals in leadership positions in the universities, NHS commissioning and provider organisations involved in the design and implementation of the HIT model. Data coalesced around four overarching themes: 'Whole system' engagement, requiring the active recruitment of all those who have a stake in the area of practice being considered, and 'collaboration' to enable coproduction were identified as 'process' themes. System-level integration and innovation were identified as potential 'outcomes' with far-reaching impacts on population health and service delivery. The HIT model emerged as a particular response to the perceived need for integration of research and practice to improve public health and

Measuring healthcare productivity - from unit to system level.

Science.gov (United States)

Kämäräinen, Vesa Johannes; Peltokorpi, Antti; Torkki, Paulus; Tallbacka, Kaj

2016-04-18

Purpose - Healthcare productivity is a growing issue in most Western countries where healthcare expenditure is rapidly increasing. Therefore, accurate productivity metrics are essential to avoid sub-optimization within a healthcare system. The purpose of this paper is to focus on healthcare production system productivity measurement. Design/methodology/approach - Traditionally, healthcare productivity has been studied and measured independently at the unit, organization and system level. Suggesting that productivity measurement should be done in different levels, while simultaneously linking productivity measurement to incentives, this study presents the challenges of productivity measurement at the different levels. The study introduces different methods to measure productivity in healthcare. In addition, it provides background information on the methods used to measure productivity and the parameters used in these methods. A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical information for managers. Findings - The study introduces different approaches and methods to measure productivity in healthcare. Practical implications - A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical benefits for managers. Originality/value - The authors focus on the measurement of the whole healthcare production system and try to avoid sub-optimization. Additionally considering an individual patient approach, productivity measurement is examined at the unit level, the organizational level and the system level.

Transferring skills in quality collaboratives focused on improving patient logistics

NARCIS (Netherlands)

J.W.M. Weggelaar-Jansen (Anne Marie); J.D.H. van Wijngaarden (Jeroen)

2018-01-01

textabstractA quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. Our research focused on quality improvement collaboratives aiming to improve patient logistics and tried to

Manipulation Robustness of Collaborative Filtering Systems

OpenAIRE

Benjamin Van Roy; Xiang Yan

2009-01-01

A collaborative filtering system recommends to users products that similar users like. Collaborative filtering systems influence purchase decisions, and hence have become targets of manipulation by unscrupulous vendors. We provide theoretical and empirical results demonstrating that while common nearest neighbor algorithms, which are widely used in commercial systems, can be highly susceptible to manipulation, two classes of collaborative filtering algorithms which we refer to as linear and a...

Consumer response to a report card comparing healthcare systems.

Science.gov (United States)

Braun, Barbara L; Kind, Elizabeth A; Fowles, Jinnet B; Suarez, Walter G

2002-06-01

Report cards to date have focused on quality of care in health plans rather than within healthcare delivery systems. The purpose of this study was to evaluate consumer response to the first healthcare system-level report card. Qualitative assessment of consumer response. We conducted 5 focus groups of community members to evaluate consumer response to the report card; 2 included community club members, 3 included community-dwelling retired persons. Discussions were audiotaped and transcribed; comments were categorized by topic area from the script, and common themes identified. Focus group participants, in general, were unaware of the current emphasis on medical quality improvement initiatives. However, they believed that the opinion that the descriptive clinic information and patient survey data contained in the report card would be most useful mainly for choosing a healthcare system if they were dissatisfied with current medical care, if their healthcare options changed, or if they were in poor health. Personal experience was considered a more trustworthy measure of healthcare quality than were patient survey results. Trustworthiness was perceived to be higher if the report card sponsor was not affiliated with the healthcare systems being evaluated. Participants also believed care system administrators should use the data to enact positive clinic-level and physician-level changes. Healthcare consumers appreciated the attention to patient experiences and supported healthcare quality improvement initiatives. Report cards were considered important for choosing a healthcare system in certain circumstances and for guiding quality improvement efforts at all levels.

Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness.

Science.gov (United States)

Cabassa, Leopoldo J; Gomes, Arminda P; Meyreles, Quisqueya; Capitelli, Lucia; Younge, Richard; Dragatsi, Dianna; Alvarez, Juana; Manrique, Yamira; Lewis-Fernández, Roberto

2014-11-30

Health-care manager interventions improve the physical health of people with serious mental illness (SMI) and could be widely implemented in public mental health clinics. Local adaptations and customization may be needed to increase the reach of these interventions in the public mental health system and across different racial and ethnic communities. In this study, we describe how we used the collaborative intervention planning framework to customize an existing health-care manager intervention to a new patient population (Hispanics with SMI) and provider group (social workers) to increase its fit with our local community. The study was conducted in partnership with a public mental health clinic that serves predominantly Hispanic clients. A community advisory board (CAB) composed of researchers and potential implementers (e.g., social workers, primary care physicians) used the collaborative intervention planning framework, an approach that combines community-based participatory research principles and intervention mapping (IM) procedures, to inform intervention adaptations. The adaptation process included four steps: fostering collaborations between CAB members; understanding the needs of the local population through a mixed-methods needs assessment, literature reviews, and group discussions; reviewing intervention objectives to identify targets for adaptation; and developing the adapted intervention. The application of this approach enabled the CAB to identify a series of cultural and provider level-adaptations without compromising the core elements of the original health-care manager intervention. Reducing health disparities in people with SMI requires community engagement, particularly when preparing existing interventions to be used with new communities, provider groups, and practice settings. Our study illustrates one approach that can be used to involve community stakeholders in the intervention adaptation process from the very beginning to enhance the

Developing a ubiquitous health management system with healthy diet control for metabolic syndrome healthcare in Taiwan.

Science.gov (United States)

Kan, Yao-Chiang; Chen, Kai-Hong; Lin, Hsueh-Chun

2017-06-01

Self-management in healthcare can allow patients managing their health data anytime and everywhere for prevention of chronic diseases. This study established a prototype of ubiquitous health management system (UHMS) with healthy diet control (HDC) for people who need services of metabolic syndrome healthcare in Taiwan. System infrastructure comprises of three portals and a database tier with mutually supportive components to achieve functionality of diet diaries, nutrition guides, and health risk assessments for self-health management. With the diet, nutrition, and personal health database, the design enables the analytical diagrams on the interactive interface to support a mobile application for diet diary, a Web-based platform for health management, and the modules of research and development for medical care. For database integrity, dietary data can be stored at offline mode prior to transformation between mobile device and server site at online mode. The UHMS-HDC was developed by open source technology for ubiquitous health management with personalized dietary criteria. The system integrates mobile, internet, and electronic healthcare services with the diet diary functions to manage healthy diet behaviors of users. The virtual patients were involved to simulate the self-health management procedure. The assessment functions were approved by capturing the screen snapshots in the procedure. The proposed system development was capable for practical intervention. This approach details the expandable framework with collaborative components regarding the self-developed UHMS-HDC. The multi-disciplinary applications for self-health management can support the healthcare professionals to reduce medical resources and improve healthcare effects for the patient who requires monitoring personal health condition with diet control. The proposed system can be practiced for intervention in the hospital. Copyright © 2017 Elsevier B.V. All rights reserved.

Healthcare and healthcare systems: inspiring progress and future prospects.

Science.gov (United States)

Durrani, Hammad

2016-01-01

Healthcare systems globally have experienced intensive changes, reforms, developments, and improvement over the past 30 years. Multiple actors (governmental and non-governmental) and countries have played their part in the reformation of the global healthcare system. New opportunities are presenting themselves while multiple challenges still remain especially in developing countries. Better way to proceed would be to learn from historical patterns while we plan for the future in a technology-driven society with dynamic demographic, epidemiological and economic uncertainties. A structured review of both peer-reviewed and gray literature on the topic was carried out. On the whole, people are healthier, doing better financially and live longer today than 30 years ago. The number of under-5 mortality worldwide has declined from 12.7 million in 1990 to 6.3 million in 2013. Infant and maternal mortality rates have also been reduced. However, both rates are still considered high in Africa and some Asian countries. The world's population nearly doubled in these 30 years, from 4.8 billion in 1985 to 7.2 billion in 2015. The majority of the increasing population was coming from the least developed countries, i.e., 3.66 to 5.33 billion. The world will be short of 12.9 million health-care workers by 2035; today, that figure stands at 7.2 million. Health care expenditures among countries also show sharp differences. In high income countries, per person health expenditure is over USD 3,000 on average, while in poor countries, it is as low as USD 12, WHO estimate of minimum spending per person per year needed to provide basic, life-saving services is USD 44. The challenges faced by the global health system over the past 30 years have been increased in population and urbanization, behavioral changes, rise in chronic diseases, traumatic injuries, infectious diseases, specific regional conflicts and healthcare delivery security. Over the next 30 years, most of the world population

Peer-led team learning in an online course on controversial medication issues and the US healthcare system.

Science.gov (United States)

Pittenger, Amy L; LimBybliw, Amy L

2013-09-12

To implement peer-led team learning in an online course on controversial issues surrounding medications and the US healthcare system. The course was delivered completely online using a learning management system. Students participated in weekly small-group discussions in online forums, completed 3 reflective writing assignments, and collaborated on a peer-reviewed grant proposal project. In a post-course survey, students reported that the course was challenging but meaningful. Final projects and peer-reviewed assignments demonstrated that primary learning goals for the course were achieved and students were empowered to engage in the healthcare debate. A peer-led team-learning is an effective strategy for an online course offered to a wide variety of student learners. By shifting some of the learning and grading responsibility to students, the instructor workload for the course was rendered more manageable.

An Official Critical Care Societies Collaborative Statement-Burnout Syndrome in Critical Care Health-care Professionals: A Call for Action.

Science.gov (United States)

Moss, Marc; Good, Vicki S; Gozal, David; Kleinpell, Ruth; Sessler, Curtis N

2016-07-01

Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Engineering Value-Effective Healthcare Solutions: A Systems Design Perspective

DEFF Research Database (Denmark)

Patou, François; Maier, Anja

2017-01-01

Our modern healthcare systems commonly face an important dilemma. While they depend on innovation to provide continuously greater healthcare value, they also struggle financially with the burden of adopting a continuous flow of new products and services. Although several disruptive healthcare...... of Design for Evolvability and by elaborating on two examples: MRI systems and Point-of-Care in-vitro diagnostics solutions. We specifically argue that Design for Evolvability can realign the agendas of various healthcare stakeholders, serving both individual and national interests. We finally acknowledge...... the limitations of current engineering design practices and call for new theoretical and empirical research initiatives taking a systems perspective on healthcare product and service design....

Collaborative Systems – Finite State Machines

Directory of Open Access Journals (Sweden)

Ion IVAN

2011-01-01

Full Text Available In this paper the finite state machines are defined and formalized. There are presented the collaborative banking systems and their correspondence is done with finite state machines. It highlights the role of finite state machines in the complexity analysis and performs operations on very large virtual databases as finite state machines. It builds the state diagram and presents the commands and documents transition between the collaborative systems states. The paper analyzes the data sets from Collaborative Multicash Servicedesk application and performs a combined analysis in order to determine certain statistics. Indicators are obtained, such as the number of requests by category and the load degree of an agent in the collaborative system.

Knowledge management in Portuguese healthcare institutions.

Science.gov (United States)

Cruz, Sofia Gaspar; Ferreira, Maria Manuela Frederico

2016-06-01

Knowledge management imposes itself as a pressing need for the organizations of several sectors of the economy, including healthcare. to evaluate the perception of healthcare institution collaborators in relation to knowledge management in the institution where they operate and analyze the existence of differences in this perception, based on the institution's management model. a study conducted in a sample consisting of 671 collaborators from 10 Portuguese healthcare institutions with different models of management. In order to assess the knowledge management perception, we used a score designed from and based on items from the scores available in the literature. the perception of moderate knowledge management on the healthcare institutions and the statistically significant differences in knowledge management perception were evidenced in each management model. management knowledge takes place in healthcare institutions, and the current management model determines the way staff at these institutions manage their knowledge.

Mapping healthcare systems: a policy relevant analytic tool.

Science.gov (United States)

Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L V

2017-07-01

In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Telemental health: responding to mandates for reform in primary healthcare.

Science.gov (United States)

Myers, Kathleen M; Lieberman, Daniel

2013-06-01

Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

Requirements for Interoperability in Healthcare Information Systems

Directory of Open Access Journals (Sweden)

Rita Noumeir

2012-01-01

Full Text Available Interoperability is a requirement for the successful deployment of Electronic Health Records (EHR. EHR improves the quality of healthcare by enabling access to all relevant information at the diagnostic decision moment, regardless of location. It is a system that results from the cooperation of several heterogeneous distributed subsystems that need to successfully exchange information relative to a specific healthcare process. This paper analyzes interoperability impediments in healthcare by first defining them and providing concrete healthcare examples, followed by discussion of how specifications can be defined and how verification can be conducted to eliminate those impediments and ensure interoperability in healthcare. This paper also analyzes how Integrating the Healthcare Enterprise (IHE has been successful in enabling interoperability, and identifies some neglected aspects that need attention.

Collaborative Practice Model: Improving the Delivery of Bad News.

Science.gov (United States)

Bowman, Pamela N; Slusser, Kim; Allen, Deborah

2018-02-01

Ideal bad news delivery requires skilled communication and team support. The literature has primarily focused on patient preferences, impact on care decisions, healthcare roles, and communication styles, without addressing systematic implementation. This article describes how an interdisciplinary team, led by advanced practice nurses, developed and implemented a collaborative practice model to deliver bad news on a unit that had struggled with inconsistencies. Using evidence-based practices, the authors explored current processes, role perceptions and expectations, and perceived barriers to developing the model, which is now the standard of care and an example of interprofessional team collaboration across the healthcare system. This model for delivering bad news can be easily adapted to meet the needs of other clinical units.
.

Depression and diabetes: Treatment and health-care delivery

DEFF Research Database (Denmark)

Petrak, Frank; Baumeister, Harald; Skinner, Timothy C.

2015-01-01

© 2015 Elsevier Ltd. Despite research efforts in the past 20 years, scientific evidence about screening and treatment for depression in diabetes remains incomplete and is mostly focused on North American and European health-care systems. Validated instruments to detect depression in diabetes......, which are often implemented through collaborative care and stepped-care approaches. The evidence for improved glycaemic control in the treatment of depression by use of selective serotonin reuptake inhibitors or psychological approaches is conflicting; only some analyses show small to moderate...... improvements in glycaemic control. More research is needed to evaluate treatment of different depression subtypes in people with diabetes, the cost-effectiveness of treatments, the use of health-care resources, the need to account for cultural differences and different health-care systems, and new treatment...

Efficiency vs Effectiveness: a Benchmarking Study on European Healthcare Systems

Directory of Open Access Journals (Sweden)

Corrado lo Storto

2017-10-01

Full Text Available ABSTRACT. This paper illustrates a benchmarking study concerning the healthcare systems in 32 European countries as of 2011 and 2014. Particularly, this study proposes a two-dimensional approach (efficiency/effectiveness models to evaluate the performance of national healthcare systems. Data Envelopment Analysis has been adopted to compute two performance indices, measuring efficiency and effectiveness of these healthcare systems. The results of the study emphasize that the national healthcare systems achieve different efficiency and effectiveness levels. Their performance indices are uncorrelated and behave differently over time, suggesting that there might be no real trade-off between them. The healthcare systems’ efficiencies remain generally stable, while the effectiveness values significantly improved from 2011 to 2014. However, comparing the efficiency and effectiveness scores, the authors identified a group of countries with the lowest performing healthcare systems that includes Ukraine, Bulgaria, Switzerland, Lithuania, and Romania. These countries need to implement healthcare reforms aimed at reducing resource intensity and increasing the quality of medical services. The results also showed the benefits of the proposed approach, which can help policy makers to identify shortcomings in national healthcare systems and justify the need for their reform.

Healthcare system information at language schools for newly arrived immigrants

DEFF Research Database (Denmark)

Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith

2017-01-01

a language school in Copenhagen in 2012 received either a course or written information on the Danish healthcare system and subsequently evaluated this quantitatively. Results: The evaluation revealed a positive appraisal of the course/information provided. Conclusion: In times of austerity, incorporating......Objective: In most European countries, immigrants do not systematically learn about the host countries’ healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Method: Immigrants attending...... healthcare information into an already existing language programme may be pertinent for providing immigrants with knowledge on the healthcare system....

A model for understanding diagnostic imaging referrals and complex interaction processes within the bigger picture of a healthcare system

International Nuclear Information System (INIS)

Makanjee, Chandra R.; Bergh, Anne-Marie; Hoffmann, Willem A.

2014-01-01

Using experiences from the South African public healthcare system with limited resources, this review proposes a model that captures a holistic perspective of diagnostic imaging services embedded in a network of negotiated decision-making processes. Professional interdependency and interprofessional collaboration, cooperation and coordination are built around the central notion of integration in order to achieve a seamless transition through the continuum of various types of services needed to come to a diagnosis. Health-system role players interact with patients who enter the system from the perspective of their life-world. The distribution of diagnostic imaging services – within one setting or at multiple levels of care – demonstrates how fragments of information are filtered, interpreted and transformed at each point of care. The proposed model could contribute to alignment towards a common goal: services providing holistic quality of care within and beyond a complex healthcare system

Selecting healthcare information systems provided by third-party vendors: a mind map beyond the manuals.

Science.gov (United States)

Gortzis, Lefteris G

2010-01-01

The selection of a new healthcare information system (HIS) has always been a daunting process for clinicians, health care providers and policy makers. The objective of this study is to present the lessons learned and the main findings from several relevant case studies to support this process. Data were collected by retrospectively reviewing the summative results of three well-established systems, acquiring feedback from two E.U. projects, and conducting semi-structured interviews with a number of collaborators involved in electronic healthcare interventions. Selection issues were identified and classified into the following five categories: (i) data creation, (ii) data management, (iii) data sharing, (iv) data presentation and (v) modules management. A mind map was also structured to provide a more manageable list of issues concerning the most common electronic clinical technologies (e-CT). The vendor manual is intended as an overview of the merchandise e-CT and therefore has limited potential in supporting effectively the selection process of a new HIS. The present classification and the mind map - based on lessons learned - provide a ready-to-use toolkit for supporting the HIS selection process when healthcare organisations are unable to employ research development groups to lay the groundwork for building a new HIS from scratch.

Army Healthcare Enterprise Management System

National Research Council Canada - National Science Library

2001-01-01

.... The complaint alleged that the Army Healthcare Enterprise Management System was not properly competed, potential conflicts of interest existed, and possible contract performance problems existed...

Infrastructure Support for Collaborative Pervasive Computing Systems

DEFF Research Database (Denmark)

Vestergaard Mogensen, Martin

Collaborative Pervasive Computing Systems (CPCS) are currently being deployed to support areas such as clinical work, emergency situations, education, ad-hoc meetings, and other areas involving information sharing and collaboration.These systems allow the users to work together synchronously......, but from different places, by sharing information and coordinating activities. Several researchers have shown the value of such distributed collaborative systems. However, building these systems is by no means a trivial task and introduces a lot of yet unanswered questions. The aforementioned areas......, are all characterized by unstable, volatile environments, either due to the underlying components changing or the nomadic work habits of users. A major challenge, for the creators of collaborative pervasive computing systems, is the construction of infrastructures supporting the system. The complexity...

System integrational and migrational concepts and methods within healthcare

DEFF Research Database (Denmark)

Endsleff, F; Loubjerg, P

1997-01-01

In this paper an overview and comparison of the basic concepts and methods behind different system integrational implementations is given, including the DHE, which is based on the coming Healthcare Information Systems Architecture pre-standard HISA, developed by CEN TC251. This standard and the DHE...... (Distributed Healthcare Environment) not only provides highly relevant standards, but also provides an efficient and well structured platform for Healthcare IT Systems....

Healthcare information technology infrastructures in Turkey.

Science.gov (United States)

Dogac, A; Yuksel, M; Ertürkmen, G L; Kabak, Y; Namli, T; Yıldız, M H; Ay, Y; Ceyhan, B; Hülür, U; Oztürk, H; Atbakan, E

2014-05-22

The objective of this paper is to describe some of the major healthcare information technology (IT) infrastructures in Turkey, namely, Sağlık-Net (Turkish for "Health-Net"), the Centralized Hospital Appointment System, the Basic Health Statistics Module, the Core Resources Management System, and the e-prescription system of the Social Security Institution. International collaboration projects that are integrated with Sağlık-Net are also briefly summarized. The authors provide a survey of the some of the major healthcare IT infrastructures in Turkey. Sağlık-Net has two main components: the National Health Information System (NHIS) and the Family Medicine Information System (FMIS). The NHIS is a nation-wide infrastructure for sharing patients' Electronic Health Records (EHRs). So far, EHRs of 78.9 million people have been created in the NHIS. Similarly, family medicine is operational in the whole country via FMIS. Centralized Hospital Appointment System enables the citizens to easily make appointments in healthcare providers. Basic Health Statistics Module is used for collecting information about the health status, risks and indicators across the country. Core Resources Management System speeds up the flow of information between the headquarters and Provincial Health Directorates. The e-prescription system is linked with Sağlık-Net and seamlessly integrated with the healthcare provider information systems. Finally, Turkey is involved in several international projects for experience sharing and disseminating national developments. With the introduction of the "Health Transformation Program" in 2003, a number of successful healthcare IT infrastructures have been developed in Turkey. Currently, work is going on to enhance and further improve their functionality.

The healthcare system and provision of oral healthcare in European Union member states. Part 4: Greece.

Science.gov (United States)

Damaskinos, P; Koletsi-Kounari, H; Economou, C; Eaton, K A; Widström, E

2016-03-11

This paper presents a description of the healthcare system and how oral healthcare is organised and provided in Greece, a country in a deep economic and social crisis. The national health system is underfunded, with severe gaps in staffing levels and the country has a large private healthcare sector. Oral healthcare has been largely provided in the private sector. Most people are struggling to survive and have no money to spend on general and oral healthcare. Unemployment is rising and access to healthcare services is more difficult than ever. Additionally, there has been an overproduction of dentists and no development of team dentistry. This has led to under or unemployment of dentists in Greece and their migration to other European Union member states, such as the United Kingdom, where over 600 Greek dentists are currently working.

Knowledge management systems success in healthcare: Leadership matters.

Science.gov (United States)

Ali, Nor'ashikin; Tretiakov, Alexei; Whiddett, Dick; Hunter, Inga

2017-01-01

To deliver high-quality healthcare doctors need to access, interpret, and share appropriate and localised medical knowledge. Information technology is widely used to facilitate the management of this knowledge in healthcare organisations. The purpose of this study is to develop a knowledge management systems success model for healthcare organisations. A model was formulated by extending an existing generic knowledge management systems success model by including organisational and system factors relevant to healthcare. It was tested by using data obtained from 263 doctors working within two district health boards in New Zealand. Of the system factors, knowledge content quality was found to be particularly important for knowledge management systems success. Of the organisational factors, leadership was the most important, and more important than incentives. Leadership promoted knowledge management systems success primarily by positively affecting knowledge content quality. Leadership also promoted knowledge management use for retrieval, which should lead to the use of that better quality knowledge by the doctors, ultimately resulting in better outcomes for patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals' views.

Science.gov (United States)

Lee, Ping Yein; Lee, Yew Kong; Ng, Chirk Jenn

2012-04-30

The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public-private) health system. In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010-11. Healthcare professionals consisting of general practitioners (n = 11), medical officers (n = 8), diabetes educators (n = 3), government policy makers (n = 4), family medicine specialists (n = 10) and endocrinologists (n = 2) were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients' peer group sessions; increasing awareness and demystifying insulin via public campaigns; and subsidising glucose

How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals’ views

Directory of Open Access Journals (Sweden)

Lee Ping Yein

2012-04-01

Full Text Available Abstract Background The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public–private health system. Methods In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010–11. Healthcare professionals consisting of general practitioners (n = 11, medical officers (n = 8, diabetes educators (n = 3, government policy makers (n = 4, family medicine specialists (n = 10 and endocrinologists (n = 2 were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Results Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients’ peer group sessions; increasing awareness and demystifying

Evaluation of a Pilot Asthma Care Program for Electronic Communication between School Health and a Healthcare System's Electronic Medical Record.

Science.gov (United States)

Reeves, Kelly W; Taylor, Yhenneko; Tapp, Hazel; Ludden, Thomas; Shade, Lindsay E; Burton, Beth; Courtlandt, Cheryl; Dulin, Michael

2016-10-19

Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient's treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation. The implementation process and the potential impact of the communication with providers on the reoccurrence of asthma exacerbations with the linked patients were evaluated. By engaging stakeholders from the school system and the healthcare system, we were able to collaboratively design a communication process and implement a pilot which demonstrated the feasibility of electronic communication between school nurses and primary care providers. Outcomes data was collected from the electronic medical record to examine the frequency of asthma exacerbations among patients with a message from their school nurse. The percent of exacerbations in the 12 months before and after electronic communication was compared using McNemar's test. The pilot system successfully established communication between the school nurse and primary care provider for 33 students who had been hospitalized for asthma and a decrease in hospital admissions was observed with students whose school nurse communicated through the EMR with the primary care provider. Findings suggest a collaborative model of care that is enhanced through electronic communication via the EMR could positively impact the health of children with asthma or other chronic illnesses.

Globally Collaborative Experiential Learning

Directory of Open Access Journals (Sweden)

Takeshi UTSUMI

2005-07-01

Full Text Available ABSTRACT The Global University System (GUS [Utsumi, et al, 2003] is a worldwide initiative to create advanced telecommunications infrastructure for access to educational resources across national and cultural boundaries for global peace. GUS aims to create a worldwide consortium of universities to provide the underdeveloped world with access to 21st Century education via broadband Internet technologies. The aim is to achieve “education and healthcare for all,” anywhere, anytime and at any pace. The GUS works in the major regions of the globe with partnerships of higher education and healthcare institutions. Learners in these regions will be able to take their courses from member institutions around the world to receive a GUS degree. These learners and their professors from partner institutions will also form a global forum for exchange of ideas and information and for conducting collaborative research and development with emerging global GRID computer network technology. Globally Collaborative Environmental Peace Gaming (GCEPG project [Utsumi, 2003] with a globally distributed computer simulation system, focusing on the issue of environment and sustainable development in developing countries, is to train would-be decision-makers in crisis management, conflict resolution, and negotiation techniques basing on “facts and figures.” The GUS will supply game players from around the world.

Cyberterrorism: is the U.S. healthcare system safe?

Science.gov (United States)

Harries, David; Yellowlees, Peter M

2013-01-01

The Internet has brought with it many benefits; key among them has been its ability to allow the expansion of communication and transfer of all kinds of information throughout the U.S. healthcare system. As a consequence, healthcare has become increasingly dependent on the activities carried out in that environment. It is this very dependence that increases the likelihood of individuals or organizations conducting activities through the Internet that will cause physical and/or psychological harm. These activities have become known by the term "cyberterrorism." In the healthcare landscape this can appear in a variety of forms, such as bringing down a hospital computer system or publicly revealing private medical records. Whatever shape it takes, the general effects are the same: patient care is compromised, and trust in the health system is diminished. Fortunately no significant cyber attack has been successfully launched against a U.S. healthcare organization to date. However, there is evidence to suggest that cyber threats are increasing and that much of the U.S. healthcare system is ill equipped to deal with them. Securing cyberspace is not an easy proposition as the threats are constantly changing, and recognizing that cyberterrorism should be part of a broader information technology risk management strategy, there are several"best practices" that can be adopted by healthcare organizations to protect themselves against cyber attacks.

Healthcare systems--an international review: an overview.

Science.gov (United States)

Lameire, N; Joffe, P; Wiedemann, M

1999-01-01

Based on the source of their funding, three main models of healthcare can be distinguished. The first is the Beveridge model, which is based on taxation and has many public providers. The second is the Bismarck 'mixed' model, funded by a premium-financed social insurance system and with a mixture of public and private providers. Finally, the 'Private Insurance model' is only in existence in the US. The present report explores the impact of these healthcare models on the access to, quality and cost of healthcare in selected European countries. Access is nearly 100% in countries with a public provider system, while in most of the 'mixed' countries, the difference from 100% is made up by supplementary private insurance. No differences are seen between public and mixed provider systems in terms of quality of care, despite the fact that the countries with the former model spend, in general, less of their Gross National Product on healthcare. The Private Insurance/private provider model of the US produces the highest costs, but is lowest in access and is close to lowest ranking in quality parameters.

Maternal healthcare in context: A qualitative study of women's tactics to improve their experience of public healthcare in rural Burkina Faso

DEFF Research Database (Denmark)

Østergaard, Lise Rosendal

2015-01-01

their chances of having a positive experience with public maternal healthcare. The synthesis of the cases shows that, in a context of poverty and social insecurity, women employ five tactics: establishing good relations with health workers, being mindful of their ‘health booklet’, attending prenatal care......Improving the use of public maternal health facilities to prevent maternal death is a priority in developing countries. Accumulating evidence suggests that a key factor in choosing a facility-based delivery is the collaboration and the communication between healthcare providers and women....... This article attempts to provide a fine-grained understanding of health system deficiencies, healthcare provider practices and women's experiences with maternal public healthcare. This article presents findings from ethnographic research conducted in the Central-East Region of Burkina Faso over a period...

Design principles for achieving integrated healthcare information systems.

Science.gov (United States)

Jensen, Tina Blegind

2013-03-01

Achieving integrated healthcare information systems has become a common goal for many countries in their pursuit of obtaining coordinated and comprehensive healthcare services. This article focuses on how a small local project termed 'Standardized pull of patient data' expanded and is now used on a large scale providing a majority of hospitals, general practitioners and citizens across Denmark with the possibility of accessing healthcare data from different electronic patient record systems and other systems. I build on design theory for information infrastructures, as presented by Hanseth and Lyytinen, to examine the design principles that facilitated this smallscale project to expand and become widespread. As a result of my findings, I outline three lessons learned that emphasize: (i) principles of flexibility, (ii) expansion from the installed base through modular strategies and (iii) identification of key healthcare actors to provide them with immediate benefits.

Creating a Regional Healthcare Network: People First.

Science.gov (United States)

Michel-Verkerke, Margreet B

2016-01-01

Care organizations in the Dutch region Apeldoorn want to collaborate more in order to improve the care provision to elderly and psychiatric patients living independently. In order to support the collaboration they intend to create a regional digital healthcare network. The research was focused on the relevance of a regional healthcare network for care providers. Eleven semi-structured interviews based on the USE IT-model, were conducted with care providers and staff members. Results show that care providers need to tune their activities for this target group and create an agreement on integrated care. The relevance of a digital communication and collaboration platform is high. The regional healthcare network should support the collaboration between care providers by: 1. Offering a communication platform to replace the time consuming communication by telephone; 2. Making patient information available for patient and care provider at patients' homes; 3. Giving insight in who is giving what care to whom; and 4. Giving access to knowledge about the target group: elderly and psychiatric patients living independently.

State of science: human factors and ergonomics in healthcare.

Science.gov (United States)

Hignett, Sue; Carayon, Pascale; Buckle, Peter; Catchpole, Ken

2013-01-01

The past decade has seen an increase in the application of human factors and ergonomics (HFE) techniques to healthcare delivery in a broad range of contexts (domains, locations and environments). This paper provides a state of science commentary using four examples of HFE in healthcare to review and discuss analytical and implementation challenges and to identify future issues for HFE. The examples include two domain areas (occupational ergonomics and surgical safety) to illustrate a traditional application of HFE and the area that has probably received the most research attention. The other two examples show how systems and design have been addressed in healthcare with theoretical approaches for organisational and socio-technical systems and design for patient safety. Future opportunities are identified to develop and embed HFE systems thinking in healthcare including new theoretical models and long-term collaborative partnerships. HFE can contribute to systems and design initiatives for both patients and clinicians to improve everyday performance and safety, and help to reduce and control spiralling healthcare costs. There has been an increase in the application of HFE techniques to healthcare delivery in the past 10 years. This paper provides a state of science commentary using four illustrative examples (occupational ergonomics, design for patient safety, surgical safety and organisational and socio-technical systems) to review and discuss analytical and implementation challenges and identify future issues for HFE.

Engineering the system of healthcare delivery

National Research Council Canada - National Science Library

Rouse, William B; Cortese, Denis A

2010-01-01

"As the United States continues to debate reform of its healthcare system, this book argues that providing health insurance for all without improving the delivery system will not improve the current...

Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

Directory of Open Access Journals (Sweden)

Nurul-Ain Mohd-Tahir

2015-07-01

Full Text Available Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%. Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients’ demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between

Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system.

Science.gov (United States)

Mohd-Tahir, Nurul-Ain; Paraidathathu, Thomas; Li, Shu-Chuen

2015-01-01

Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients' demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders

Discover collaboration: Collaborative learning from the implementation of a discovery system

Directory of Open Access Journals (Sweden)

Åsa Forsberg

2013-12-01

Full Text Available Background Lund University Library purchased and implemented a new discovery system in the end of 2011 and the beginning of 2012. Historically there has been no collaboration between the digital library unit and the pedagogical unit at the University Library. The conditions for the implementation were quite difficult; an extremely tight time frame, changes of the member of staff, high demands from the library network, a bad relation with current system supplier, a dependency of the current system and its functionalities. What to do? In order to reach trustworthiness and to make sure that we have a learning perspective in all the processes we initiated a close collaboration between the digital unit and the pedagogical unit and formed an implementation group. We also initiated a close and active collaboration between the implementation group and an expert group formed by members from the faculty libraries i.e. the super user group. Activities We had four workshops about pedagogical issues regarding discovery systems. The workshops turned out to be a forum for a dialogue between the digital library, the pedagogical unit and the teacher librarians. They resulted in an action plan which was integrated in the implementation process. We also invited colleagues to informal discussions about the pedagogical use of the discovery system. We encouraged all teaching librarians to share their educational materials on our intranet. Conclusion We found the collaborative strategy fruitful and not only did it result in a closer collaboration between the digital library and the pedagogical unit but also with the library network. Due to several reasons we conducted a new tender of a discovery system during 2012. The tender resulted in a new system with a different supplier. In the implementation started in the autumn 2012, we implemented the experiences and learnings gained by our previous implementation.

The eICU research institute - a collaboration between industry, health-care providers, and academia.

Science.gov (United States)

McShea, Michael; Holl, Randy; Badawi, Omar; Riker, Richard R; Silfen, Eric

2010-01-01

As the volume of data that is electronically available promliferates, the health-care industry is identifying better ways to use this data for patient care. Ideally, these data are collected in real time, can support point-of-care clinical decisions, and, by providing instantaneous quality metrics, can create the opportunities to improve clinical practice as the patient is being cared for. The business-world technology supporting these activities is referred to as business intelligence, which offers competitive advantage, increased quality, and operational efficiencies. The health-care industry is plagued by many challenges that have made it a latecomer to business intelligence and data-mining technology, including delayed adoption of electronic medical records, poor integration between information systems, a lack of uniform technical standards, poor interoperability between complex devices, and the mandate to rigorously protect patient privacy. Efforts at developing a health care equivalent of business intelligence (which we will refer to as clinical intelligence) remains in its infancy. Until basic technology infrastructure and mature clinical applications are developed and implemented throughout the health-care system, data aggregation and interpretation cannot effectively progress. The need for this approach in health care is undisputed. As regional and national health information networks emerge, we need to develop cost-effective systems that reduce time and effort spent documenting health-care data while increasing the application of knowledge derived from that data.

A web-based information system for a regional public mental healthcare service network in Brazil.

Science.gov (United States)

Yoshiura, Vinicius Tohoru; de Azevedo-Marques, João Mazzoncini; Rzewuska, Magdalena; Vinci, André Luiz Teixeira; Sasso, Ariane Morassi; Miyoshi, Newton Shydeo Brandão; Furegato, Antonia Regina Ferreira; Rijo, Rui Pedro Charters Lopes; Del-Ben, Cristina Marta; Alves, Domingos

2017-01-01

Regional networking between services that provide mental health care in Brazil's decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients' status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized

Understanding how orthopaedic surgery practices generate value for healthcare systems.

Science.gov (United States)

Olson, Steven A; Mather, Richard C

2013-06-01

Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

Hadoop-Based Healthcare Information System Design and Wireless Security Communication Implementation

Directory of Open Access Journals (Sweden)

Hongsong Chen

2015-01-01

Full Text Available Human health information from healthcare system can provide important diagnosis data and reference to doctors. However, continuous monitoring and security storage of human health data are challenging personal privacy and big data storage. To build secure and efficient healthcare application, Hadoop-based healthcare security communication system is proposed. In wireless biosensor network, authentication and key transfer should be lightweight. An ECC (Elliptic Curve Cryptography based lightweight digital signature and key transmission method are proposed to provide wireless secure communication in healthcare information system. Sunspot wireless sensor nodes are used to build healthcare secure communication network; wireless nodes and base station are assigned different tasks to achieve secure communication goal in healthcare information system. Mysql database is used to store Sunspot security entity table and measure entity table. Hadoop is used to backup and audit the Sunspot security entity table. Sqoop tool is used to import/export data between Mysql database and HDFS (Hadoop distributed file system. Ganglia is used to monitor and measure the performance of Hadoop cluster. Simulation results show that the Hadoop-based healthcare architecture and wireless security communication method are highly effective to build a wireless healthcare information system.

Using Genetic Algorithms for Building Metrics of Collaborative Systems

Directory of Open Access Journals (Sweden)

Cristian CIUREA

2011-01-01

Full Text Available he paper objective is to reveal the importance of genetic algorithms in building robust metrics of collaborative systems. The main types of collaborative systems in economy are presented and some characteristics of genetic algorithms are described. A genetic algorithm was implemented in order to determine the local maximum and minimum points of the relative complexity function associated to a collaborative banking system. The intelligent collaborative systems based on genetic algorithms, representing the new generation of collaborative systems, are analyzed and the implementation of auto-adaptive interfaces in a banking application is described.

Intelligent scheduling of execution for customized physical fitness and healthcare system.

Science.gov (United States)

Huang, Chung-Chi; Liu, Hsiao-Man; Huang, Chung-Lin

2015-01-01

Physical fitness and health of white collar business person is getting worse and worse in recent years. Therefore, it is necessary to develop a system which can enhance physical fitness and health for people. Although the exercise prescription can be generated after diagnosing for customized physical fitness and healthcare. It is hard to meet individual execution needs for general scheduling of physical fitness and healthcare system. So the main purpose of this research is to develop an intelligent scheduling of execution for customized physical fitness and healthcare system. The results of diagnosis and prescription for customized physical fitness and healthcare system will be generated by fuzzy logic Inference. Then the results of diagnosis and prescription for customized physical fitness and healthcare system will be scheduled and executed by intelligent computing. The scheduling of execution is generated by using genetic algorithm method. It will improve traditional scheduling of exercise prescription for physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent scheduling of execution for customized physical fitness and healthcare system.

[Quality in the healthcare sector: new strategic measures for new challenges].

Science.gov (United States)

Larroca, Norberto

2002-01-01

This article reviews the experience of the organizations representing the private healthcare industry in Argentina in their request to improve the quality of care. In it, the author highlights how their collaboration with the PAHO/WHO in the nineties led to the drafting of a Quality Accreditation Handbook, as well as its circulation in most of the countries in the area. Ten years on, the new challenges are analyzed in order to achieve better quality fro all, without limits. With these challenges in mind, the study presents the five programmes being developed at present, by the private health sector as a way of collaborating with society and the government in its progress towards the nationalization of resources and achieving a fairer system and better quality in healthcare.

Mixed Methods Analysis of Medical Error Event Reports: A Report from the ASIPS Collaborative

National Research Council Canada - National Science Library

Harris, Daniel M; Westfall, John M; Fernald, Douglas H; Duclos, Christine W; West, David R; Niebauer, Linda; Marr, Linda; Quintela, Javan; Main, Deborah S

2005-01-01

The Applied Strategies for Improving Patient Safety (ASIPS) collaborative developed an ambulatory primary care patient safety reporting system through an Agency for Healthcare Research and Quality (AHRQ...

Commercial versus in-situ usability testing of healthcare information systems: towards "public" usability testing in healthcare organizations.

Science.gov (United States)

Kushniruk, Andre W; Borycki, Elizabeth M; Kannry, Joseph

2013-01-01

The need for improved usability in healthcare IT has been widely recognized. In addition, methods from usability engineering, including usability testing and usability inspection have received greater attention. Many vendors of healthcare software are now employing usability testing methods in the design and development of their products. However, despite this, the usability of healthcare IT is still considered to be problematic and many healthcare organizations that have purchased systems that have been tested at vendor testing sites are still reporting a range of usability and safety issues. In this paper we explore the distinction between commercial usability testing (conducted at centralized vendor usability laboratories and limited beta test sites) and usability testing that is carried out locally within healthcare organizations that have purchased vendor systems and products (i.e. public "in-situ" usability testing). In this paper it will be argued that both types of testing (i.e. commercial vendor-based testing) and in-situ testing are needed to ensure system usability and safety.

Development of Intelligent Auxiliary System for Customized Physical Fitness and Healthcare

Directory of Open Access Journals (Sweden)

Huang Chung-Chi

2016-01-01

Full Text Available With the advent of global high-tech industry and commerce era, the sedentary reduces opportunities of physical activity. And physical fitness and health of people is getting worse and worse. At present, the shortage of physical fitness instructors greatly affected the effectiveness of health promotion. Therefore, it is necessary to develop an auxiliary system which can reduce the workload of instructors and enhance physical fitness and health for people. But current general physical fitness and healthcare system is hard to meet individualized needs. The main purpose of this research is to develop an intelligent auxiliary system for customized physical fitness and healthcare. It records all processes of physical fitness and healthcare system by wireless sensors network. The results of intelligent auxiliary systems for customized physical fitness and healthcare will be generated by fuzzy logic Inference. It will improve individualized physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent auxiliary system for customized physical fitness and healthcare.

LIFE CYCLE ASSESSMENT IN HEALTHCARE SYSTEM OPTIMIZATION. INTRODUCTION

Directory of Open Access Journals (Sweden)

V. Sarancha

2015-03-01

Full Text Available Article describes the life cycle assessment method and introduces opportunities for method performance in healthcare system settings. LSA draws attention to careful use of resources, environmental, human and social responsibility. Modelling of environmental and technological inputs allows optimizing performance of the system. Various factors and parameters that may influence effectiveness of different sectors in healthcare system are detected. Performance optimization of detected parameters could lead to better system functioning, higher patient safety, economic sustainability and reduce resources consumption.

3rd August 2010 - CEO Siemens Healthcare Sector, Chief Technology Officer, Head of Corporate Technology, Member of Siemens AG Managing Board, Germany, H. Requardt, signing the guest book with CERN Director-General R. Heuer

CERN Multimedia

Maximilien Brice

2010-01-01

CERN-HI-1008148 11: H. von Dewitz in the ATLAS Visitor centre with Collaboration member M. Hauschild (left) and Former IT Department Head W. von Rüden (right) CERN-HI-1008148 18 : Head of Innovation and Systems Projects, Siemens Healthcare Sector O. Heid (left) in the ATLAS Visitor centre with Collaboration member M. Hauschild. CERN-HI-1008148: in the ATLAS visitor centre, from left to right: Former IT Department Head W. von Rüden; ATLAS Collaboration P. Mättig; CEO Siemens Healthcare Sector, Chief Technology Officer, Head of Corporate Technology, Member of Siemens AG Managing Board, Germany, H. Requardt; Head of Innovation and Systems Projects, Siemens Healthcare Sector O. Heid; H. von Dewitz; ATLAS Collaboration member M. Hauschild.

Enhancing Health-Care Services with Mixed Reality Systems

Science.gov (United States)

Stantchev, Vladimir

This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

Health Maintenance System (HMS) Hardware Research, Design, and Collaboration

Science.gov (United States)

Gonzalez, Stefanie M.

2010-01-01

The Space Life Sciences division (SLSD) concentrates on optimizing a crew member's health. Developments are translated into innovative engineering solutions, research growth, and community awareness. This internship incorporates all those areas by targeting various projects. The main project focuses on integrating clinical and biomedical engineering principles to design, develop, and test new medical kits scheduled for launch in the Spring of 2011. Additionally, items will be tagged with Radio Frequency Interference Devices (RFID) to keep track of the inventory. The tags will then be tested to optimize Radio Frequency feed and feed placement. Research growth will occur with ground based experiments designed to measure calcium encrusted deposits in the International Space Station (ISS). The tests will assess the urine calcium levels with Portable Clinical Blood Analyzer (PCBA) technology. If effective then a model for urine calcium will be developed and expanded to microgravity environments. To support collaboration amongst the subdivisions of SLSD the architecture of the Crew Healthcare Systems (CHeCS) SharePoint site has been redesigned for maximum efficiency. Community collaboration has also been established with the University of Southern California, Dept. of Aeronautical Engineering and the Food and Drug Administration (FDA). Hardware disbursements will transpire within these communities to support planetary surface exploration and to serve as an educational tool demonstrating how ground based medicine influenced the technological development of space hardware.

Process-driven selection of information systems for healthcare

Science.gov (United States)

Mills, Stephen F.; Yeh, Raymond T.; Giroir, Brett P.; Tanik, Murat M.

1995-05-01

Integration of networking and data management technologies such as PACS, RIS and HIS into a healthcare enterprise in a clinically acceptable manner is a difficult problem. Data within such a facility are generally managed via a combination of manual hardcopy systems and proprietary, special-purpose data processing systems. Process modeling techniques have been successfully applied to engineering and manufacturing enterprises, but have not generally been applied to service-based enterprises such as healthcare facilities. The use of process modeling techniques can provide guidance for the placement, configuration and usage of PACS and other informatics technologies within the healthcare enterprise, and thus improve the quality of healthcare. Initial process modeling activities conducted within the Pediatric ICU at Children's Medical Center in Dallas, Texas are described. The ongoing development of a full enterprise- level model for the Pediatric ICU is also described.

Public trust in the healthcare system in a developing country.

Science.gov (United States)

Peters, Dexnell; Youssef, Farid F

2016-04-01

Broadly defined, trust in the healthcare system is concerned with how the public perceives the system and the actors therein as it pertains to their ability to both deliver services and seek the best interests of their clientele. Trust is important because it impacts upon a range of health behaviors including compliance and ultimately affects the ability of the healthcare system to meet its goals. While several studies exist on public trust within the developed world, few studies have explored this issue in developing countries. This paper therefore assesses public trust in the healthcare system of a developing small island nation, Trinidad and Tobago. A cross-sectional survey of adults was conducted using a questionnaire that has been successfully used across Europe. We report that trust levels in the healthcare system in Trinidad and Tobago are relatively low with less than 50% of persons indicating fair trust in the healthcare system. In addition, individual health professionals also did not score highly with lowest scores found for nurses and complementary therapists. Results on four out of five dimensions of trust also demonstrated scores significantly lower than those reported in more developed nations. Open-ended comments supported these findings with the majority of persons indicating a lack of confidence in the healthcare system. These results may reflect the reality in the wider developing world, and we suggest that bolstering trust is a needed area of focus in the delivery of healthcare services throughout the nation. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

A review of the Australian healthcare system: A policy perspective

Science.gov (United States)

Sambasivan, Murali

2018-01-01

This article seeks to review the Australian healthcare system and compare it to similar systems in other countries to highlight the main issues and problems. A literature search for articles relating to the Australian and other developed countries’ healthcare systems was conducted by using Google and the library of Victoria University, Melbourne. Data from the websites of the Commonwealth of Australia, the Australian Institute of Health and Welfare, the Australian Productivity Commission, the Organisation for Economic Co-operation and Development and the World Bank have also been used. Although care within the Australian healthcare system is among the best in the world, there is a need to change the paradigm currently being used to measure the outcomes and allocate resources. The Australian healthcare system is potentially dealing with two main problems: (a) resource allocation, and (b) performance and patient outcomes improvements. An interdisciplinary research approach in the areas of performance measurement, quality and patient outcomes improvement could be adopted to discover new insights, by using the policy implementation error/efficiency and bureaucratic capacity. Hospital managers, executives and healthcare management practitioners could use an interdisciplinary approach to design new performance measurement models, in which financial performance, quality, healthcare and patient outcomes are blended in, for resource allocation and performance improvement. This article recommends that public policy implementation error and the bureaucratic capacity models be applied to healthcare to optimise the outcomes for the healthcare system in Australia. In addition, it highlights the need for evaluation of the current reimbursement method, freedom of choice to patients and a regular scrutiny of the appropriateness of care. PMID:29686869

[Interpretation in the Danish health-care system].

Science.gov (United States)

Lund Hansen, Marianne Taulo; Nielsen, Signe Smith

2013-03-04

Communication between health professional and patient is central for treatment and patient safety in the health-care system. This systematic review examines the last ten years of specialist literature concerning interpretation in the Danish health-care system. Structural search in two databases, screening of references and recommended literature from two scientists led to identification of seven relevant articles. The review showed that professional interpreters were not used consistently when needed. Family members were also used as interpreters. These results were supported by international investigations.

Network security vulnerabilities and personal privacy issues in Healthcare Information Systems: a case study in a private hospital in Turkey.

Science.gov (United States)

Namoğlu, Nihan; Ulgen, Yekta

2013-01-01

Healthcare industry has become widely dependent on information technology and internet as it moves from paper to electronic records. Healthcare Information System has to provide a high quality service to patients and a productive knowledge share between healthcare staff by means of patient data. With the internet being commonly used across hospitals, healthcare industry got its own share from cyber threats like other industries in the world. The challenge is allowing knowledge transfer to hospital staff while still ensuring compliance with security mandates. Working in collaboration with a private hospital in Turkey; this study aims to reveal the essential elements of a 21st century business continuity plan for hospitals while presenting the security vulnerabilities in the current hospital information systems and personal privacy auditing standards proposed by regulations and laws. We will survey the accreditation criteria in Turkey and counterparts in US and EU. We will also interview with medical staff in the hospital to understand the needs for personal privacy and the technical staff to perceive the technical requirements in terms of network security configuration and deployment. As hospitals are adopting electronic transactions, it should be considered a must to protect these electronic health records in terms of personal privacy aspects.

Utilizing Health Information Technology to Support Universal Healthcare Delivery: Experience of a National Healthcare System.

Science.gov (United States)

Syed-Abdul, Shabbir; Hsu, Min-Huei; Iqbal, Usman; Scholl, Jeremiah; Huang, Chih-Wei; Nguyen, Phung Anh; Lee, Peisan; García-Romero, Maria Teresa; Li, Yu-Chuan Jack; Jian, Wen-Shan

2015-09-01

Recent discussions have focused on using health information technology (HIT) to support goals related to universal healthcare delivery. These discussions have generally not reflected on the experience of countries with a large amount of experience using HIT to support universal healthcare on a national level. HIT was compared globally by using data from the Ministry of the Interior, Republic of China (Taiwan). Taiwan has been providing universal healthcare since 1995 and began to strategically implement HIT on a national level at that time. Today the national-level HIT system is more extensive in Taiwan than in many other countries and is used to aid administration, clinical care, and public health. The experience of Taiwan thus can provide an illustration of how HIT can be used to support universal healthcare delivery. In this article we present an overview of some key historical developments and successes in the adoption of HIT in Taiwan over a 17-year period, as well as some more recent developments. We use this experience to offer some strategic perspectives on how it can aid in the adoption of large-scale HIT systems and on how HIT can be used to support universal healthcare delivery.

Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region.

Science.gov (United States)

Barbarito, Fulvio; Pinciroli, Francesco; Mason, John; Marceglia, Sara; Mazzola, Luca; Bonacina, Stefano

2012-08-01

Information technologies (ITs) have now entered the everyday workflow in a variety of healthcare providers with a certain degree of independence. This independence may be the cause of difficulty in interoperability between information systems and it can be overcome through the implementation and adoption of standards. Here we present the case of the Lombardy Region, in Italy, that has been able, in the last 10 years, to set up the Regional Social and Healthcare Information System, connecting all the healthcare providers within the region, and providing full access to clinical and health-related documents independently from the healthcare organization that generated the document itself. This goal, in a region with almost 10 millions citizens, was achieved through a twofold approach: first, the political and operative push towards the adoption of the Health Level 7 (HL7) standard within single hospitals and, second, providing a technological infrastructure for data sharing based on interoperability specifications recognized at the regional level for messages transmitted from healthcare providers to the central domain. The adoption of such regional interoperability specifications enabled the communication among heterogeneous systems placed in different hospitals in Lombardy. Integrating the Healthcare Enterprise (IHE) integration profiles which refer to HL7 standards are adopted within hospitals for message exchange and for the definition of integration scenarios. The IHE patient administration management (PAM) profile with its different workflows is adopted for patient management, whereas the Scheduled Workflow (SWF), the Laboratory Testing Workflow (LTW), and the Ambulatory Testing Workflow (ATW) are adopted for order management. At present, the system manages 4,700,000 pharmacological e-prescriptions, and 1,700,000 e-prescriptions for laboratory exams per month. It produces, monthly, 490,000 laboratory medical reports, 180,000 radiology medical reports, 180

Integrating hospital information systems in healthcare institutions: a mediation architecture.

Science.gov (United States)

El Azami, Ikram; Cherkaoui Malki, Mohammed Ouçamah; Tahon, Christian

2012-10-01

Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent.

WISH: a Wireless Mobile Multimedia Information System in Healthcare using RFID.

Science.gov (United States)

Yu, Weider D; Ray, Pradeep; Motoc, Tiberiu

2008-05-01

It is important to improve the efficiency of healthcare-related operations and the associated costs. Healthcare organizations are constantly under increased pressure to streamline operations and provide enhanced services to their patients. Wireless mobile computing technology has the potential to provide the desired benefits and would be a critical part of today's healthcare information system. In this paper, a system is presented to better facilitate the functions of physicians and medical staff in healthcare by using modern wireless mobile technology, Radio Frequency Identification (RFID) tools, and multimedia streaming. The paper includes a case study of the development of such a system in the context of healthcare in the United States. The results of the study show how wireless mobile multimedia systems can be developed for the improvement of the quality and efficiency in healthcare for other nations as well. Our testing data show a time reduction of more than 50% in the daily activities of hospital staff.

Transferring skills in quality collaboratives focused on improving patient logistics

NARCIS (Netherlands)

J.W.M. Weggelaar-Jansen (Anne Marie); J.D.H. van Wijngaarden (Jeroen)

2018-01-01

textabstractBackground: A quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. However, no prior research has been done on the knowledge and skills healthcare professionals need

Implementation of a Web-Based Collaborative Process Planning System

Science.gov (United States)

Wang, Huifen; Liu, Tingting; Qiao, Li; Huang, Shuangxi

Under the networked manufacturing environment, all phases of product manufacturing involving design, process planning, machining and assembling may be accomplished collaboratively by different enterprises, even different manufacturing stages of the same part may be finished collaboratively by different enterprises. Based on the self-developed networked manufacturing platform eCWS(e-Cooperative Work System), a multi-agent-based system framework for collaborative process planning is proposed. In accordance with requirements of collaborative process planning, share resources provided by cooperative enterprises in the course of collaboration are classified into seven classes. Then a reconfigurable and extendable resource object model is built. Decision-making strategy is also studied in this paper. Finally a collaborative process planning system e-CAPP is developed and applied. It provides strong support for distributed designers to collaboratively plan and optimize product process though network.

The use of collaboration to implement evidence-based safe practices.

Science.gov (United States)

Clarke, John R

2013-12-01

The Pennsylvania Patient Safety Authority receives over 235,000 reports of medical error per year. Near miss and serious event reports of common and interesting problems are analysed to identify best practices for preventing harmful errors. Dissemination of this evidence-based information in the peer-reviewed Pennsylvania Patient Safety Advisory and presentations to medical staffs are not sufficient for adoption of best practices. Adoption of best practices has required working with institutions to identify local barriers to and incentives for adopting best practices and redesigning the delivery system to make desired behaviour easy and undesirable behaviour more difficult. Collaborations, where institutions can learn from the experiences of others, have show decreases in harmful events. The Pennsylvania Program to Prevent Wrong-Site Surgery is used as an example. Two collaborations to prevent wrong-site surgery have been completed, one with 30 institutions in eastern Pennsylvania and one with 19 in western Pennsylvania. The first collaboration achieved a 73% decrease in the rolling average of wrong-site events over 18 months. The second collaboration experienced no wrong-site operating room procedures over more than one year. Significance for public healthSince the Institute of Medicine's To Err is Human identified medical errors as a major cause of death, the public has been interested in the recommendations for reporting of medical errors and implementing safe systems for the delivery of healthcare. The Commonwealth of Pennsylvania has followed those recommendations and found that an essential intermediate step between analysing reports and implementing safe systems is collaborative learning among healthcare institutions. The experience in Pennsylvania should be useful to other public organizations wishing to improve safety.

Networks and social capital: a relational approach to primary healthcare reform

Directory of Open Access Journals (Sweden)

Scott Catherine

2007-09-01

Full Text Available Abstract Collaboration among health care providers and across systems is proposed as a strategy to improve health care delivery the world over. Over the past two decades, health care providers have been encouraged to work in partnership and build interdisciplinary teams. More recently, the notion of networks has entered this discourse but the lack of consensus and understanding about what is meant by adopting a network approach in health services limits its use. Also crucial to this discussion is the work of distinguishing the nature and extent of the impact of social relationships – generally referred to as social capital. In this paper, we review the rationale for collaboration in health care systems; provide an overview and synthesis of key concepts; dispel some common misconceptions of networks; and apply the theory to an example of primary healthcare network reform in Alberta (Canada. Our central thesis is that a relational approach to systems change, one based on a synthesis of network theory and social capital can provide the fodation for a multi-focal approach to primary healthcare reform. Action strategies are recommended to move from an awareness of 'networks' to fully translating knowledge from existing theory to guide planning and practice innovations. Decision-makers are encouraged to consider a multi-focal approach that effectively incorporates a network and social capital approach in planning and evaluating primary healthcare reform.

The healthcare experiences of Arab Israeli women in a reformed healthcare system.

Science.gov (United States)

Elnekave, Eldad; Gross, Revital

2004-07-01

Arab Israeli women are subject to unique social stresses deriving from their status as part of an ethno-political minority and from their position as women in a patriarchal community. Collectively, their health profiles rate poorly in comparison to Jewish Israeli women or to women in the vast majority of developed countries. To examine the experiences of Arab Israeli women in the contemporary Israeli healthcare system, following implementation of the National Health Insurance Law (NHIL). The study combined quantitative and qualitative research methodologies. A telephone survey utilizing a structured questionnaire was conducted during August-September 1998 among a random national sample of 849 women, with a response rate of 83%. Between the months of January and July of 2000, qualitative data was attained via participant-observation, long and short semi-structured interviews, and focus groups in one large Muslim Arab Israeli village. Arab Israeli women in the national survey reported poorer self-assessed health, lower rates of care by a woman primary care physician, lower satisfaction ratings for primary care physicians and more frequently foregoing medical care than did native or immigrant Jewish Israeli women. Three major factors contributing to Arab Israeli women's healthcare experiences were elucidated by the qualitative study: (1) the threat of physical and social exposure (2) difficulties in communicating with male physicians and (3) the stifling effect of family politics and surveillance on healthcare. We discuss our findings in relation to structural changes associated with the recent reform of the Israeli health care system. We conclude by suggesting policy measures for better adapting primary care services to the needs of Arab Israeli women, and note the relevance to other systems that aim to provide service to cultural and ethno-political minorities, in which healthcare delivery is shaped by unique local circumstances.

Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors.

Science.gov (United States)

Xesfingi, Sofia; Vozikis, Athanassios

2016-03-15

Patient satisfaction is an important measure of healthcare quality as it offers information on the provider's success at meeting clients' expectations and is a key determinant of patients' perspective behavioral intention. The aim of this paper is first to assess the degree of patient satisfaction, and second, to study the relationship between patient satisfaction of healthcare system and a set of socio-economic and healthcare provision indicators. This empirical analysis covers 31 countries for the years 2007, 2008, 2009 and 2012. The dependent variable, the satisfaction index, is defined as the patient satisfaction of their country's health system. We first construct an index of patient satisfaction and then, at a second stage, this index is related to socio-economic and healthcare provision variables. Our findings support that there is a strong positive association between patient satisfaction level and healthcare provision indicators, such as nurses and physicians per 100,000 habitants, with the latter being the most important contributor, and a negative association between patient satisfaction level and number of hospital beds. Among the socio-economic variables, public health expenditures greatly shape and positive relate to patient satisfaction, while private spending on health relates negatively. Finally, the elder a patient is, the more satisfied with a country's healthcare system appears to be. We conclude that there is a strong positive association between patient satisfaction and public health expenditures, number of physicians and nurses, and the age of the patient, while there is a negative evidence for private health spending and number of hospital beds.

Systems healthcare: a holistic paradigm for tomorrow.

Science.gov (United States)

Fiandaca, Massimo S; Mapstone, Mark; Connors, Elenora; Jacobson, Mireille; Monuki, Edwin S; Malik, Shaista; Macciardi, Fabio; Federoff, Howard J

2017-12-19

Systems healthcare is a holistic approach to health premised on systems biology and medicine. The approach integrates data from molecules, cells, organs, the individual, families, communities, and the natural and man-made environment. Both extrinsic and intrinsic influences constantly challenge the biological networks associated with wellness. Such influences may dysregulate networks and allow pathobiology to evolve, resulting in early clinical presentation that requires astute assessment and timely intervention for successful mitigation. Herein, we describe the components of relevant biological systems and the nature of progression from at-risk to manifest disease. We illustrate the systems approach by examining two relevant clinical examples: Alzheimer's and cardiovascular diseases. The implications of systems healthcare management are examined through the lens of economics, ethics, policy and the law. Finally, we propose the need to develop new educational paradigms to enhance the training of the health professional in an era of systems medicine.

Evaluating Complex Healthcare Systems: A Critique of Four Approaches

Directory of Open Access Journals (Sweden)

Heather Boon

2007-01-01

Full Text Available The purpose of this paper is to bring clarity to the emerging conceptual and methodological literature that focuses on understanding and evaluating complex or ‘whole’ systems of healthcare. An international working group reviewed literature from interdisciplinary or interprofessional groups describing approaches to the evaluation of complex systems of healthcare. The following four key approaches were identified: a framework from the MRC (UK, whole systems research, whole medical systems research described by NCCAM (USA and a model from NAFKAM (Norway. Main areas of congruence include acknowledgment of the inherent complexity of many healthcare interventions and the need to find new ways to evaluate these; the need to describe and understand the components of complex interventions in context (as they are actually practiced; the necessity of using mixed methods including randomized clinical trials (RCTs (explanatory and pragmatic and qualitative approaches; the perceived benefits of a multidisciplinary team approach to research; and the understanding that methodological developments in this field can be applied to both complementary and alternative medicine (CAM as well as conventional therapies. In contrast, the approaches differ in the following ways: terminology used, the extent to which the approach attempts to be applicable to both CAM and conventional medical interventions; the prioritization of research questions (in order of what should be done first especially with respect to how the ‘definitive’ RCT fits into the process of assessing complex healthcare systems; and the need for a staged approach. There appears to be a growing international understanding of the need for a new perspective on assessing complex healthcare systems.

Google DeepMind and healthcare in an age of algorithms.

Science.gov (United States)

Powles, Julia; Hodson, Hal

2017-01-01

Data-driven tools and techniques, particularly machine learning methods that underpin artificial intelligence, offer promise in improving healthcare systems and services. One of the companies aspiring to pioneer these advances is DeepMind Technologies Limited, a wholly-owned subsidiary of the Google conglomerate, Alphabet Inc. In 2016, DeepMind announced its first major health project: a collaboration with the Royal Free London NHS Foundation Trust, to assist in the management of acute kidney injury. Initially received with great enthusiasm, the collaboration has suffered from a lack of clarity and openness, with issues of privacy and power emerging as potent challenges as the project has unfolded. Taking the DeepMind-Royal Free case study as its pivot, this article draws a number of lessons on the transfer of population-derived datasets to large private prospectors, identifying critical questions for policy-makers, industry and individuals as healthcare moves into an algorithmic age.

The healthcare system and the provision of oral healthcare in European Union member states. Part 8: Italy.

Science.gov (United States)

Bindi, M; Paganelli, C; Eaton, K A; Widström, E

2017-05-26

In Italy healthcare is provided for all Italian citizens and residents and it is delivered mainly by public providers, with some private or private-public entities. Italy's public healthcare system - the Servizio Sanitario Nazionale (SSN) - is organised by the Ministry of Health and administered on a devolved regional basis. It is financed by general taxation that provides universal coverage, largely free of charge at the point of service. The central government establishes the basic national health benefits package, which must be uniformly provided throughout the country, through services guaranteed under the NHS provision called LEA - (Livelli Essenziali di Assistenza [Essential Level of Assistance]) and allocates national funds to the regions. The regions, through their regional health departments, are responsible for organising, administering and delivering primary, secondary and tertiary healthcare services as well as preventive and health promotion services. Regions are allowed a large degree of autonomy in how they perform this role and regarding decisions about the local structure of the system. Complementary and supplementary private health insurance is also available. However, as in most other Mediterranean European countries, in Italy oral healthcare is mainly provided under private arrangements. The public healthcare system provides only 5-8% of oral healthcare services and this percentage varies from region to region. Oral healthcare is included in the Legislation on Essential levels of care (LEAs) for specific populations such as children, vulnerable people (medically compromised and those on low income) and individuals who need oral healthcare in some urgent/emergency cases. For other people, oral healthcare is generally not covered. Apart from the national benefits package, regions may also carry out their own initiatives autonomously, but must finance these themselves. The number of dentists working in Italy has grown rapidly in the last few years

Improved obstetric safety through programmatic collaboration.

Science.gov (United States)

Goffman, Dena; Brodman, Michael; Friedman, Arnold J; Minkoff, Howard; Merkatz, Irwin R

2014-01-01

Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company. Under the guidance of 4 obstetrics and gynecology departmental chairmen, consensus best practices for obstetrics were developed which included: implementation of evidence based protocols with audit and feedback; standardized educational interventions; mandatory electronic fetal monitoring training; and enhanced in-house physician coverage. Each institution developed unique safety related expertise (development of electronic documentation, team training, and simulation education), and experiences were shared across the collaborative. The collaborative group developed robust systems for audit of outcomes and documentation quality, as well as enforcement mechanisms. Ongoing feedback to providers served as a key component of the intervention. The liability carrier provided financial support for these patient safety innovations. As a result of the interventions, the overall AOI for our institutions decreased 42% from baseline (January-June 2008) to the most recently reviewed time period (July-December 2011) (10.7% vs 6.2%, p Risk Management of the American Hospital Association.

How mHealth will spur consumer-led healthcare

Science.gov (United States)

2015-01-01

Consumer attitudes about their healthcare are beginning to shift. They are taking more responsibility for their health and seeking to collaborate with their doctors. In some cases consumers will engage in self-diagnosis. Mobile health apps and devices, in combination with cloud computing, will play a major role to empower consumers. Consumer expectations for healthcare are rising by the day. mHealth has provided empowerment to patients through the power of the PSC, which I describe as personal supercomputers. The number of devices and apps are exploding onto the healthcare scene. Although some providers are not comfortable with consumer technology for self-diagnosis, the new technologies will lead to a new model for collaboration between patient and physician. PMID:28293572

Corruption in the Nigerian healthcare system | Buowari | Nigerian ...

African Journals Online (AJOL)

Corruption is the use of public resources for private gain. This is common in most countries though reduced in some and alarming in others. It affects all sectors of the economy and the healthcare system is not spared. Medical corruption is increasing in countries with high rates of corruption and all healthcare professionals ...

Oral healthcare systems in the extended European union.

Science.gov (United States)

Widström, Eeva; Eaton, Kenneth A

2004-01-01

This article reports a survey of the systems for the provision of oral healthcare in the 28 member and accession states of the EU/EEA in 2003. Descriptions of the systems were collected from the principal dental advisers to governments in the individual states. In many states these were the Chief Dental Officers (CDOs). In states without a CDO, descriptions were gathered from CDO equivalents or senior academics. A template (model description) was used to guide all respondents. Additional statistical information on oral healthcare costs and workforce was collected from the Council of European Chief Dental Officers, WHO and World Bank websites. The study showed that in broad terms there were six patterns (Beveridgian, Bismarkian, The Eastern European (in transition), Nordic, Southern European and Hybrid) for the administration and financing of oral healthcare in the expanding EU. The extent and nature of government involvement in planning and coordinating oral healthcare services and the numbers and pay of the oral healthcare workforce varied between the different models. The biggest recent changes in European oral healthcare were found to have occurred in Eastern Europe, where there has been wide scale privatization of the previously public dental services. However, most of the EU accession (Eastern European) states seemed to be slowly developing insurance systems to cover oral health treatment costs. In the existing EU/EEA, the public dental services such as those in the Nordic countries still have strong political support and some expansion has occurred. In Southern Europe public dental services seemed to have gained some acceptance for the treatment of children and special needs groups. In UK, which has a unique public dental service system, there are plans to make big changes in the delivery, commissioning and remuneration of dental services in the near future. Some EU member states which operate the Bismarkian system with health insurances offering wide

Development of Wearable Systems for Ubiquitous Healthcare Service Provisioning

OpenAIRE

Ogunduyile, O.O.; Olugbara, O.O.; Lall, M.

2013-01-01

This paper reports on the development of a wearable system using wireless biomedical sensors for ubiquitous healthcare service provisioning. The prototype system is developed to address current healthcare challenges such as increasing cost of services, inability to access diverse services, low quality services and increasing population of elderly as experienced globally. The biomedical sensors proactively collect physiological data of remote patients to recommend diagnostic services. The prot...

Quality of the ophthalmological service to outpatients of the public and private healthcare systems.

Science.gov (United States)

Hercos, Benigno Vicente Santos; Berezovsky, Adriana

2017-01-01

To compare perceptions of the quality of ophthalmological services offered to outpatients from the public healthcare system to those from the private healthcare system, and to determine which measures are seen as necessary and a priority for improving the quality of care. This was a prospective observational study on 200 patients, 101 and 99 of whom were from the public and private healthcare systems, respectively. All patients underwent an ophthalmological examination at an ophthalmology hospital in Belo Horizonte, Minas Gerais, Brazil. Personal interviews were conducted using two structured questionnaires adapted from the modified SERVQUAL scale. Overall, patients from the private healthcare system were significantly more dissatisfied than those from the public healthcare system. In both systems, reliability was considered to be the most important determinant of quality, and it presented the highest level of dissatisfaction. Satisfaction with the public healthcare system was significantly greater than that with the private healthcare system in terms of the tangibles, reliability, responsiveness, and assurance determinants of the SERVQUAL scale. Institutions must plan, execute, evaluate, and monitor measures that seek to improve the overall patient satisfaction with the quality of services provided, particularly in the private healthcare system, and special attention must be paid to reliability in both healthcare systems. The identification and monitoring of the quality of healthcare services through the periodic use of the SERVQUAL scale may provide healthcare managers with information so that they can identify, plan, and monitor necessary and priority measures. This could be a key strategy for improving the quality of outpatient health services in the public and private systems.

The Cochrane collaboration

NARCIS (Netherlands)

Scholten, R. J. P. M.; Clarke, M.; Hetherington, J.

2005-01-01

The Cochrane Collaboration is an international, not-for-profit organisation that aims to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health-care interventions. Cochrane systematic reviews

A scalable healthcare information system based on a service-oriented architecture.

Science.gov (United States)

Yang, Tzu-Hsiang; Sun, Yeali S; Lai, Feipei

2011-06-01

Many existing healthcare information systems are composed of a number of heterogeneous systems and face the important issue of system scalability. This paper first describes the comprehensive healthcare information systems used in National Taiwan University Hospital (NTUH) and then presents a service-oriented architecture (SOA)-based healthcare information system (HIS) based on the service standard HL7. The proposed architecture focuses on system scalability, in terms of both hardware and software. Moreover, we describe how scalability is implemented in rightsizing, service groups, databases, and hardware scalability. Although SOA-based systems sometimes display poor performance, through a performance evaluation of our HIS based on SOA, the average response time for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 s, respectively. The outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 s. The scalability of the rightsizing project and our evaluation results show that the SOA HIS we propose provides evidence that SOA can provide system scalability and sustainability in a highly demanding healthcare information system.

Using HFACS-Healthcare to Identify Systemic Vulnerabilities During Surgery.

Science.gov (United States)

Cohen, Tara N; Francis, Sarah E; Wiegmann, Douglas A; Shappell, Scott A; Gewertz, Bruce L

2018-03-01

The Human Factors Analysis and Classification System for Healthcare (HFACS-Healthcare) was used to classify surgical near miss events reported via a hospital's event reporting system over the course of 1 year. Two trained analysts identified causal factors within each event narrative and subsequently categorized the events using HFACS-Healthcare. Of 910 original events, 592 could be analyzed further using HFACS-Healthcare, resulting in the identification of 726 causal factors. Most issues (n = 436, 60.00%) involved preconditions for unsafe acts, followed by unsafe acts (n = 257, 35.39%), organizational influences (n = 27, 3.72%), and supervisory factors (n = 6, 0.82%). These findings go beyond the traditional methods of trending incident data that typically focus on documenting the frequency of their occurrence. Analyzing near misses based on their underlying contributing human factors affords a greater opportunity to develop process improvements to reduce reoccurrence and better provide patient safety approaches.

CMOS Enabled Microfluidic Systems for Healthcare Based Applications

KAUST Repository

Khan, Sherjeel M.; Gumus, Abdurrahman; Nassar, Joanna M.; Hussain, Muhammad Mustafa

2018-01-01

With the increased global population, it is more important than ever to expand accessibility to affordable personalized healthcare. In this context, a seamless integration of microfluidic technology for bioanalysis and drug delivery and complementary metal oxide semiconductor (CMOS) technology enabled data-management circuitry is critical. Therefore, here, the fundamentals, integration aspects, and applications of CMOS-enabled microfluidic systems for affordable personalized healthcare systems are presented. Critical components, like sensors, actuators, and their fabrication and packaging, are discussed and reviewed in detail. With the emergence of the Internet-of-Things and the upcoming Internet-of-Everything for a people-process-data-device connected world, now is the time to take CMOS-enabled microfluidics technology to as many people as possible. There is enormous potential for microfluidic technologies in affordable healthcare for everyone, and CMOS technology will play a major role in making that happen.

CMOS Enabled Microfluidic Systems for Healthcare Based Applications

KAUST Repository

Khan, Sherjeel M.

2018-02-27

With the increased global population, it is more important than ever to expand accessibility to affordable personalized healthcare. In this context, a seamless integration of microfluidic technology for bioanalysis and drug delivery and complementary metal oxide semiconductor (CMOS) technology enabled data-management circuitry is critical. Therefore, here, the fundamentals, integration aspects, and applications of CMOS-enabled microfluidic systems for affordable personalized healthcare systems are presented. Critical components, like sensors, actuators, and their fabrication and packaging, are discussed and reviewed in detail. With the emergence of the Internet-of-Things and the upcoming Internet-of-Everything for a people-process-data-device connected world, now is the time to take CMOS-enabled microfluidics technology to as many people as possible. There is enormous potential for microfluidic technologies in affordable healthcare for everyone, and CMOS technology will play a major role in making that happen.

The socioeconomic impact of international aid: a qualitative study of healthcare recovery in post-earthquake Haiti and implications for future disaster relief.

Science.gov (United States)

Kligerman, Maxwell; Walmer, David; Bereknyei Merrell, Sylvia

2017-05-01

We assessed healthcare provider perspectives of international aid four years after the Haiti Earthquake to better understand the impact of aid on the Haitian healthcare system and learn best practices for recovery in future disaster contexts. We conducted 22 semi-structured interviews with the directors of local, collaborative, and aid-funded healthcare facilities in Leogane, Haiti. We coded and analysed the interviews using an iterative method based on a grounded theory approach of data analysis. Healthcare providers identified positive aspects of aid, including acute emergency relief, long-term improved healthcare access, and increased ease of referrals for low-income patients. However, they also identified negative impacts of international aid, including episodes of poor quality care, internal brain drain, competition across facilities, decrease in patient flow to local facilities, and emigration of Haitian doctors to abroad. As Haiti continues to recover, it is imperative for aid institutions and local healthcare facilities to develop a more collaborative relationship to transition acute relief to sustainable capacity building. In future disaster contexts, aid institutions should specifically utilise quality of care metrics, NGO Codes of Conduct, Master Health Facility Lists, and sliding scale payment systems to improve disaster response.

Value Systems Alignment Analysis in Collaborative Networked Organizations Management

OpenAIRE

Patricia Macedo; Luis Camarinha-Matos

2017-01-01

The assessment of value systems alignment can play an important role in the formation and evolution of collaborative networks, contributing to reduce potential risks of collaboration. For this purpose, an assessment tool is proposed as part of a collaborative networks information system, supporting both the formation and evolution of long-term strategic alliances and goal-oriented networks. An implementation approach for value system alignment analysis is described, which is intended to assis...

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems

DEFF Research Database (Denmark)

Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

2016-01-01

unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia......Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely......, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than...

The implementation of mindfulness in healthcare systems: a theoretical analysis.

Science.gov (United States)

Demarzo, M M P; Cebolla, A; Garcia-Campayo, J

2015-01-01

Evidence regarding the efficacy of mindfulness-based interventions (MBIs) is increasing exponentially; however, there are still challenges to their integration in healthcare systems. Our goal is to provide a conceptual framework that addresses these challenges in order to bring about scholarly dialog and support health managers and practitioners with the implementation of MBIs in healthcare. This is an opinative narrative review based on theoretical and empirical data that address key issues in the implementation of mindfulness in healthcare systems, such as the training of professionals, funding and costs of interventions, cost effectiveness and innovative delivery models. We show that even in the United Kingdom, where mindfulness has a high level of implementation, there is a high variability in the access to MBIs. In addition, we discuss innovative approaches based on "complex interventions," "stepped-care" and "low intensity-high volume" concepts that may prove fruitful in the development and implementation of MBIs in national healthcare systems, particularly in Primary Care. In order to better understand barriers and opportunities for mindfulness implementation in healthcare systems, it is necessary to be aware that MBIs are "complex interventions," which require innovative approaches and delivery models to implement these interventions in a cost-effective and accessible way. Copyright © 2015 Elsevier Inc. All rights reserved.

ERP (enterprise resource planning) systems can streamline healthcare business functions.

Science.gov (United States)

Jenkins, E K; Christenson, E

2001-05-01

Enterprise resource planning (ERP) software applications are designed to facilitate the systemwide integration of complex processes and functions across a large enterprise consisting of many internal and external constituents. Although most currently available ERP applications generally are tailored to the needs of the manufacturing industry, many large healthcare systems are investigating these applications. Due to the significant differences between manufacturing and patient care, ERP-based systems do not easily translate to the healthcare setting. In particular, the lack of clinical standardization impedes the use of ERP systems for clinical integration. Nonetheless, an ERP-based system can help a healthcare organization integrate many functions, including patient scheduling, human resources management, workload forecasting, and management of workflow, that are not directly dependent on clinical decision making.

A healthcare management system for Turkey based on a service-oriented architecture.

Science.gov (United States)

Herand, Deniz; Gürder, Filiz; Taşkin, Harun; Yuksel, Emre Nuri

2013-09-01

The current Turkish healthcare management system has a structure that is extremely inordinate, cumbersome and inflexible. Furthermore, this structure has no common point of view and thus has no interoperability and responds slowly to innovations. The purpose of this study is to show that using which methods can the Turkish healthcare management system provide a structure that could be more modern, more flexible and more quick to respond to innovations and changes taking advantage of the benefits given by a service-oriented architecture (SOA). In this paper, the Turkish healthcare management system is chosen to be examined since Turkey is considered as one of the Third World countries and the information architecture of the existing healthcare management system of Turkey has not yet been configured with SOA, which is a contemporary innovative approach and should provide the base architecture of the new solution. The innovation of this study is the symbiosis of two main integration approaches, SOA and Health Level 7 (HL7), for integrating divergent healthcare information systems. A model is developed which is based on SOA and enables obtaining a healthcare management system having the SSF standards (HSSP Service Specification Framework) developed by the framework of the HSSP (Healthcare Services Specification Project) under the leadership of HL7 and the Object Management Group.

Collaborative Recurrent Neural Networks forDynamic Recommender Systems

Science.gov (United States)

2016-11-22

JMLR: Workshop and Conference Proceedings 63:366–381, 2016 ACML 2016 Collaborative Recurrent Neural Networks for Dynamic Recommender Systems Young...an unprece- dented scale. Although such activity logs are abundantly available, most approaches to recommender systems are based on the rating...Recurrent Neural Network, Recommender System , Neural Language Model, Collaborative Filtering 1. Introduction As ever larger parts of the population

EVALUATION OF THE GOVERNANCE OF EXTERNAL SUPERVISORY INSTITUTIONS TOWARDS SOCIAL SECURITY AGENCY (BADAN PENYELENGGARA JAMINAN SOSIAL/BPJS FOR HEALTHCARE

Directory of Open Access Journals (Sweden)

Dyani D.A.M.

2017-09-01

Full Text Available Since the formation of the Social Security Agency (Badan Penyelenggara Jaminan Sosial/BPJS for Healthcare has found the public spotlight rising with its management; including the regulatory body BPJS for Healthcare activities. BPJS for Healthcare external supervisors such as DJSN, OJK, BPK are entities established according to the Law of the Republic of Indonesia 24 Year 2011. However, there are views on neutrality, independence, and supervisor capability. By using Soft System Methodology, this research invites us to understand the problem situation and what efforts should be taken in managing the complexity. This paper will analyze the co-operation with collaborative governance perspective as a cooperative approach in overseeing BPJS for Healthcare. The focus of this paper is in the stage of identifying a series of factors that are crucial within the collaborative process itself, which includes shared understanding as stated by Ansel & Gash (2008 and Emerson & Nabatchi (2015.

ICT use for information management in healthcare system for chronic disease patient

Science.gov (United States)

Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira

2013-10-01

Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.

Method for selecting e-health standards to support interoperability of healthcare information systems

CSIR Research Space (South Africa)

Adebesin, F

2014-05-01

Full Text Available There is growing concern over the fragmentation and inability of healthcare information systems (e-health systems) to exchange pertinent healthcare information that can empower healthcare professionals to make informed decisions regarding the care...

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

Directory of Open Access Journals (Sweden)

Kristina D. Wood

2013-01-01

Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology. Setting: Ambulatory care and community practice Practice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers. Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients. Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system. Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.   Type: Idea Paper

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

Directory of Open Access Journals (Sweden)

Cathy H. Ficzere, PharmD, BCPS

2013-01-01

Full Text Available Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology.Setting: Ambulatory care and community practicePractice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party payers, point-of-care testing, and all health-care providers.Main Outcome Measures: By providing integrated and customized information at the point of use, medication adherence and access to care will be increased and patients will engage in healthy behaviors more often resulting in an improved level of care for patients.Results: In the future, the authors believe if the vision is achieved, the health care system and patients will see improved health outcomes and more efficient utilization of the healthcare system.Conclusions: Our proposed use of technology provides an opportunity to empower patients to positively improve their own health which could be a vital advancement in health care, especially in the areas of medication adherence, improving access to care, and health behavior support. As pharmacists, we may also embrace technology opportunities to expand our roles as health care professionals as we continue to partner with patients and the health care team to improve outcomes.

Align, share responsibility and collaborate: potential considerations to aid in e-health policy development.

Science.gov (United States)

Ragaban, Nouran; Day, Karen; Orr, Martin

2012-01-01

Policies that support strategic development and implementation are related to health ICT implementation successes. This research aimed to explore the question, 'Why have we not seen more successful ICT implementation in healthcare, and what does policy have to do with success?' Healthcare systems are faced with rising costs, increased prevalence of chronic diseases and diminishing resources. E-health initiatives have gained acceptance in addressing these crucial health sector issues. National governments and healthcare organisations are finding it necessary to have health Information and Communications Technology (ICT) systems in place. However, poorly developed health information policies, lack of a clear business plan and ineffective leadership contribute to failure of ICT implementation in healthcare. This study uses a Grounded Theory approach, in which a series of data gathering activities will be completed. The first author attended the Health Information Management & Systems Society (HIMSS) Policy Summit in the USA in 2011. Five Summit participants were approached individually and informally discussed the 'meaningful use' policy and how it influences ICT implementation in healthcare. Field notes were made and analysed for themes relating to the research question. There were three overlapping concepts that all of the participants indicated as primary considerations for policymakers. The alignment aspect stresses the need to align e-health initiatives with overall health policy, ensuring that e-health is incorporated with other healthcare investments. The shared responsibility theme involves the need for e-health initiatives to be recognised as a priority along all levels of government, i.e. local, state, federal, and national. This stresses the importance of health ICT development and implementation in a joint government direction. The last theme is collaboration with stakeholders, including clear division of tasks and clarity about technical and non

Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

Science.gov (United States)

Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

2012-04-01

This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

Multiprofessional education to stimulate collaboration: a circular argument and its consequences.

Science.gov (United States)

Roodbol, Petrie F

2010-01-01

The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance.

Social organization of self-management support of persons with diabetes: a health systems comparison.

Science.gov (United States)

Schiøtz, Michaela; Frølich, Anne; Krasnik, Allan; Taylor, Warren; Hsu, John

2012-09-01

Identify important organizational elements for providing self-management support (SMS). Semi-structured qualitative interviews conducted in two healthcare systems. Kaiser Permanente Northern California and the Danish Health Care System. 36 managers and healthcare professionals in the two healthcare systems. Elements important to providing self-management support to persons with diabetes. Healthcare professionals' provision of SMS was influenced by healthcare system organization and their perceptions of SMS, the capability and responsibility of healthcare systems, and their roles in the healthcare organization. Enabling factors for providing SMS included: strong leadership; aligned incentives; use of an integrated health information technology (HIT) system; multidisciplinary healthcare provider teams; ongoing training for healthcare professionals; outreach; and quality goals. Barriers to providing SMS included lack of collaboration between providers and skeptical attitudes towards prevention and outreach. Implementation of SMS can be improved by an understanding of the elements that enhance its provision: (1) initiatives seeking to improve collaboration and integration between providers; (2) implementation of an integrated HIT system; and (3) ongoing training of healthcare professionals.

Task-role-based Access Control Model in Smart Health-care System

OpenAIRE

Wang Peng; Jiang Lingyun

2015-01-01

As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for...

Task-role-based Access Control Model in Smart Health-care System

Directory of Open Access Journals (Sweden)

Wang Peng

2015-01-01

Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

Effects of an incinerator project on a healthcare-waste management system.

Science.gov (United States)

Khammaneechan, Patthanasak; Okanurak, Kamolnetr; Sithisarankul, Pornchai; Tantrakarnapa, Kraichat; Norramit, Poonsup

2011-10-01

This evaluative research study aimed to assess the effects of the central healthcare incinerator project on waste management in Yala Province. The study data were collected twice: at baseline and during the operational phase. A combination of structured interview and observation were used during data collection. The study covered 127 healthcare facilities: government hospitals, healthcare centres, and private clinics. The results showed 63% of healthcare risk waste (HCRW) handlers attended the HCRW management training. Improvements in each stage of the HCRW management system were observed in all groups of facilities. The total cost of the HCRW management system did not change, however; the costs for hospitals decreased, whereas those for clinics increased significantly. It was concluded that the central healthcare waste incinerator project positively affected HCRW management in the area, although the costs of management might increase for a particular group. However, the benefits of changing to a more appropriately managed HCRW system will outweigh the increased costs.

Injustice to transsexual women in a hetero-normative healthcare system.

Science.gov (United States)

Newman-Valentine, Douglas; Duma, Sinegugu

2014-11-21

Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process. The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa. An electronic literature search was executed via the EBSCO host with specific inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded. Transsexual women have the potential to suffer significant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity figures of women. A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homo- and trans-phobia that will in turn strengthen the belief that transsexual women are un-African.

Co-constructing IT and Healthcare

DEFF Research Database (Denmark)

Andersen, Tariq Osman; Bansler, Jørgen P.; Bjørn, Pernille

The CITH project (Co-constructing IT and Healthcare) is an ongoing 4-year interdisciplinary research project, which investigates while intervenes in the collaborative practices involved in disease management of chronic heart patients with an ICD (Implantable Cardioverter Defibrillator)....

Group Discovery in a CollaborativeTagging System

OpenAIRE

Chen, Zijian

2007-01-01

Tagging refers to the process of adding metadata to describe things by usingone or several words. Collaborative Tagging systems, which allow different webusers to tag web content like weblogs, pictures, and bookmarks and so on, haverecently gained great popularity on internet. There are already a greatvariety of debates on internet of the advantages and disadvantages ofcollaborative tagging systems from the aspect of information organizing. Inthis paper, we primarily focus on a collaborative ...

Collaborative Educational Systems in the Virtual Environment

OpenAIRE

Cristian CIUREA; Paul POCATILU

2012-01-01

The work leads to an original approach to the construction of collaborative systems metrics. The approach is based both on research already conducted by the author, on the experimental results obtained, and the foundation taken from the specific literature. The collaborative systems in knowledge-based economy are formalized and their characteristics are identified. The virtual campus structure is described and a comparison with the classical university is achieved. The architecture of virtual...

The board's role in meaningful collaboration. After negotiations are completed, a new round of work begins.

Science.gov (United States)

Deets, M K

1991-06-01

For collaborations that in some way modify involved organizations' assets and organizational or governance issues, negotiations are the responsibility of the congregation and not the healthcare system. Congregational leaders should, however, actively involve the system chief executive officer in the process and should also seek the advice of the system board. The board can be particularly helpful in offering financial, legal, and managerial advice to negotiators. Once an agreement is reached, however, the board must consider whether to approve it. And from this point forward, its involvement in the details of the collaboration will be more active. Because board members must evaluate a proposed collaboration from the perspective of the organization they serve, they may not always take the same view of it as did the congregational leaders. Moreover, what congregational leaders believe to be in the best interests of Catholic healthcare may not be consistent with the legitimate self-interest of some of the many constituencies affected by a collaboration. After negotiators have reached an agreement and the board has approved it, the board must make the necessary financial and organizational changes necessary to achieve the transition to a new corporate entity. In doing so, its goal will be to promote standardization without destroying the member institutions' rich traditions.

Collaborating to optimize nursing students' agency information technology use.

Science.gov (United States)

Fetter, Marilyn S

2009-01-01

As the learning laboratory for gaining actual patient care experience, clinical agencies play an essential role in nursing education. With an information technology revolution transforming healthcare, nursing programs are eager for their students to learn the latest informatics systems and technologies. However, many healthcare institutions are struggling to meet their own information technology needs and report limited resources and other as barriers to nursing student training. In addition, nursing students' information technology access and use raise security and privacy concerns. With the goal of a fully electronic health record by 2014, it is imperative that agencies and educational programs collaborate. They need to establish educationally sound, cost-effective, and secure policies and procedures for managing students' use of information technology systems. Strategies for evaluating options, selecting training methods, and ensuring data security are shared, along with strategies that may reap clinical, economic, and educational benefits. Students' information technology use raises numerous issues that the nursing profession must address to participate in healthcare's transformation into the digital age.

Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture

Directory of Open Access Journals (Sweden)

Marie E. Ward

2018-06-01

Full Text Available While co-design methods are becoming more popular in healthcare; there is a gap within the peer-reviewed literature on how to do co-design in practice. This paper addresses this gap by delineating the approach taken in the co-design of a collective leadership intervention to improve healthcare team performance and patient safety culture. Over the course of six workshops healthcare staff, patient representatives and advocates, and health systems researchers collaboratively co-designed the intervention. The inputs to the process, exercises and activities that took place during the workshops and the outputs of the workshops are described. The co-design method, while challenging at times, had many benefits including grounding the intervention in the real-world experiences of healthcare teams. Implications of the method for health systems research are discussed.

Strategic information technology alliances for effective health-care supply chain management.

Science.gov (United States)

Shih, Stephen C; Rivers, Patrick A; Hsu, H Y Sonya

2009-08-01

To gain and sustain competitive advantage, health-care providers have to continuously review and renovate their operational and information technology (IT) strategies through collaborative and cooperative endeavour with their supply chain channel members. This paper explores new ways of enhancing a health-care organization's responsiveness to changes and increasing its competitiveness through implementing strategic information technology alliances among channel members in a health-care supply chain network. An overview of issues and problems (e.g. bullwhip effect, negative externalities and free-riding phenomenon in multichannel supply chains) presented in the health-care supply chains is first delineated. This paper further goes over the issues of health-care supply chain coordination and integration for strategic IT alliances, followed by the discussion of the spillover effect of IT investments. A number of viable IT practices (such as information sharing and Internet-enabled supply chain portal) for effective health-care supply chain collaboration and coordination are then examined in this research. Finally, the paper discusses how strategic IT alliances can help improve the effectiveness of health-care supply chain management.

Strategies for healthcare information systems

NARCIS (Netherlands)

Stegwee, R.A.; Spil, Antonius A.M.

2001-01-01

Information technologies of the past two decades have created significant fundamental changes in the delivery of healthcare services by healthcare provider organizations. Many healthcare organizations have been in search of ways and strategies to keep up with continuously emerging information

Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

An Attribute Based Access Control Framework for Healthcare System

Science.gov (United States)

Afshar, Majid; Samet, Saeed; Hu, Ting

2018-01-01

Nowadays, access control is an indispensable part of the Personal Health Record and supplies for its confidentiality by enforcing policies and rules to ensure that only authorized users gain access to requested resources in the system. In other words, the access control means protecting patient privacy in healthcare systems. Attribute-Based Access Control (ABAC) is a new access control model that can be used instead of other traditional types of access control such as Discretionary Access Control, Mandatory Access Control, and Role-Based Access Control. During last five years ABAC has shown some applications in both recent academic fields and industry purposes. ABAC by using user’s attributes and resources, makes a decision according to an access request. In this paper, we propose an ABAC framework for healthcare system. We use the engine of ABAC for rendering and enforcing healthcare policies. Moreover, we handle emergency situations in this framework.

Software engineering principles applied to large healthcare information systems--a case report.

Science.gov (United States)

Nardon, Fabiane Bizinella; de A Moura, Lincoln

2007-01-01

São Paulo is the largest city in Brazil and one of the largest cities in the world. In 2004, São Paulo City Department of Health decided to implement a Healthcare Information System to support managing healthcare services and provide an ambulatory health record. The resulting information system is one of the largest public healthcare information systems ever built, with more than 2 million lines of code. Although statistics shows that most software projects fail, and the risks for the São Paulo initiative were enormous, the information system was completed on-time and on-budget. In this paper, we discuss the software engineering principles adopted that allowed to accomplish that project's goals, hoping that sharing the experience of this project will help other healthcare information systems initiatives to succeed.

Architecture and implementation for a system enabling smartphones to access smart card based healthcare records.

Science.gov (United States)

Karampelas, Vasilios; Pallikarakis, Nicholas; Mantas, John

2013-01-01

The healthcare researchers', academics' and practitioners' interest concerning the development of Healthcare Information Systems has been on a steady rise for the last decades. Fueling this steady rise has been the healthcare professional need of quality information, in every healthcare provision incident, whenever and wherever this incident may take place. In order to address this need a truly mobile health care system is required, one that will be able to provide a healthcare provider with accurate patient-related information regardless of the time and place that healthcare is provided. In order to fulfill this role the present study proposes the architecture for a Healthcare Smartcard system, which provides authenticated healthcare professionals with remote mobile access to a Patient's Healthcare Record, through their Smartphone. Furthermore the research proceeds to develop a working prototype system.

Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

Directory of Open Access Journals (Sweden)

Anne Marie Lyngsø

2016-03-01

Full Text Available Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals.

Multiprofessional education to stimulate collaboration: a circular argument and its consequences [

Directory of Open Access Journals (Sweden)

Roodbol, Petrie F.

2010-04-01

Full Text Available [english] The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE or multidisciplinary training (MDT seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance.

Transferring skills in quality collaboratives focused on improving patient logistics.

Science.gov (United States)

Weggelaar-Jansen, Anne Marie; van Wijngaarden, Jeroen

2018-04-02

A quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. However, no prior research has been done on the knowledge and skills healthcare professionals need to achieve improvements or the extent to which quality improvement collaboratives help enhance both knowledge and skills. Our research focused on quality improvement collaboratives aiming to improve patient logistics and tried to identify which knowledge and skills are required and to what extent these were enhanced during the QIC. We defined skills important for logistic improvements in a three-phase Delphi study. Based on the Delphi results we made a questionnaire. We surveyed participants in a national quality improvement collaborative to assess the skills rated as 1) important, 2) available and 3) improved during the collaborative. At two sense-making meetings, experts reflected on our findings and hypothesized on how to improve (logistics) collaboratives. The Delphi study found 18 skills relevant for reducing patient access time and 21 for reducing throughput time. All skills retrieved from the Delphi study were scored as 'important' in the survey. Teams especially lacked soft skills connected to project and change management. Analytical skills increased the most, while more reflexive skills needed for the primary goal of the collaborative (reduce access and throughput times) increased modestly. At two sense-making meetings, attendees suggested four improvements for a quality improvement collaborative: 1) shift the focus to project- and change management skills; 2) focus more on knowledge transfer to colleagues; 3) teach participants to adapt the taught principles to their own situations; and 4) foster intra-project reflexive learning to translate gained insights to other projects (inter-project learning). Our findings seem to suggest that Quality collaboratives could benefit if more

CMOS Enabled Microfluidic Systems for Healthcare Based Applications.

Science.gov (United States)

Khan, Sherjeel M; Gumus, Abdurrahman; Nassar, Joanna M; Hussain, Muhammad M

2018-04-01

With the increased global population, it is more important than ever to expand accessibility to affordable personalized healthcare. In this context, a seamless integration of microfluidic technology for bioanalysis and drug delivery and complementary metal oxide semiconductor (CMOS) technology enabled data-management circuitry is critical. Therefore, here, the fundamentals, integration aspects, and applications of CMOS-enabled microfluidic systems for affordable personalized healthcare systems are presented. Critical components, like sensors, actuators, and their fabrication and packaging, are discussed and reviewed in detail. With the emergence of the Internet-of-Things and the upcoming Internet-of-Everything for a people-process-data-device connected world, now is the time to take CMOS-enabled microfluidics technology to as many people as possible. There is enormous potential for microfluidic technologies in affordable healthcare for everyone, and CMOS technology will play a major role in making that happen. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Systems and Methods for Collaboratively Controlling at Least One Aircraft

Science.gov (United States)

Estkowski, Regina I. (Inventor)

2016-01-01

An unmanned vehicle management system includes an unmanned aircraft system (UAS) control station controlling one or more unmanned vehicles (UV), a collaborative routing system, and a communication network connecting the UAS and the collaborative routing system. The collaborative routing system being configured to receive flight parameters from an operator of the UAS control station and, based on the received flight parameters, automatically present the UAS control station with flight plan options to enable the operator to operate the UV in a defined airspace.

The orthopaedist's role in healthcare system governance.

Science.gov (United States)

Probe, Robert A

2013-06-01

Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

Service models for remote healthcare monitoring systems.

Science.gov (United States)

Moorman, Bridget A

2010-01-01

These scenarios reflect where the future is heading for remote health monitoring technology and service expectations. Being able to manage a "system of systems" with timely service hand-off over seams of responsibility and system interfaces will become very important for a BMET or clinical engineer. These interfaces will include patient homes, clinician homes, commercial/civilian infrastructure, public utilities, vendor infrastructure as well as internal departmental domains. Concurrently, technology is changing rapidly resulting in newer software delivery modes and hardware appliances as well as infrastructure changes. Those who are able to de-construct the complex systems and identify infrastructure assumptions and seams of servicing responsibility will be able to better understand and communicate the expectations for service of these systems. Moreover, as identified in Case 1, prodigious use of underlying system monitoring tools (managing the "meta-data") could move servicing of these remote systems from a reactive approach to a proactive approach. A prepared healthcare organization will identify their current and proposed future service combination use cases and design service philosophies and expectations for those use cases, while understanding the infrastructure assumptions and seams of responsibility. This is the future of technical service to the healthcare clinicians and patients.

Ensuring healthcare system integrity with blockchain

OpenAIRE

I. L?hmus

2016-01-01

Blockchain, the underlying protocol behind Bitcoin, has received a tremendous amount of attention over the last two years. Whilst initially focused on financial services, the technology holds much promise for addressing challenges in health-care system. Electronic health records and related information systems have several advantages over historical paper-based management - smooth data transfer between medical care providers, patient empowerment etc. While being convenient and effient these s...

Enhancing international collaboration among early-career researchers

Science.gov (United States)

Carroll, Jennifer K; Albada, Akke; Farahani, Mansoureh; Lithner, Maria; Neumann, Melanie; Sandhu, Harbinder; Shepherd, Heather L

2010-01-01

Objective The European Association of Communication in Healthcare (EACH) Early Career Researchers Network (ECRN) aims are to (1) promote international collaboration among young investigators and (2) provide a support network for future innovative communication research projects. In October 2009, Miami, USA at a workshop facilitated by the ECRN at the International Conference on Communication in Healthcare (ICCH) hosted by the American Academy of Communication in Healthcare we explored common facilitators and challenges faced by early career researchers in health communication research. Methods Attendees introduced themselves, their research area(s) of interest, and listed one facilitator and one barrier for their career development. EACH ECRN members then led a discussion of facilitators and challenges encountered in communication research projects and career development. We discussed potential collaboration opportunities, future goals, and activities. Results Having supportive collegial relationships, institutional support, job security, and funding are critical facilitators for early career investigators. Key challenges include difficulty with time management and prioritizing, limited resources, and contacts. Conclusion International collaboration among early career researchers is a feasible and effective means to address important challenges, by increasing opportunities for professional support and networking, problem-solving, discussion of data, and ultimately publishing. Practice Implications Future AACH-EACH Early Career Researcher Networks should continue to build collaborations by developing shared research projects, papers, and other scholarly products. PMID:20663630

Sustainable interprofessional teamwork needs a team-friendly healthcare system : experiences from a collaborative Dutch programme

NARCIS (Netherlands)

Marloes Amantia van Bokhoven; Jerôme Jean Jacques van Dongen; Anneke van Dijk-de Vries

2017-01-01

The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time.

Breakdowns in collaborative information seeking

DEFF Research Database (Denmark)

Hertzum, Morten

2010-01-01

Collaborative information seeking is integral to many professional activities. In hospital work, the medication process encompasses continual seeking for information and collaborative grounding of information. This study investigates breakdowns in collaborative information seeking through analyses...... of the use of the electronic medication record adopted in a Danish healthcare region and of the reports of five years of medication incidents at Danish hospitals. The results show that breakdowns in collaborative information seeking is a major source of medication incidents, that most of these breakdowns...... are breakdowns in collaborative grounding rather than information seeking, that the medication incidents mainly concern breakdowns in the use of records as opposed to oral communication, that the breakdowns span multiple degrees of separation between clinicians, and that the electronic medication record has...

Large scale healthcare data integration and analysis using the semantic web.

Science.gov (United States)

Timm, John; Renly, Sondra; Farkash, Ariel

2011-01-01

Healthcare data interoperability can only be achieved when the semantics of the content is well defined and consistently implemented across heterogeneous data sources. Achieving these objectives of interoperability requires the collaboration of experts from several domains. This paper describes tooling that integrates Semantic Web technologies with common tools to facilitate cross-domain collaborative development for the purposes of data interoperability. Our approach is divided into stages of data harmonization and representation, model transformation, and instance generation. We applied our approach on Hypergenes, an EU funded project, where we use our method to the Essential Hypertension disease model using a CDA template. Our domain expert partners include clinical providers, clinical domain researchers, healthcare information technology experts, and a variety of clinical data consumers. We show that bringing Semantic Web technologies into the healthcare interoperability toolkit increases opportunities for beneficial collaboration thus improving patient care and clinical research outcomes.

Designing and evaluating an effective theory-based continuing interprofessional education program to improve sepsis care by enhancing healthcare team collaboration.

Science.gov (United States)

Owen, John A; Brashers, Valentina L; Littlewood, Keith E; Wright, Elisabeth; Childress, Reba Moyer; Thomas, Shannon

2014-05-01

Continuing interprofessional education (CIPE) differs from traditional continuing education (CE) in both the learning process and content, especially when it occurs in the workplace. Applying theories to underpin the development, implementation, and evaluation of CIPE activities informs educational design, encourages reflection, and enhances our understanding of CIPE and collaborative practice. The purpose of this article is to describe a process of design, implementation, and evaluation of CIPE through the application of explicit theories related to CIPE and workplace learning. A description of an effective theory-based program delivered to faculty and clinicians to enhance healthcare team collaboration is provided. Results demonstrated that positive changes in provider perceptions of and commitment to team-based care were achieved using this theory-based approach. Following this program, participants demonstrated a greater appreciation for the roles of other team members by indicating that more responsibility for implementing the Surviving Sepsis guideline should be given to nurses and respiratory therapists and less to physicians. Furthermore, a majority (86%) of the participants made commitments to demonstrate specific collaborative behaviors in their own practice. The article concludes with a discussion of our enhanced understanding of CIPE and a reinterpretation of the learning process which has implications for future CIPE workplace learning activities.

[Current legislation in the healthcare system 2015/2016].

Science.gov (United States)

Martenstein, I; Wienke, A

2016-05-01

The energy of the legislator in the healthcare system was barely stoppable in 2015. Many new laws have been brought into force and legal initiatives have also been implemented. The Hospital Structure Act, the Treatment Enhancement Act, amendments of the official medical fee schedules for physicians, the Prevention Act, the E-Health Act, the Anti-corruption Act, the hospital admission guidelines and amendments of the model specialty training regulations are just some of the essential alterations that lie ahead of the medical community. This article gives a review of the most important new legislative regulations in the healthcare system and presents the fundamental consequences for the practice.

Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

Directory of Open Access Journals (Sweden)

Ramona Fernanda Ceriotti Toassi

2013-06-01

Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

Applying the balanced scorecard in healthcare provider organizations.

Science.gov (United States)

Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin

2002-01-01

Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system.

Flexible solution for interoperable cloud healthcare systems.

Science.gov (United States)

Vida, Mihaela Marcella; Lupşe, Oana Sorina; Stoicu-Tivadar, Lăcrămioara; Bernad, Elena

2012-01-01

It is extremely important for the healthcare domain to have a standardized communication because will improve the quality of information and in the end the resulting benefits will improve the quality of patients' life. The standards proposed to be used are: HL7 CDA and CCD. For a better access to the medical data a solution based on cloud computing (CC) is investigated. CC is a technology that supports flexibility, seamless care, and reduced costs of the medical act. To ensure interoperability between healthcare information systems a solution creating a Web Custom Control is presented. The control shows the database tables and fields used to configure the two standards. This control will facilitate the work of the medical staff and hospital administrators, because they can configure the local system easily and prepare it for communication with other systems. The resulted information will have a higher quality and will provide knowledge that will support better patient management and diagnosis.

Collaborative Educational Systems in the Virtual Environment

Directory of Open Access Journals (Sweden)

Cristian CIUREA

2012-01-01

Full Text Available The work leads to an original approach to the construction of collaborative systems metrics. The approach is based both on research already conducted by the author, on the experimental results obtained, and the foundation taken from the specific literature. The collaborative systems in knowledge-based economy are formalized and their characteristics are identified. The virtual campus structure is described and a comparison with the classical university is achieved. The architecture of virtual is designed and the categories of agents in virtual campus are analyzed.

It is time to talk about people: a human-centered healthcare system

Directory of Open Access Journals (Sweden)

Borgi Lea

2010-11-01

Full Text Available Abstract Examining vulnerabilities within our current healthcare system we propose borrowing two tools from the fields of engineering and design: a Reason's system approach 1 and b User-centered design 23. Both approaches are human-centered in that they consider common patterns of human behavior when analyzing systems to identify problems and generate solutions. This paper examines these two human-centered approaches in the context of healthcare. We argue that maintaining a human-centered orientation in clinical care, research, training, and governance is critical to the evolution of an effective and sustainable healthcare system.

Establishing values-based leadership and value systems in healthcare organizations.

Science.gov (United States)

Graber, David R; Kilpatrick, Anne Osborne

2008-01-01

The importance of values in organizations is often discussed in management literature. Possessing strong or inspiring values is increasingly considered to be a key quality of successful leaders. Another common theme is that organizational values contribute to the culture and ultimate success of organizations. These conceptions or expectations are clearly applicable to healthcare organizations in the United States. However, healthcare organizations have unique structures and are subject to societal expectations that must be accommodated within an organizational values system. This article describes theoretical literature on organizational values. Cultural and religious influences on Americans and how they may influence expectations from healthcare providers are discussed. Organizational cultures and the training and socialization of the numerous professional groups in healthcare also add to the considerable heterogeneity of value systems within healthcare organizations. These contribute to another challenge confronting healthcare managers--competing or conflicting values within a unit or the entire organization. Organizations often fail to reward members who uphold or enact the organization's values, which can lead to lack of motivation and commitment to the organization. Four key elements of values-based leadership are presented for healthcare managers who seek to develop as values-based leaders. 1) Recognize your personal and professional values, 2) Determine what you expect from the larger organization and what you can implement within your sphere of influence, 3) Understand and incorporate the values of internal stakeholders, and 4) Commit to values-based leadership.

Remote collaboration system based on large scale simulation

International Nuclear Information System (INIS)

Kishimoto, Yasuaki; Sugahara, Akihiro; Li, J.Q.

2008-01-01

Large scale simulation using super-computer, which generally requires long CPU time and produces large amount of data, has been extensively studied as a third pillar in various advanced science fields in parallel to theory and experiment. Such a simulation is expected to lead new scientific discoveries through elucidation of various complex phenomena, which are hardly identified only by conventional theoretical and experimental approaches. In order to assist such large simulation studies for which many collaborators working at geographically different places participate and contribute, we have developed a unique remote collaboration system, referred to as SIMON (simulation monitoring system), which is based on client-server system control introducing an idea of up-date processing, contrary to that of widely used post-processing. As a key ingredient, we have developed a trigger method, which transmits various requests for the up-date processing from the simulation (client) running on a super-computer to a workstation (server). Namely, the simulation running on a super-computer actively controls the timing of up-date processing. The server that has received the requests from the ongoing simulation such as data transfer, data analyses, and visualizations, etc. starts operations according to the requests during the simulation. The server makes the latest results available to web browsers, so that the collaborators can monitor the results at any place and time in the world. By applying the system to a specific simulation project of laser-matter interaction, we have confirmed that the system works well and plays an important role as a collaboration platform on which many collaborators work with one another

Impact of managed care on healthcare delivery practices: the perception of healthcare administrators and clinical practitioners.

Science.gov (United States)

Tietze, Mari F

2003-01-01

Managed care has introduced changes, such as cost effectiveness, access to care, and quality of care, to many components of the U.S. healthcare delivery system. These changes have affected how healthcare administrators and clinical practitioners perceive the impact of managed care on healthcare delivery practices. A survey was initiated to explore whether the perceptions of administrators differed from those of practitioners and to discover which organizational variables could explain the difference. A descriptive, cross-sectional survey design was used for the target population of administrators and practitioners in high, moderate, and low managed-care-penetration markets. Two investigator-developed instruments--the Managed Care Perceptions Inventory (MCPI) and the MCPI-Demographic--and an intact centralization of decision-making assessment subscale were used for data collection. Administrators had a statistically significant, more positive perception of the impact of managed care on healthcare delivery than did practitioners. When the distinction between administrator and practitioner was not used as a grouping factor, managed care market penetration, nonprofit status, and years in current employment position were factors that had statistically significant associations with a more positive perception of managed care. Based on these findings, both administrators and practitioners have a role in maintaining awareness regarding their perceptions and should work collaboratively to address issues of concern. Similarly, promoting trust and commitment at the organizational level is important. Recommendations for further research are also provided.

[Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013].

Science.gov (United States)

Roth-Deubel, André N; Molina-Marín, Gloria

2013-01-01

Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

Integrating Diverse Data Systems for International Collaboration

Science.gov (United States)

Fox, Peter

2014-05-01

International collaborations, especially ones that arise with little or no financial resources, still face challenges in opening up data collections via a wide variety of differing and often non-interoperable means. In turn, this hampers the collaborative process, slows or even prevents scientific exchange. Early efforts that proposed a centralized, and project specific data archive encountered many difficulties, ranging from little or no adoption, to the inability to provide required documentation and metadata to make the datasets findable or usable. In time, virtualized approaches appeared to gain traction, for e.g. virtual observatories. In this contribution, we report on several international collaboration case studies with distributed data systems; their needs, successes, challenges and failures and synthesize a set of suggested practices to inform future international collaboration efforts.

Using grey literature to prepare pharmacy students for an evolving healthcare delivery system.

Science.gov (United States)

Happe, Laura E; Walker, Desiree'

2013-05-13

To assess the impact of using "grey literature" (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students' perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information. A reading from the grey literature was identified and assigned to the students for each topic in the course. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students' knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (pgrey literature in a course on healthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.

Integration of healthcare rehabilitation in chronic conditions

Directory of Open Access Journals (Sweden)

Anne Frølich

2010-02-01

Full Text Available Introduction: Quality of care provided to people with chronic conditions does not often fulfil standards of care in Denmark and in other countries. Inadequate organisation of healthcare systems has been identified as one of the most important causes for observed performance inadequacies, and providing integrated healthcare has been identified as an important organisational challenge for healthcare systems. Three entities—Bispebjerg University Hospital, the City of Copenhagen, and the GPs in Copenhagen—collaborated on a quality improvement project focusing on integration and implementation of rehabilitation programmes in four conditions. Description of care practice: Four multidisciplinary rehabilitation intervention programmes, one for each chronic condition: chronic obstructive pulmonary disease, type 2 diabetes, chronic heart failure, and falls in elderly people were developed and implemented during the project period. The chronic care model was used as a framework for support of implementing and integration of the four rehabilitation programmes. Conclusion and discussion: The chronic care model provided support for implementing rehabilitation programmes for four chronic conditions in Bispebjerg University Hospital, the City of Copenhagen, and GPs' offices. New management practices were developed, known practices were improved to support integration, and known practices were used for implementation purposes. Several barriers to integrated care were identified.

Coarse cluster enhancing collaborative recommendation for social network systems

Science.gov (United States)

Zhao, Yao-Dong; Cai, Shi-Min; Tang, Ming; Shang, Min-Sheng

2017-10-01

Traditional collaborative filtering based recommender systems for social network systems bring very high demands on time complexity due to computing similarities of all pairs of users via resource usages and annotation actions, which thus strongly suppresses recommending speed. In this paper, to overcome this drawback, we propose a novel approach, namely coarse cluster that partitions similar users and associated items at a high speed to enhance user-based collaborative filtering, and then develop a fast collaborative user model for the social tagging systems. The experimental results based on Delicious dataset show that the proposed model is able to dramatically reduce the processing time cost greater than 90 % and relatively improve the accuracy in comparison with the ordinary user-based collaborative filtering, and is robust for the initial parameter. Most importantly, the proposed model can be conveniently extended by introducing more users' information (e.g., profiles) and practically applied for the large-scale social network systems to enhance the recommending speed without accuracy loss.

Asan medical information system for healthcare quality improvement.

Science.gov (United States)

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil.

Science.gov (United States)

Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; Ferreira da Silva, Maria Rejane; Unger, Jean-Pierre; Vázquez, María-Luisa

2016-07-01

Although integrated healthcare networks (IHNs) are promoted in Latin America in response to health system fragmentation, few analyses on the coordination of care across levels in these networks have been conducted in the region. The aim is to analyse the existence of healthcare coordination across levels of care and the factors influencing it from the health personnel' perspective in healthcare networks of two countries with different health systems: Colombia, with a social security system based on managed competition and Brazil, with a decentralized national health system. A qualitative, exploratory and descriptive-interpretative study was conducted, based on a case study of healthcare networks in four municipalities. Individual semi-structured interviews were conducted with a three stage theoretical sample of (a) health (112) and administrative (66) professionals of different care levels, and (b) managers of providers (42) and insurers (14). A thematic content analysis was conducted, segmented by cases, informant groups and themes. The results reveal poor clinical information transfer between healthcare levels in all networks analysed, with added deficiencies in Brazil in the coordination of access and clinical management. The obstacles to care coordination are related to the organization of both the health system and the healthcare networks. In the health system, there is the existence of economic incentives to compete (exacerbated in Brazil by partisan political interests), the fragmentation and instability of networks in Colombia and weak planning and evaluation in Brazil. In the healthcare networks, there are inadequate working conditions (temporary and/or part-time contracts) which hinder the use of coordination mechanisms, and inadequate professional training for implementing a healthcare model in which primary care should act as coordinator in patient care. Reforms are needed in these health systems and networks in order to modify incentives, strengthen

Preventing healthcare-associated infections through human factors engineering.

Science.gov (United States)

Jacob, Jesse T; Herwaldt, Loreen A; Durso, Francis T

2018-05-24

Human factors engineering (HFE) approaches are increasingly being used in healthcare, but have been applied in relatively limited ways to infection prevention and control (IPC). Previous studies have focused on using selected HFE tools, but newer literature supports a system-based HFE approach to IPC. Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care. Simplifying workflow can lead to better understanding of why a process fails and allow for improvements to reduce errors and increase efficiency. Hand hygiene can be improved using visual cues and nudges based on room layout. Using personal protective equipment appropriately appears simple, but exists in a complex interaction with workload, behavior, emotion, and environmental variables including product placement. HFE can help prevent the pathogen transmission through improving environmental cleaning and appropriate use of medical devices. Emerging evidence suggests that HFE can be applied in IPC to reduce healthcare-associated infections. HFE and IPC collaboration can help improve many of the basic best practices including use of hand hygiene and personal protective equipment by healthcare workers during patient care.

Applying analytic hierarchy process to assess healthcare-oriented cloud computing service systems.

Science.gov (United States)

Liao, Wen-Hwa; Qiu, Wan-Li

2016-01-01

Numerous differences exist between the healthcare industry and other industries. Difficulties in the business operation of the healthcare industry have continually increased because of the volatility and importance of health care, changes to and requirements of health insurance policies, and the statuses of healthcare providers, which are typically considered not-for-profit organizations. Moreover, because of the financial risks associated with constant changes in healthcare payment methods and constantly evolving information technology, healthcare organizations must continually adjust their business operation objectives; therefore, cloud computing presents both a challenge and an opportunity. As a response to aging populations and the prevalence of the Internet in fast-paced contemporary societies, cloud computing can be used to facilitate the task of balancing the quality and costs of health care. To evaluate cloud computing service systems for use in health care, providing decision makers with a comprehensive assessment method for prioritizing decision-making factors is highly beneficial. Hence, this study applied the analytic hierarchy process, compared items related to cloud computing and health care, executed a questionnaire survey, and then classified the critical factors influencing healthcare cloud computing service systems on the basis of statistical analyses of the questionnaire results. The results indicate that the primary factor affecting the design or implementation of optimal cloud computing healthcare service systems is cost effectiveness, with the secondary factors being practical considerations such as software design and system architecture.

Improvement of emotional healthcare system with stress detection from ECG signal.

Science.gov (United States)

Tivatansakul, S; Ohkura, M

2015-01-01

Our emotional healthcare system is designed to cope with users' negative emotions in daily life. To make the system more intelligent, we integrated emotion recognition by facial expression to provide appropriate services based on user's current emotional state. Our emotion recognition by facial expression has confusion issue to recognize some positive, neutral and negative emotions that make the emotional healthcare system provide a relaxation service even though users don't have negative emotions. Therefore, to increase the effectiveness of the system to provide the relaxation service, we integrate stress detection from ECG signal. The stress detection might be able to address the confusion issue of emotion recognition by facial expression to provide the service. Indeed, our results show that integration of stress detection increases the effectiveness and efficiency of the emotional healthcare system to provide services.

Discourse analysis: A useful methodology for health-care system researches.

Science.gov (United States)

Yazdannik, Ahmadreza; Yousefy, Alireza; Mohammadi, Sepideh

2017-01-01

Discourse analysis (DA) is an interdisciplinary field of inquiry and becoming an increasingly popular research strategy for researchers in various disciplines which has been little employed by health-care researchers. The methodology involves a focus on the sociocultural and political context in which text and talk occur. DA adds a linguistic approach to an understanding of the relationship between language and ideology, exploring the way in which theories of reality and relations of power are encoded in such aspects as the syntax, style, and rhetorical devices used in texts. DA is a useful and productive qualitative methodology but has been underutilized within health-care system research. Without a clear understanding of discourse theory and DA it is difficult to comprehend important research findings and impossible to use DA as a research strategy. To redress this deficiency, in this article, represents an introduction to concepts of discourse and DA, DA history, Philosophical background, DA types and analysis strategy. Finally, we discuss how affect to the ideological dimension of such phenomena discourse in health-care system, health beliefs and intra-disciplinary relationship in health-care system.

Designing for competence: spaces that enhance collaboration readiness in healthcare.

Science.gov (United States)

Lamb, Gerri; Shraiky, James

2013-09-01

Many universities in the United States are investing in classrooms and campuses designed to increase collaboration and teamwork among the health professions. To date, we know little about whether these learning spaces are having the intended impact on student performance. Recent advances in the identification of interprofessional teamwork competencies provide a much-needed step toward a defined outcome metric. Rigorous study of the relationship between design and student competence in collaboration also requires clear specification of design concepts and development of testable frameworks. Such theory-based evaluation is crucial for design to become an integral part of interprofessional education strategies and initiatives. Current classroom and campus designs were analyzed for common themes and features in collaborative spaces as a starting place for specification of design concepts and model development. Four major themes were identified: flexibility, visual transparency/proximity, technology and environmental infrastructure. Potential models linking this preliminary set of design concepts to student competencies are proposed and used to generate hypotheses for future study of the impact of collaborative design spaces on student outcomes.

Aerospace Systems Design in NASA's Collaborative Engineering Environment

Science.gov (United States)

Monell, Donald W.; Piland, William M.

1999-01-01

Past designs of complex aerospace systems involved an environment consisting of collocated design teams with project managers, technical discipline experts, and other experts (e.g. manufacturing and systems operations). These experts were generally qualified only on the basis of past design experience and typically had access to a limited set of integrated analysis tools. These environments provided less than desirable design fidelity, often lead to the inability of assessing critical programmatic and technical issues (e.g., cost risk, technical impacts), and generally derived a design that was not necessarily optimized across the entire system. The continually changing, modern aerospace industry demands systems design processes that involve the best talent available (no matter where it resides) and access to the best design and analysis tools. A solution to these demands involves a design environment referred to as collaborative engineering. The collaborative engineering environment evolving within the National Aeronautics and Space Administration (NASA) is a capability that enables the Agency's engineering infrastructure to interact and use the best state-of-the-art tools and data across organizational boundaries. Using collaborative engineering, the collocated team is replaced with an interactive team structure where the team members are geographically distributed and the best engineering talent can be applied to the design effort regardless of physical location. In addition, a more efficient, higher quality design product is delivered by bringing together the best engineering talent with more up-to-date design and analysis tools. These tools are focused on interactive, multidisciplinary design and analysis with emphasis on the complete life cycle of the system, and they include nontraditional, integrated tools for life cycle cost estimation and risk assessment. NASA has made substantial progress during the last two years in developing a collaborative

Aerospace Systems Design in NASA's Collaborative Engineering Environment

Science.gov (United States)

Monell, Donald W.; Piland, William M.

2000-07-01

Past designs of complex aerospace systems involved an environment consisting of collocated design teams with project managers, technical discipline experts, and other experts (e.g., manufacturing and systems operations). These experts were generally qualified only on the basis of past design experience and typically had access to a limited set of integrated analysis tools. These environments provided less than desirable design fidelity, often led to the inability of assessing critical programmatic and technical issues (e.g., cost, risk, technical impacts), and generally derived a design that was not necessarily optimized across the entire system. The continually changing, modern aerospace industry demands systems design processes that involve the best talent available (no matter where it resides) and access to the best design and analysis tools. A solution to these demands involves a design environment referred to as collaborative engineering. The collaborative engineering environment evolving within the National Aeronautics and Space Administration (NASA) is a capability that enables the Agency's engineering infrastructure to interact and use the best state-of-the-art tools and data across organizational boundaries. Using collaborative engineering, the collocated team is replaced with an interactive team structure where the team members are geographically distributed and the best engineering talent can be applied to the design effort regardless of physical location. In addition, a more efficient, higher quality design product is delivered by bringing together the best engineering talent with more up-to-date design and analysis tools. These tools are focused on interactive, multidisciplinary design and analysis with emphasis on the complete life cycle of the system, and they include nontraditional, integrated tools for life cycle cost estimation and risk assessment. NASA has made substantial progress during the last two years in developing a collaborative

Perceptions of racism in healthcare among patients with systemic lupus erythematosus: a cross-sectional study

Science.gov (United States)

Vina, Ernest R; Hausmann, Leslie R M; Utset, Tammy O; Masi, Christopher M; Liang, Kimberly P; Kwoh, C Kent

2015-01-01

Background Racial disparities in the clinical outcomes of systemic lupus erythematosus (SLE) exist. Perceived racial discrimination may contribute to disparities in health. Objectives To determine if perceived racism in healthcare differs by race among patients with SLE and to evaluate its contribution to racial disparities in SLE-related outcomes. Methods 163 African–American (AA) and 180 white (WH) patients with SLE were enrolled. Structured interviews and chart reviews were done to determine perceptions of racism, SLE-related outcomes (Systemic Lupus International Collaborating Clinics (SLICC) Damage Index, SLE Disease Activity, Center for Epidemiologic Studies-Depression (CES-D)), and other variables that may affect perceptions of racism. Serial hierarchical multivariable logistic regression models were conducted. Race-stratified analyses were also performed. Results 56.0% of AA patients compared with 32.8% of WH patients had high perceptions of discrimination in healthcare (pracism. The odds of having greater disease damage (SLICC damage index ≥2) were higher in AA patients than in WH patients (crude OR 1.55 (95% CI 1.01 to 2.38)). The odds of having moderate to severe depression (CES-D ≥17) were also higher in AA patients than in WH patients (crude OR 1.94 (95% CI 1.26 to 2.98)). When adjusted for sociodemographic and clinical characteristics, racial disparities in disease damage and depression were no longer significant. Among AA patients, higher perceived racism was associated with having moderate to severe depression (adjusted OR 1.23 (95% CI 1.05 to 1.43)) even after adjusting for sociodemographic and clinical variables. Conclusions Perceptions of racism in healthcare were more common in AA patients than in WH patients with SLE and were associated with depression. Interventions aimed at modifiable factors (eg, trust in providers) may reduce higher perceptions of race-based discrimination in SLE. PMID:26322238

Implementing non-invasive prenatal testing for aneuploidy in a national healthcare system: global challenges and national solutions.

Science.gov (United States)

van Schendel, Rachèl V; van El, Carla G; Pajkrt, Eva; Henneman, Lidewij; Cornel, Martina C

2017-09-19

Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of establishing a responsible implementation of NIPT for aneuploidy in prenatal healthcare, by looking at the Netherlands. A mixed methods approach involving 13 stakeholder interviews, document analysis and (participatory) observations of the Dutch NIPT Consortium meetings were used. The Diffusion of Innovation Theory and a Network of Actors model were used to interpret the findings. Implementation of NIPT was facilitated by several factors. The set-up of a national NIPT Consortium enabled discussion and collaboration between stakeholders. Moreover, it led to the plan to offer NIPT through a nationwide research setting (TRIDENT studies), which created a learning phase for careful implementation. The Dutch legal context was perceived as a delaying factor, but eventually gave room for the parties involved to organise themselves and their practices. This study shows that implementing advanced technologies with profound effects on prenatal care benefit from a learning phase that allows time to carefully evaluate the technical performance and women's experiences and to enable public debate. Such a coordinated learning phase, involving all stakeholders, will stimulate the process of responsible and sustainable implementation.

Forging a Frailty-Ready Healthcare System to Meet Population Ageing.

Science.gov (United States)

Lim, Wee Shiong; Wong, Sweet Fun; Leong, Ian; Choo, Philip; Pang, Weng Sun

2017-11-24

The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered. These reforms can be achieved through building partnerships and relationships that engage, empower, and activate patients and their support systems. To meet the challenges of population ageing, Singapore has reorganised its public healthcare into regional healthcare systems (RHSs) aimed at improving population health and the experience of care, and reducing costs. This paper will describe initiatives within the RHS frameworks of the National Health Group (NHG) and the Alexandra Health System (AHS) to forge a frailty-ready healthcare system across the spectrum, which includes the well healthy ("living well"), the well unhealthy ("living with illness"), the unwell unhealthy ("living with frailty"), and the end-of-life (EoL) ("dying well"). For instance, the AHS has adopted a community-centered population health management strategy in older housing estates such as Yishun to build a geographically-based care ecosystem to support the self-management of chronic disease through projects such as "wellness kampungs" and "share-a-pot". A joint initiative by the Lien Foundation and Khoo Teck Puat Hospital aims to launch dementia-friendly communities across the island by building a network comprising community partners, businesses, and members of the public. At the National

Immersion research education: students as catalysts in international collaboration research.

Science.gov (United States)

Anderson, K H; Friedemann, M L; Bűscher, A; Sansoni, J; Hodnicki, D

2012-12-01

This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research. To narrow the healthcare gap for disadvantaged families in the USA and partner countries. Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA students in the MHIRT program complete two introductory courses followed by a 3-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored. Cross-fertilization of research, cultural awareness and ideas about improving family health occur through education, international exchange and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences and healthcare systems. The students are catalysts in the research effort, the dissemination of research findings and other educational endeavours. Five steps of the collaborative activities lead to programmatic success. MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

Corruption in health-care systems and its effect on cancer care in Africa.

Science.gov (United States)

Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

2015-08-01

At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Patient-reported outcomes in adults with congenital heart disease: Inter-country variation, standard of living and healthcare system factors.

Science.gov (United States)

Moons, Philip; Kovacs, Adrienne H; Luyckx, Koen; Thomet, Corina; Budts, Werner; Enomoto, Junko; Sluman, Maayke A; Yang, Hsiao-Ling; Jackson, Jamie L; Khairy, Paul; Cook, Stephen C; Subramanyan, Raghavan; Alday, Luis; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Johansson, Bengt; Mackie, Andrew S; Menahem, Samuel; Caruana, Maryanne; Veldtman, Gruschen; Soufi, Alexandra; Fernandes, Susan M; White, Kamila; Callus, Edward; Kutty, Shelby; Van Bulck, Liesbet; Apers, Silke

2018-01-15

Geographical differences in patient-reported outcomes (PROs) of adults with congenital heart disease (ConHD) have been observed, but are poorly understood. We aimed to: (1) investigate inter-country variation in PROs in adults with ConHD; (2) identify patient-related predictors of PROs; and (3) explore standard of living and healthcare system characteristics as predictors of PROs. Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS) was a cross-sectional, observational study, in which 4028 patients from 15 countries in 5 continents were enrolled. Self-report questionnaires were administered: patient-reported health (12-item Short Form Health Survey; EuroQOL-5D Visual Analog Scale); psychological functioning (Hospital Anxiety and Depression Scale); health behaviors (Health Behavior Scale-Congenital Heart Disease) and quality of life (Linear Analog Scale for quality of life; Satisfaction With Life Scale). A composite PRO score was calculated. Standard of living was expressed as Gross Domestic Product per capita and Human Development Index. Healthcare systems were operationalized as the total health expenditure per capita and the overall health system performance. Substantial inter-country variation in PROs was observed, with Switzerland having the highest composite PRO score (81.0) and India the lowest (71.3). Functional class, age, and unemployment status were patient-related factors that independently and consistently predicted PROs. Standard of living and healthcare system characteristics predicted PROs above and beyond patient characteristics. This international collaboration allowed us to determine that PROs in ConHD vary as a function of patient-related factors as well as the countries in which patients live. Copyright © 2017 Elsevier B.V. All rights reserved.

Combination Treatment of People with Multiple Sclerosis based on Collaboration between Conventional Healthcare Providers and Alternative Practitioners

DEFF Research Database (Denmark)

Skovgaard, Lasse; Launsø, Laila; Pedersen, Inge Kryger

2011-01-01

The use of alternative and complementary medicine (CAM) is prevalent among People with Multiple Sclerosis (PwMS) in Denmark as well as in other Western countries. Many PwMS combine conventional treatments and CAM; however there is little research-based knowledge about the outcomes that PwMS achieve...... from combined treatments. The purpose of this article is to describe which outcomes PwMS have experienced from combination treatment based on collaboration between conventional healthcare providers and CAM practitioners. A second purpose is to identify and study aspects of the courses of treatment...... that have generally characterized the achieved outcomes. During the course of their treatment, 59 PwMS participated in semi-structured individual or group interviews. The analyses show that the participants’ experienced outcomes can be classified in four ways 1) short-term positive outcomes; 2) long...

Crew resource management: applications in healthcare organizations.

Science.gov (United States)

Oriol, Mary David

2006-09-01

Healthcare organizations continue their struggle to establish a culture of open communication and collaboration. Lessons are learned from the aviation industry, which long ago acknowledged that most errors were the result of poor communication and coordination rather than individual mistakes. The author presents a review of how some healthcare organizations have successfully adopted aviation's curriculum called Crew Resource Management, which promotes and reinforces the conscious, learned team behaviors of cooperation, coordination, and sharing.

Seven Guiding Commitments: Making the U.S. Healthcare System More Compassionate

Directory of Open Access Journals (Sweden)

Beth A. Lown MD

2014-11-01

Full Text Available Despite the current focus on patient centeredness, healthcare professionals face numerous challenges that impede their ability to provide compassionate care that ameliorates concerns, distress, or suffering. These include fragmentation and discontinuity of care, technologies that both help and hinder communication and relationship-building, burgeoning operational and administrative requirements, inadequate communication skills training, alarming rates of burnout, and increased cost and market pressures. A compassionate healthcare system begins with compassionate people, but the organizations in which they train and work must reliably enable them to express and act on their compassion rather than impede it. We present a set of guiding commitments and recommendations to foster a more compassionate healthcare system. We urge healthcare organizations to adopt these commitments and take action to embed compassionate care in all aspects of training, research, patient care and organizational life.

The Power of Collaboration for Improving Safety in Complex Systems

International Nuclear Information System (INIS)

Hart, C. A.

2016-01-01

Many potentially hazardous industries involve systems that consist of a complex array of subsystems that must work together effectively in order for the entire system to perform. Often the subsystems are coupled, such that changes in any one subsystem can affect other subsystems. “System Think” refers to an awareness of the impacts throughout a system of changes in any subsystem. The U.S. commercial aviation industry, in its continuing endeavor to improve safety, uses a collaborative approach to accomplish System Think— bringing all of the key parts of the industry together to work in a collaborative manner to identify and address potential safety concerns. The collaborative approach resulted in an 83% reduction in the fatal accident rate in only 10 years. It also demonstrated that, contrary to conventional wisdom that safety improvements usually hurt productivity, safety improvements that result from a collaborative approach can simultaneously improve productivity. Last but not least, it minimised one of the continuing challenges of making changes in complex systems, which is unintended consequences. The purpose of this presentation is to describe the collaborative approach and to discuss its transferability to other potentially hazardous industries that are seeking to manage their risks more efficiently and effectively. (author)

Social Medicine: Twitter in Healthcare.

Science.gov (United States)

Pershad, Yash; Hangge, Patrick T; Albadawi, Hassan; Oklu, Rahmi

2018-05-28

Social media enables the public sharing of information. With the recent emphasis on transparency and the open sharing of information between doctors and patients, the intersection of social media and healthcare is of particular interest. Twitter is currently the most popular form of social media used for healthcare communication; here, we examine the use of Twitter in medicine and specifically explore in what capacity using Twitter to share information on treatments and research has the potential to improve care. The sharing of information on Twitter can create a communicative and collaborative atmosphere for patients, physicians, and researchers and even improve quality of care. However, risks involved with using Twitter for healthcare discourse include high rates of misinformation, difficulties in verifying the credibility of sources, overwhelmingly high volumes of information available on Twitter, concerns about professionalism, and the opportunity cost of using physician time. Ultimately, the use of Twitter in healthcare can allow patients, healthcare professionals, and researchers to be more informed, but specific guidelines for appropriate use are necessary.

Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.

Science.gov (United States)

Munro, Neil; Duckett, Jane

2016-06-01

To identify factors associated with health-care system satisfaction in China. Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. Stratified nationwide survey sample analysed using multilevel logistic regression. 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Satisfaction with the way the health-care system in China is run. We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices. © 2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Collaborative Systems Biology Projects for the Military Medical Community.

Science.gov (United States)

Zalatoris, Jeffrey J; Scheerer, Julia B; Lebeda, Frank J

2017-09-01

This pilot study was conducted to examine, for the first time, the ongoing systems biology research and development projects within the laboratories and centers of the U.S. Army Medical Research and Materiel Command (USAMRMC). The analysis has provided an understanding of the breadth of systems biology activities, resources, and collaborations across all USAMRMC subordinate laboratories. The Systems Biology Collaboration Center at USAMRMC issued a survey regarding systems biology research projects to the eight U.S.-based USAMRMC laboratories and centers in August 2016. This survey included a data call worksheet to gather self-identified project and programmatic information. The general topics focused on the investigators and their projects, on the project's research areas, on omics and other large data types being collected and stored, on the analytical or computational tools being used, and on identifying intramural (i.e., USAMRMC) and extramural collaborations. Among seven of the eight laboratories, 62 unique systems biology studies were funded and active during the final quarter of fiscal year 2016. Of 29 preselected medical Research Task Areas, 20 were associated with these studies, some of which were applicable to two or more Research Task Areas. Overall, studies were categorized among six general types of objectives: biological mechanisms of disease, risk of/susceptibility to injury or disease, innate mechanisms of healing, diagnostic and prognostic biomarkers, and host/patient responses to vaccines, and therapeutic strategies including host responses to therapies. We identified eight types of omics studies and four types of study subjects. Studies were categorized on a scale of increasing complexity from single study subject/single omics technology studies (23/62) to studies integrating results across two study subject types and two or more omics technologies (13/62). Investigators at seven USAMRMC laboratories had collaborations with systems biology experts

Collaboration in Healthcare Through Boundary Work and Boundary Objects

DEFF Research Database (Denmark)

Meier, Ninna

2015-01-01

This article contributes to our understanding of how boundary work is practiced in healthcare settings. Previous studies have shown how boundaries are constantly changing, multiple, and co-existing, and can also be relatively stable cognitive and social distinctions between individuals and groups...

Components of Maternal Healthcare Delivery System Contributing to ...

African Journals Online (AJOL)

Components of Maternal Healthcare Delivery System Contributing to Maternal Deaths ... transcripts were analyzed using a directed approach to content analysis. Excerpts were categorized according to three main components of the maternal ...

Real-time locating systems (RTLS) in healthcare: a condensed primer.

Science.gov (United States)

Kamel Boulos, Maged N; Berry, Geoff

2012-06-28

Real-time locating systems (RTLS, also known as real-time location systems) have become an important component of many existing ubiquitous location aware systems. While GPS (global positioning system) has been quite successful as an outdoor real-time locating solution, it fails to repeat this success indoors. A number of RTLS technologies have been used to solve indoor tracking problems. The ability to accurately track the location of assets and individuals indoors has many applications in healthcare. This paper provides a condensed primer of RTLS in healthcare, briefly covering the many options and technologies that are involved, as well as the various possible applications of RTLS in healthcare facilities and their potential benefits, including capital expenditure reduction and workflow and patient throughput improvements. The key to a successful RTLS deployment lies in picking the right RTLS option(s) and solution(s) for the application(s) or problem(s) at hand. Where this application-technology match has not been carefully thought of, any technology will be doomed to failure or to achieving less than optimal results.

Applying e-procurement system in the healthcare: the EPOS paradigm

Science.gov (United States)

Ketikidis, Panayiotis H.; Kontogeorgis, Apostolos; Stalidis, George; Kaggelides, Kostis

2010-03-01

One of the goals of procurement is to establish a competitive price, while e-procurement utilises electronic commerce to identify potential sources of supply, to purchase goods and services, to exchange contractual information and to interact with suppliers. Extensive academic work has been extensively devoted to e-procurement in diverse industries. However, applying e-procurement in the healthcare sector remains unexplored. It lacks an efficient e-procurement mechanism that will enable hospitals and healthcare suppliers to electronically exchange contractual information, aided by the technologies of optimisation and business rules. The development and deployment of e-procurement requires a major effort in the coordination of complex interorganisational business process. This article presents an e-procurement optimised system (EPOS) for the healthcare marketplace, a complete methodological approach for deploying and operating such system, as piloted in public and private hospitals in three European countries (Greece, Spain and Belgium) and suppliers of healthcare items in the fourth country (Italy). The efficient e-procurement mechanism that EPOS suggests enables hospitals and pharmaceutical and medical equipment suppliers to electronically exchange contractual information.

Healthcare system simulation using Witness

International Nuclear Information System (INIS)

Khakdaman, Masoud; Zeinahvazi, Milad; Zohoori, Bahareh; Nasiri, Fardokht; Wong, Kuan Yew

2013-01-01

Simulation techniques have a proven track record in manufacturing industry as well as other areas such as healthcare system improvement. In this study, simulation model of a health center in Malaysia is developed through the application of WITNESS simulation software which has shown its flexibility and capability in manufacturing industry. Modelling procedure is started through process mapping and data collection and continued with model development, verification, validation and experimentation. At the end, final results and possible future improvements are demonstrated.

Physician Leadership: A Central Strategy to Transforming Healthcare.

Science.gov (United States)

Oostra, Randall D

2016-01-01

As the role of the physician leader becomes increasingly important in the transformation of healthcare, how hospitals, health systems, and other healthcare organizations define that role is undergoing radical change. Traditional physician leadership roles no longer are effective, and the independent medical staff approach is changing to a collaborative, team-oriented model. The dyad relationship between physician leaders and operational leaders is shifting from a rigid, siloed set of responsibilities to a model characterized by a distributed, situational framework of accountabilities, and the scope of influence of the physician leader and operational leader fluctuates depending on the situation and individuals involved. In addition, the focus of the physician leader is moving to one founded in servant leadership, with an increased emphasis on creating supportive models to enhance physicians' success and place them in the roles of leader and integrator of health.

The Erasure of Sex and Gender Minorities in the Healthcare System

Directory of Open Access Journals (Sweden)

Marianne LeBreton

2013-09-01

Full Text Available Socio-cultural notions of gender and sex influence the structuring of healthcare systems. This case study exemplifies how the Western gender binary, and cisnormativity in particular, can create barriers to accessing healthcare services for transgender populations and lead to erasure.

Security And Privacy Issues in Healthcare Monitoring Systems: A Case Study

DEFF Research Database (Denmark)

Handler, Daniel Tolboe; Hauge, Lotte; Spognardi, Angelo

2017-01-01

Security and privacy issues are rarely taken into account in automated systems for monitoring elderly people in their home, exposing inhabitants to a number of threats they are usually not aware of. As a case study to expose the major vulnerabilities these systems are exposed to, this paper reviews...... a generic example of automated healthcare monitoring system. The security and privacy issues identified in this case study can be easily generalised and regarded as alarm bells for all the pervasive healthcare professionals....

The Healthcare Future for the iGeneration: Integrating the Patient and the Healthcare System

OpenAIRE

Cathy H. Ficzere, PharmD, BCPS; Traci M. Poole, PharmD, BCACP; Rachel B. Franks, PharmD, BCACP; Elisa M. Greene, PharmD, BCACP; Kristina D. Wood, PharmD, BCACP; Philip E. Johnston, PharmD

2013-01-01

Objective: To propose a vision to integrate patients, their health-related data, and their wellness plans into the healthcare system using smartphone and tablet computer technology. Setting: Ambulatory care and community practice Practice Innovation: Utilization of smartphone and tablet computer technology to assess health care conditions, educate and involve patients, and facilitate seamless communication between the patient, electronic health record, pharmacy system, third-party p...

Collaborations and Partnerships in NASA’s Earth Science Data Systems

Directory of Open Access Journals (Sweden)

Hampapuram K. Ramapriyan

2017-11-01

Full Text Available NASA has been collecting Earth observation data from spaceborne instruments since 1960. Today, there are tens of satellites orbiting the Earth and collecting frequent global observations for the benefit of mankind. Collaboration between NASA and organizations in the US and other countries has been extremely important in maintaining the Earth observation capabilities as well as collecting, organizing and managing the data. These collaborations have occurred in the form of: 1. NASA’s developing and launching spacecraft and instruments for operation by other agencies; 2. Instruments from collaborating organizations being flown on NASA satellites; and 3. Instruments from NASA being flown on satellites from collaborating organizations. In addition, there are collaborations such as joint science teams, data exchanges, and participation in international organizations to promote interoperability of various data systems. The purpose of this paper is to describe some of the Earth science data-related collaborative efforts in which NASA participates, and highlight a few results relevant to Earth system science research obtained through such collaborations.

Web-based integrated public healthcare information system of Korea: development and performance.

Science.gov (United States)

Ryu, Seewon; Park, Minsu; Lee, Jaegook; Kim, Sung-Soo; Han, Bum Soo; Mo, Kyoung Chun; Lee, Hyung Seok

2013-12-01

The Web-based integrated public healthcare information system (PHIS) of Korea was planned and developed from 2005 to 2010, and it is being used in 3,501 regional health organizations. This paper introduces and discusses development and performance of the system. We reviewed and examined documents about the development process and performance of the newly integrated PHIS. The resources we analyzed the national plan for public healthcare, information strategy for PHIS, usage and performance reports of the system. The integrated PHIS included 19 functional business areas, 47 detailed health programs, and 48 inter-organizational tasks. The new PHIS improved the efficiency and effectiveness of the business process and inter-organizational business, and enhanced user satisfaction. Economic benefits were obtained from five categories: labor, health education and monitoring, clinical information management, administration and civil service, and system maintenance. The system was certified by a patent from the Korean Intellectual Property Office and accredited as an ISO 9001. It was also reviewed and received preliminary comments about its originality, advancement, and business applicability from the Patent Cooperation Treaty. It has been found to enhance the quality of policy decision-making about regional healthcare at the self-governing local government level. PHIS, a Web-based integrated system, has contributed to the improvement of regional healthcare services of Korea. However, when it comes to an appropriate evolution, the needs and changing environments of community-level healthcare service and IT infrastructure should be analyzed properly in advance.

Collaboration system for simulation using commercial Web3D

International Nuclear Information System (INIS)

Okamoto, Koji; Ohkubo, Kohei

2004-01-01

The Web-3D system has been widely used in the internet. It can show the 3D environment easily and friendly. In order to develop the network collaboration system, the Web-3D system is used as the front end of the visualization tool. The 3D geometries have been transferred from the server using HTTP with the viewpoint, one of the commercialized Web-3D. The simulation results are directly transferred to the client using the TCP/IP socket with JAVA. The viewpoint can be controlled by the JAVA, so the transferred simulation data are displayed on the web, in real-time. The multi-client system enables the visualization of the real-time simulation results with remote site. The same results are shown on the remote web site, simultaneously. This means the remote collaboration can be achievable for the real-time simulation. Also, the system has the feedback system, which control the simulation parameter remotely. In this prototype system, the key feature of the collaboration system are discussed using the viewpoint as the frontend. (author)

Population aging and its impacts: strategies of the health-care system in Taipei.

Science.gov (United States)

Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

2010-11-01

Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities. Copyright © 2010 Elsevier B.V. All rights reserved.

Value Systems Alignment Analysis in Collaborative Networked Organizations Management

Directory of Open Access Journals (Sweden)

Patricia Macedo

2017-11-01

Full Text Available The assessment of value systems alignment can play an important role in the formation and evolution of collaborative networks, contributing to reduce potential risks of collaboration. For this purpose, an assessment tool is proposed as part of a collaborative networks information system, supporting both the formation and evolution of long-term strategic alliances and goal-oriented networks. An implementation approach for value system alignment analysis is described, which is intended to assist managers in virtual and networked organizations management. The implementation of the assessment and analysis methods is supported by a set of software services integrated in the information system that supports the management of the networked organizations. A case study in the solar energy sector was conducted, and the data collected through this study allow us to confirm the practical applicability of the proposed methods and the software services.

The Learning Healthcare System: Where are we now? A systematic review.

Science.gov (United States)

Budrionis, Andrius; Bellika, Johan Gustav

2016-12-01

The Learning Healthcare System paradigm has attracted the attention of researchers worldwide. The great potential originating from high-scale health data reuse and the inclusion of patient perspectives into care models promises personalized care, lower costs of health services and minimized consumption of resources. The aim of this review is to summarize the attempts to adopt the novel paradigm, putting emphasis on implementations and evaluating the impact on current medical practices. PRISMA methodology was followed for structuring the review process. Three major research databases (PubMed, IEEE Xplore and ACM DL) were queried with the predefined search terms "learning healthcare" and "learning health". Publications containing specific theoretical or empirical results were considered. Three hundred and fifty-eight publications were identified; however, only 32 met the inclusion criteria. Nineteen papers were characterized as theoretical contributions, while the rest presented empirical achievements. Only one paper described the initial estimates of impact and economy. Individualistic communication of studies ignoring popular frameworks for assessing and reporting research achievements prevents the systematic generation of knowledge. Evaluating the impact of the Learning Healthcare System instances where it is implemented could work as a catalyst in reaching higher acceptance and adoption of the proposed ideas by healthcare worldwide; however, it mostly remains described in theory. The review demonstrated the interest of researchers in exploring the Learning Healthcare System ideas. However, it also revealed minimal focus on evaluating the impact of the novel paradigm on both healthcare service delivery and patient outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Co-production of healthcare services with immigrant patients

DEFF Research Database (Denmark)

Radl-Karimi, Christina Mathilde; Nicolaisen, Anne; Sodemann, Morten

2018-01-01

’s methodology for scoping reviews. The data will stem from the following databases: PubMed, Scopus, Ovid EMBASE, EBSCO CINAHL, EBSCO PsycINFO, Cochrane Library, and Web of Science. We will also screen the websites of national authorities and research organisations for publications and review the literature...... a new perspective on how to collaboratively create the highest possible value for both the patient and the healthcare system. The concept acknowledges that all services are co-produced and directs attention to the relationship between patient and care provider. Co-production is still a new concept...

Implementation of a Recommender System using Collaborative Filtering

Directory of Open Access Journals (Sweden)

Andrei-Cristian Prodan

2010-12-01

Full Text Available Nowadays, consumers have a lot of choices. Electronic retailers offer a great variety of products. Because of this, there is a need for Recommender Systems. These systems aim to solve the problem of matching consumers with the most appealing products for them. They do this by analyzing either the products information details (Content Based methods or users social behavior (Collaborative Filtering. This paper describes the Collaborative Filtering technique in more detail. It then presents one of the best methods for CF: the Matrix Factorization technique. Next, it presents two algorithms used for matrix factorization. Then, the paper describes the implementation details of a framework created by us, called Rho, that uses Collaborative Filtering. In the end, we present some results obtained after experimenting with this framework.

A National Quality Improvement Collaborative for the clinical use of outcome measurement in specialised mental healthcare: results from a parallel group design and a nested cluster randomised controlled trial.

Science.gov (United States)

Metz, Margot J; Veerbeek, Marjolein A; Franx, Gerdien C; van der Feltz-Cornelis, Christina M; de Beurs, Edwin; Beekman, Aartjan T F

2017-05-01

Although the importance and advantages of measurement-based care in mental healthcare are well established, implementation in daily practice is complex and far from optimal. To accelerate the implementation of outcome measurement in routine clinical practice, a government-sponsored National Quality Improvement Collaborative was initiated in Dutch-specialised mental healthcare. To investigate the effects of this initiative, we combined a matched-pair parallel group design (21 teams) with a cluster randomised controlled trial (RCT) (6 teams). At the beginning and end, the primary outcome 'actual use and perceived clinical utility of outcome measurement' was assessed. In both designs, intervention teams demonstrated a significant higher level of implementation of outcome measurement than control teams. Overall effects were large (parallel group d =0.99; RCT d =1.25). The National Collaborative successfully improved the use of outcome measurement in routine clinical practice. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

Developing Distributed Collaboration Systems at NASA: A Report from the Field

Science.gov (United States)

Becerra-Fernandez, Irma; Stewart, Helen; Knight, Chris; Norvig, Peter (Technical Monitor)

2001-01-01

Web-based collaborative systems have assumed a pivotal role in the information systems development arena. While business to customers (B-to-C) and business to business (B-to-B) electronic commerce systems, search engines, and chat sites are the focus of attention, web-based systems span the gamut of information systems that were traditionally confined to internal organizational client server networks. For example, the Domino Application Server allows Lotus Notes (trademarked) uses to build collaborative intranet applications and mySAP.com (trademarked) enables web portals and e-commerce applications for SAP users. This paper presents the experiences in the development of one such system: Postdoc, a government off-the-shelf web-based collaborative environment. Issues related to the design of web-based collaborative information systems, including lessons learned from the development and deployment of the system as well as measured performance, are presented in this paper. Finally, the limitations of the implementation approach as well as future plans are presented as well.

Data Privacy in Cloud-assisted Healthcare Systems: State of the Art and Future Challenges.

Science.gov (United States)

Sajid, Anam; Abbas, Haider

2016-06-01

The widespread deployment and utility of Wireless Body Area Networks (WBAN's) in healthcare systems required new technologies like Internet of Things (IoT) and cloud computing, that are able to deal with the storage and processing limitations of WBAN's. This amalgamation of WBAN-based healthcare systems to cloud-based healthcare systems gave rise to serious privacy concerns to the sensitive healthcare data. Hence, there is a need for the proactive identification and effective mitigation mechanisms for these patient's data privacy concerns that pose continuous threats to the integrity and stability of the healthcare environment. For this purpose, a systematic literature review has been conducted that presents a clear picture of the privacy concerns of patient's data in cloud-assisted healthcare systems and analyzed the mechanisms that are recently proposed by the research community. The methodology used for conducting the review was based on Kitchenham guidelines. Results from the review show that most of the patient's data privacy techniques do not fully address the privacy concerns and therefore require more efforts. The summary presented in this paper would help in setting research directions for the techniques and mechanisms that are needed to address the patient's data privacy concerns in a balanced and light-weight manner by considering all the aspects and limitations of the cloud-assisted healthcare systems.

The evolving role of supply chain management technology in healthcare.

Science.gov (United States)

Langabeer, Jim

2005-01-01

The healthcare supply chain is a vast, disintegrated network of products and players, loosely held together by manual and people-intensive processes. Managing the flow of information, supplies, equipment, and services from manufacturers to distributors to providers of care is especially difficult in clinical supply chains, compared with more technology-intense industries like consumer goods or industrial manufacturing. As supplies move downstream towards hospitals and clinics, the quality and robustness of accompanying management and information systems used to manage these products deteriorates significantly. Technology that provides advanced planning, synchronization, and collaboration upstream at the large supply manufacturers and distributors rarely is used at even the world's larger and more sophisticated hospitals. This article outlines the current state of healthcare supply chain management technologies, addresses potential reasons for the lack of adoption of technologies and provides a roadmap for the evolution of technology for the future. This piece is based on both quantitative and qualitative research assessments of the healthcare supply chain conducted during the last two years.

Using Explorative Simulation to Drive User-Centered Design and IT-Development in Healthcare

DEFF Research Database (Denmark)

Edwards, Kasper; Thommesen, Jacob; Broberg, Ole

2012-01-01

We describe a method involving user-system simulation to drive rapid development and evaluation of layout, organization or information technology in healthcare. The method has been developed, tested and refined in three sub-projects in the Capital Region of Denmark. The overall goal of the project...... was to validate such a development method in a two-year project (2010-11). Explorative simulation is primarily based on approaches in design and usability engineering and simulation-based training in healthcare, and involves end-users and designers or engineers in a collaborative exploration of design solution...... can gain insight into the healthcare work practice and design applications accordingly - Theories and new ideas can be readily transformed to into the simulated world where they are explored and quickly rejected or used further - A very cost-effective approach to innovation....

Applying an Activity System to Online Collaborative Group Work Analysis

Science.gov (United States)

Choi, Hyungshin; Kang, Myunghee

2010-01-01

This study determines whether an activity system provides a systematic framework to analyse collaborative group work. Using an activity system as a unit of analysis, the research examined learner behaviours, conflicting factors and facilitating factors while students engaged in collaborative work via asynchronous computer-mediated communication.…

Modeling and Control of Collaborative Robot System using Haptic Feedback

Directory of Open Access Journals (Sweden)

Vivekananda Shanmuganatha

2017-08-01

Full Text Available When two robot systems can share understanding using any agreed knowledge, within the constraints of the system’s communication protocol, the approach may lead to a common improvement. This has persuaded numerous new research inquiries in human-robot collaboration. We have built up a framework prepared to do independent following and performing table-best protest object manipulation with humans and we have actualized two different activity models to trigger robot activities. The idea here is to explore collaborative systems and to build up a plan for them to work in a collaborative environment which has many benefits to a single more complex system. In the paper, two robots that cooperate among themselves are constructed. The participation linking the two robotic arms, the torque required and parameters are analyzed. Thus the purpose of this paper is to demonstrate a modular robot system which can serve as a base on aspects of robotics in collaborative robots using haptics.

Patient Relationship Management: What the U.S. Healthcare System Can Learn from Other Industries.

Science.gov (United States)

Poku, Michael K; Behkami, Nima A; Bates, David W

2017-01-01

As the U.S. healthcare system moves to value-based care, the importance of engaging patients and families continues to intensify. However, simply engaging patients and families to improve their subjective satisfaction will not be enough for providers who want to maximize value. True optimization entails developing deep and long-term relationships with patients. We suggest that healthcare organizations must build such a discipline of "patient relationship management" (PRM) just as companies in non-healthcare industries have done with the concept of customer relationship management (CRM). Some providers have already made strides in this area, but overall it has been underemphasized or ignored by most healthcare systems to date. As healthcare providers work to develop their dedicated PRM systems, tools, and processes, we suggest they may benefit from emulating companies in other industries who have been able to engage their customers in innovative ways while acknowledging the differences between healthcare and other industries.

Collaborative Care in Schools: Enhancing Integration and Impact in Youth Mental Health

Science.gov (United States)

Lyon, Aaron R.; Whitaker, Kelly; French, William P.; Richardson, Laura P.; Wasse, Jessica Knaster; McCauley, Elizabeth

2016-01-01

Collaborative Care is an innovative approach to integrated mental health service delivery that focuses on reducing access barriers, improving service quality, and lowering healthcare expenditures. A large body of evidence supports the effectiveness of Collaborative Care models with adults and, increasingly, for youth. Although existing studies examining these models for youth have focused exclusively on primary care, the education sector is also an appropriate analog for the accessibility that primary care offers to adults. Collaborative Care aligns closely with the practical realities of the education sector and may represent a strategy to achieve some of the objectives of increasingly popular multi-tiered systems of supports frameworks. Unfortunately, no resources exist to guide the application of Collaborative Care models in schools. Based on the existing evidence for Collaborative Care models, the current paper (1) provides a rationale for the adaptation of Collaborative Care models to improve mental health service accessibility and effectiveness in the education sector; (2) presents a preliminary Collaborative Care model for use in schools; and (3) describes avenues for research surrounding school-based Collaborative Care, including the currently funded Accessible, Collaborative Care for Effective School-based Services (ACCESS) project. PMID:28392832

Healthcare technology: physician collaboration in reducing the surgical cost.

Science.gov (United States)

Olson, Steven A; Obremskey, William T; Bozic, Kevin J

2013-06-01

The increasing cost of providing health care is a national concern. Healthcare spending related to providing hospital care is one of the primary drivers of healthcare spending in the United States. Adoption of advanced medical technologies accounts for the largest percentage of growth in healthcare spending in the United States when compared with other developed countries. Within the specialty of orthopaedic surgery, a variety of implants can result in similar outcomes for patients in several areas of clinical care. However, surgeons often do not know the cost of implants used in a specific procedure or how the use of an implant or technology affects the overall cost of the episode of care. The purposes of this study were (1) to describe physician-led processes for introduction of new surgical products and technologies; and (2) to inform physicians of potential cost savings of physician-led product contract negotiations and approval of new technology. We performed a detailed review of the steps taken by two centers that have implemented surgeon-led programs to demonstrate responsibility in technology acquisition and product procurement decision-making. Each program has developed a physician peer review process in technology and new product acquisition that has resulted in a substantial reduction in spending for the respective hospitals in regard to surgical implants. Implant costs have decreased between 3% and 38% using different negotiating strategies. At the same time, new product requests by physicians have been approved in greater than 90% of instances. Hospitals need physicians to be engaged and informed in discussions concerning current and new technology and products. Surgeons can provide leadership for these efforts to reduce the cost of high-quality care.

Experiences of Caregivers in Healthcare for and Social Support of HIV Positive Children Attending Schools in Bangkok

Directory of Open Access Journals (Sweden)

Duangkamol Wattradul, DNS, RN

2014-09-01

Conclusion: Our findings can inform the design of systems for educational and social support alongside adequate healthcare for children living with HIV/AIDS attending school. The Thai government needs to establish collaboration between the educational and health sectors to reduce the stigma of HIV, promote acceptance and provide support.

Electronic construction collaboration system : phase III.

Science.gov (United States)

2011-12-01

This phase of the electronic collaboration project involved two major efforts: 1) implementation of AEC Sync (formerly known as Attolist), a web-based project management system (WPMS), on the Broadway Viaduct Bridge Project and the Iowa Falls Arch Br...

Data governance and transparency for collaborative systems

NARCIS (Netherlands)

Mahmudlu, R.; den Hartog, J.; Zannone, N.

2016-01-01

As social networks, shared editing platforms and other collaborative systems are becoming increasingly popular, the demands for proper protection of the data created and used within these systems grows. Yet, existing access control mechanisms are not suited for the challenges imposed by

An Intelligent Virtual Human System For Providing Healthcare Information And Support

Science.gov (United States)

2011-01-01

healthcare system, and also to other SMs and Veterans by way of a variety of social networking tools (e.g., 2nd Life, Facebook, etc.). The user can progress... CyberPsychology and Behavior 8, 3 (2005), 187-211. [2] T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508 [4] G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8

Collaborative HIV care in primary health care: nurses' views.

Science.gov (United States)

Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S

2017-12-01

Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.

Healthcare Systems and Other Applications

NARCIS (Netherlands)

van Kasteren, T.L.M.; Kröse, B.J.A.

2007-01-01

This Works in Progress department discusses eight projects related to healthcare. The first project aims to aid people with mild dementia. The second project plans to simplify the delivery of healthcare services to the elderly and cognitively disabled, while the third project is developing models

CAM: A Collaborative Object Memory System

NARCIS (Netherlands)

Vyas, Dhaval; Nijholt, Antinus; Kröner, Alexander

2010-01-01

Physical design objects such as sketches, drawings, collages, storyboards and models play an important role in supporting communication and coordination in design studios. CAM (Cooperative Artefact Memory) is a mobile-tagging based messaging system that allows designers to collaboratively store

Recent advances in standards for collaborative Digital Anatomic Pathology

Science.gov (United States)

2011-01-01

Context Collaborative Digital Anatomic Pathology refers to the use of information technology that supports the creation and sharing or exchange of information, including data and images, during the complex workflow performed in an Anatomic Pathology department from specimen reception to report transmission and exploitation. Collaborative Digital Anatomic Pathology can only be fully achieved using medical informatics standards. The goal of the international integrating the Healthcare Enterprise (IHE) initiative is precisely specifying how medical informatics standards should be implemented to meet specific health care needs and making systems integration more efficient and less expensive. Objective To define the best use of medical informatics standards in order to share and exchange machine-readable structured reports and their evidences (including whole slide images) within hospitals and across healthcare facilities. Methods Specific working groups dedicated to Anatomy Pathology within multiple standards organizations defined standard-based data structures for Anatomic Pathology reports and images as well as informatic transactions in order to integrate Anatomic Pathology information into the electronic healthcare enterprise. Results The DICOM supplements 122 and 145 provide flexible object information definitions dedicated respectively to specimen description and Whole Slide Image acquisition, storage and display. The content profile “Anatomic Pathology Structured Report” (APSR) provides standard templates for structured reports in which textual observations may be bound to digital images or regions of interest. Anatomic Pathology observations are encoded using an international controlled vocabulary defined by the IHE Anatomic Pathology domain that is currently being mapped to SNOMED CT concepts. Conclusion Recent advances in standards for Collaborative Digital Anatomic Pathology are a unique opportunity to share or exchange Anatomic Pathology structured

An Evaluation Framework for Selecting Collaboration Systems for Student Teamwork

Science.gov (United States)

Shen, Yide; Li, Lei; Zheng, Guangzhi; Guo, Rong

2017-01-01

Collaboration technologies play an increasingly important role in student teamwork in universities. With the proliferation of collaboration systems on the market and the wide range of features they offer, choosing an appropriate system can be an overwhelming task for college students. In this paper, the authors present an empirical study that…

Challenges in Achieving Collaboration in Clinical Practice: The Case of Norwegian Health Care

Directory of Open Access Journals (Sweden)

Sissel Steihaug

2016-07-01

Full Text Available Introduction: This article summarizes and synthesizes the findings of four separate but inter-linked empirical projects which explored challenges of collaboration in the Norwegian health system from the perspectives of providers and patients. The results of the four projects are summarised in eight articles. Methods: The eight articles constituted our empirical material. Meta-ethnography was used as a method to integrate, translate, and synthesize the themes and concepts contained in the articles in order to understand how challenges related to collaboration impact on clinical work. Results: Providers’ collaboration across all contexts was hampered by organizational and individual factors, including, differences in professional power, knowledge bases, and professional culture. The lack of appropriate collaboration between providers impeded clinical work. Mental health service users experienced fragmented services leading to insecurity and frustration. The lack of collaboration resulted in inadequate rehabilitation services and lengthened the institutional stay for older patients. Conclusion: Focusing on the different perspectives and the inequality in power between patients and healthcare providers and between different providers might contribute to a better environment for achieving appropriate collaboration. Organizational systems need to be redesigned to better nurture collaborative relationships and information sharing and support integrated working between providers, health care professionals and patients.

Embracing uncertainty, managing complexity: applying complexity thinking principles to transformation efforts in healthcare systems.

Science.gov (United States)

Khan, Sobia; Vandermorris, Ashley; Shepherd, John; Begun, James W; Lanham, Holly Jordan; Uhl-Bien, Mary; Berta, Whitney

2018-03-21

Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here. We synthesized topics from this series into a set of six insights on how complexity thinking fosters a deeper understanding of accepted ideas in healthcare, applications of CAS to actors within the system, and paradoxes in applications of complexity thinking that may require further debate: 1) a complexity lens helps us better understand the nebulous term "context"; 2) concepts of CAS may be applied differently when actors are cognizant of the system in which they operate; 3) actor responses to uncertainty within a CAS is a mechanism for emergent and intentional adaptation; 4) acknowledging complexity supports patient-centred intersectional approaches to patient care; 5) complexity perspectives can support ways that leaders manage change (and transformation) in healthcare; and 6) complexity demands different ways of implementing ideas and assessing the system. To enhance our exploration of key insights, we augmented the knowledge gleaned from the series with key articles on complexity in the literature. Ultimately, complexity thinking acknowledges the "messiness" that we seek to control in healthcare and encourages us to embrace it. This means seeing challenges as opportunities for adaptation, stimulating innovative solutions to ensure positive adaptation, leveraging the social system to enable ideas to emerge and spread across the system, and even more important, acknowledging that these adaptive actions are part of system behaviour just as much as periods of stability are. By

Trends in control and decision-making for human-robot collaboration systems

CERN Document Server

Zhang, Fumin

2017-01-01

This book provides an overview of recent research developments in the automation and control of robotic systems that collaborate with humans. A measure of human collaboration being necessary for the optimal operation of any robotic system, the contributors exploit a broad selection of such systems to demonstrate the importance of the subject, particularly where the environment is prone to uncertainty or complexity. They show how such human strengths as high-level decision-making, flexibility, and dexterity can be combined with robotic precision, and ability to perform task repetitively or in a dangerous environment. The book focuses on quantitative methods and control design for guaranteed robot performance and balanced human experience. Its contributions develop and expand upon material presented at various international conferences. They are organized into three parts covering: one-human–one-robot collaboration; one-human–multiple-robot collaboration; and human–swarm collaboration. Individual topic ar...

Stuck in the middle: the impact of collaborative interprofessional communication on patient expectations.

Science.gov (United States)

Stewart, Michael Adrian

2018-01-01

A central aim of modern day healthcare is to deliver a high quality, patient-centred service that addresses the expectations of its service users. However, mounting research evidence highlights a lack of patient satisfaction across a range of healthcare settings, with an overwhelming proportion of complaints relating to interprofessional communication. The link between interprofessional miscommunication and poor patient outcomes has been well documented. All too often, patients are left feeling stuck in the middle between opposing opinions, differing diagnoses and conflicting clinical outlooks. This article aims to highlight the issues surrounding interprofessional communication in healthcare, at the same time as addressing the potential facilitators and barriers for developing improved collaborative links between healthcare providers. Several key questions will be considered: (i) what are the underlying causes of interprofessional miscommunication; (ii) what do patients expect from healthcare professionals; and (iii) how might we reduce the risk of miscommunication and develop interprofessional collaboration?

IoT-based Asset Management System for Healthcare-related Industries

Directory of Open Access Journals (Sweden)

Lee Carman Ka Man

2015-11-01

Full Text Available The healthcare industry has been focusing efforts on optimizing inventory management procedures through the incorporation of Information and Communication Technology, in the form of tracking devices and data mining, to establish ideal inventory models. In this paper, a roadmap is developed towards a technological assessment of the Internet of Things (IoT in the healthcare industry, 2010–2020. According to the roadmap, an IoT-based healthcare asset management system (IoT-HAMS is proposed and developed based on Artificial Neural Network (ANN and Fuzzy Logic (FL, incorporating IoT technologies for asset management to optimize the supply of resources.

Individualized Healthcare Plans: The Role of the School Nurse. Position Statement. Revised

Science.gov (United States)

McDowell, Bernadette Moran; Buswell, Sue A.; Mattern, Cheryl; Westendorf, Georgene; Clark, Sandra

2015-01-01

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse), in collaboration with the student, family and healthcare providers, shall meet nursing regulatory requirements and professional standards by developing an Individualized Healthcare Plan…

An Interprofessional Approach to Business Planning: A Model of Collaboration

Science.gov (United States)

Ross, Cory; Alexander, Kathleen; Gritsyuk, Renata; Morrin, Arleen; Tan, Jackie

2011-01-01

George Brown College is among the leaders in the interprofessional health-care education movement in Canada. Interprofessional Education (IPE) and Collaborative Practice occur "when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes." According to the…

Essential technologies for developing human and robot collaborative system

International Nuclear Information System (INIS)

Ishikawa, Nobuyuki; Suzuki, Katsuo

1997-10-01

In this study, we aim to develop a concept of new robot system, i.e., 'human and robot collaborative system', for the patrol of nuclear power plants. This paper deals with the two essential technologies developed for the system. One is the autonomous navigation program with human intervention function which is indispensable for human and robot collaboration. The other is the position estimation method by using gyroscope and TV image to make the estimation accuracy much higher for safe navigation. Feasibility of the position estimation method is evaluated by experiment and numerical simulation. (author)

A home healthcare system in the cloud - Addressing security and privacy challenges

OpenAIRE

Deng M.; Petkovic M.; Nalin M.; Baroni I.

2011-01-01

Cloud computing is an emerging technology that is expected to support Internet scale critical applications which could be essential to the healthcare sector. Its scalability, resilience, adaptability, connectivity, cost reduction, and high performance features have high potential to lift the efficiency and quality of healthcare. However,it is also important to understand specific risks related to security and privacy that this technology brings. This paper focuses on a home healthcare system ...

Healthcare regions and their care networks: an organizational-systemic model for SUS.

Science.gov (United States)

Santos, Lenir

2017-04-01

This paper describes a comprehensive effort to develop studies regarding Brazil's Unified Healthcare System (SUS), as a result of the combination of public services in a network that follows a region-based rationale (tripartite organization). The SUS emerges from such an integration and should be organized as such. The intention is to demonstrate that this type of organization is essential, given that Brazil is organized as a Federation, and all three governmental levels are, in a broad sense, equally responsible for healthcare. Healthcare services and actions are a complex set of activities that are interconnected on behalf of citizen health, which is a global concept that cannot be split up. Services must follow this rationale and be organized as such. Thus, healthcare services must be systematically organized to serve everyone equally, regardless of where a citizen lives. This systemic organization requires permanent interaction between federative units to discuss and operationalize reference services, funding and other technical and administrative aspects. These are the essential elements that make the SUS so complex and demand it be organized regionally, as a network of healthcare services.

Developing patient portals in a fragmented healthcare system.

Science.gov (United States)

Otte-Trojel, Terese; de Bont, Antoinette; Aspria, Marcello; Adams, Samantha; Rundall, Thomas G; van de Klundert, Joris; de Mul, Marleen

2015-10-01

Use of patient portals may contribute to improved patient health and experiences and better organizational performance. In the Netherlands, patient portals have gained considerable attention in recent years, as evidenced by various policy initiatives and practical efforts directed at developing portals. Due to the fragmented setup of the Dutch healthcare system patient portals that give patients access to information and services from across their providers are developed in inter-organizational collaboration. The objective of this paper is to identify and describe the types of collaborations, or networks, that have been established to develop patient portals in the Netherlands. Understanding the characteristics of these networks as well as the development of their respective portals enables us to assess the enabling and constraining effects of different network types on patient portal initiatives. We used qualitative methods including interview and documents analysis. In a first step, we interviewed eighteen experts and reviewed relevant national policy and strategy documents. Based on this orientation, we selected three networks we deemed to be representative of inter-organizational efforts to develop Dutch patient portals in 2012. In a second step, we interviewed twelve representatives of these patient portal networks and collected documents related to the portals. We applied content analytic techniques to analyze data from the three cases. The three studied networks differed in their number and diversity of actors, the degree to which these actors were mutually dependent, the degree to which network governance was decentralized, and the dynamics of the network structures. We observed that the portals developed in networks displaying the highest degree of these characteristics experienced most difficulties associated with developing patient portals - such as achieving interoperability, successful implementation, regulatory complaisance, and financial

Collaboration and Virtualization in Large Information Systems Projects

Directory of Open Access Journals (Sweden)

Stefan Ioan NITCHI

2009-01-01

Full Text Available A project is evolving through different phases from idea and conception until the experiments, implementation and maintenance. The globalization, the Internet, the Web and the mobile computing changed many human activities, and in this respect, the realization of the Information System (IS projects. The projects are growing, the teams are geographically distributed, and the users are heterogeneous. In this respect, the realization of the large Information Technology (IT projects needs to use collaborative technologies. The distribution of the team, the users' heterogeneity and the project complexity determines the virtualization. This paper is an overview of these aspects for large IT projects. It shortly present a general framework developed by the authors for collaborative systems in general and adapted to collaborative project management. The general considerations are illustrated on the case of a large IT project in which the authors were involved.

Sociological refigurations of patient safety; ontologies of improvement and 'acting with' quality collaboratives in healthcare.

Science.gov (United States)

Zuiderent-Jerak, Teun; Strating, Mathilde; Nieboer, Anna; Bal, Roland

2009-12-01

The increasing focus on patient safety in the field of health policy is accompanied by research programs that articulate the role of the social sciences as one of contributing to enhancing safety in healthcare. Through these programs, new approaches to studying safety are facing a narrow definition of 'usefulness' in which researchers are to discover the factors that support or hamper the implementation of existing policy agendas. This is unfortunate since such claims for useful involvement in predefined policy agendas may undo one of the strongest assets of good social science research: the capacity to complexify the taken-for-granted conceptualizations of the object of study. As an alternative to this definition of 'usefulness', this article proposes a focus on multiple ontologies in the making when studying patient safety. Through such a focus, the role of social scientists becomes the involvement in refiguring the problem space of patient safety, the relations between research subjects and objects, and the existing policy agendas. This role gives medical sociologists the opportunity to focus on the question of which practices of 'effective care' are being enacted through different approaches for dealing with patient safety and what their consequences are for the care practices under study. In order to explore these questions, this article draws on empirical material from an ongoing evaluation of a large quality improvement collaborative for the care sectors in the Netherlands. It addresses how issues like 'effectiveness' and 'client participation' are at present articulated in this collaborative and shows that alternative figurations of these notions dissolve many 'implementation problems' presently experienced. Further it analyzes how such a focus of medical sociology on multiple ontologies engenders new potential for exploring particular spaces for 'acting with' quality improvement agents.

Medical data transmission system for remote healthcare centres

International Nuclear Information System (INIS)

Gonzalez, E A; Cagnolo, F J; Olmos, C E; Centeno, C A; Riva, G G; Zerbini, C A

2007-01-01

The main motivation of this project is to improve the healthcare centres equipment and human resources efficiency, enabling those centres for transmission of parameters of medical interest. This system facilitates remote consultation, in particular between specialists and remote healthcare centres. Likewise it contributes to the qualification of professionals. The electrocardiographic (ECG) and electroencephalographic (EEG) signals are acquired, processed and then sent, fulfilling the effective norms, for application in the hospital network of Cordoba Province, which has nodes interconnected by phone line. As innovative aspects we emphasized the low cost of development and maintenance, great versatility and handling simplicity with a modular design for interconnection with diverse data transmission media (Wi-Fi, GPRS, etc.). Successfully experiences were obtained during the acquisition of the signals and transmissions on wired LAN networks. As improvements, we can mention: energy consumption optimization and mobile communication systems usage, in order to offer more autonomy

Collaborative planning approach to inform the implementation of a healthcare manager intervention for hispanics with serious mental illness: a study protocol

Directory of Open Access Journals (Sweden)

Cabassa Leopoldo J

2011-07-01

Full Text Available Abstract Background This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI and at risk for cardiovascular disease (CVD. Methods The proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30 to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention. Discussion The proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population.

Collaborative planning approach to inform the implementation of a healthcare manager intervention for Hispanics with serious mental illness: a study protocol.

Science.gov (United States)

Cabassa, Leopoldo J; Druss, Benjamin; Wang, Yuanjia; Lewis-Fernández, Roberto

2011-07-26

This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI) and at risk for cardiovascular disease (CVD). The proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30) to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention. The proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population.

Collective action for implementation: a realist evaluation of organisational collaboration in healthcare.

Science.gov (United States)

Rycroft-Malone, Jo; Burton, Christopher R; Wilkinson, Joyce; Harvey, Gill; McCormack, Brendan; Baker, Richard; Dopson, Sue; Graham, Ian D; Staniszewska, Sophie; Thompson, Carl; Ariss, Steven; Melville-Richards, Lucy; Williams, Lynne

2016-02-09

Increasingly, it is being suggested that translational gaps might be eradicated or narrowed by bringing research users and producers closer together, a theory that is largely untested. This paper reports a national study to fill a gap in the evidence about the conditions, processes and outcomes related to collaboration and implementation. A longitudinal realist evaluation using multiple qualitative methods case studies was conducted with three Collaborations for Leadership in Applied Health Research in Care (England). Data were collected over four rounds of theory development, refinement and testing. Over 200 participants were involved in semi-structured interviews, non-participant observations of events and meetings, and stakeholder engagement. A combined inductive and deductive data analysis process was focused on proposition refinement and testing iteratively over data collection rounds. The quality of existing relationships between higher education and local health service, and views about whether implementation was a collaborative act, created a path dependency. Where implementation was perceived to be removed from service and there was a lack of organisational connections, this resulted in a focus on knowledge production and transfer, rather than co-production. The collaborations' architectures were counterproductive because they did not facilitate connectivity and had emphasised professional and epistemic boundaries. More distributed leadership was associated with greater potential for engagement. The creation of boundary spanning roles was the most visible investment in implementation, and credible individuals in these roles resulted in cross-boundary work, in facilitation and in direct impacts. The academic-practice divide played out strongly as a context for motivation to engage, in that 'what's in it for me' resulted in variable levels of engagement along a co-operation-collaboration continuum. Learning within and across collaborations was patchy

Implications of climate change (global warming) for the healthcare system.

Science.gov (United States)

Raffa, R B; Eltoukhy, N S; Raffa, K F

2012-10-01

Temperature-sensitive pathogenic species and their vectors and hosts are emerging in previously colder regions as a consequence of several factors, including global warming. As a result, an increasing number of people will be exposed to pathogens against which they have not previously needed defences. We illustrate this with a specific example of recent emergence of Cryptococcus gattii infections in more temperate climates. The outbreaks in more temperate climates of the highly virulent--but usually tropically restricted--C. gattii is illustrative of an anticipated growing challenge for the healthcare system. There is a need for preparedness by healthcare professionals in anticipation and for management of such outbreaks, including other infections whose recent increased prevalence in temperate climates can be at least partly associated with global warming. (Re)emergence of temperature-sensitive pathogenic species in more temperate climates will present new challenges for healthcare systems. Preparation for outbreaks should precede their occurrence. © 2012 Blackwell Publishing Ltd.

Interdisciplinary collaboration: the role of the clinical nurse leader.

Science.gov (United States)

Bender, Miriam; Connelly, Cynthia D; Brown, Caroline

2013-01-01

  To explore the feasibility and acceptability of a clinical nurse leader (CNL) role to improve interdisciplinary collaboration (IC) within a fragmented acute-care microsystem.   Fragmented patient care is associated with preventable adverse healthcare outcomes. IC decreases fragmentation and improves patient care quality. The CNL role is theorized to provide the necessary leadership and competency skill base to impact IC at the optimal organizational level, the point of care where most healthcare decisions are made.   This study used a descriptive non-experimental design. CNL daily workflow was developed to target empirical determinants of IC. Descriptive data were collected from multiple stakeholders using an investigator-developed survey.   Findings indicate the integration of the role is feasible and acceptable to the microsystem healthcare team.   Preliminary evidence suggests the CNL role may be an effective intervention to facilitate IC. More research is needed to support the CNL role's association with microsystem IC.   The CNL role presents an innovative opportunity for clinical and administrative leadership to partner together to redesign a healthcare delivery system and improve patient care quality. © 2012 Blackwell Publishing Ltd.

MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

Science.gov (United States)

ROBBINS, JACOB A.

2015-01-01

The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered. We find that in areas with greater enrollment of Medicare beneficiaries in managed care, the non–managed care beneficiaries have fewer days in the hospital but more outpatient visits, consistent with a substitution of less expensive outpatient care for more expensive inpatient care, particularly at high levels of managed care. We find no evidence that care is of lower quality. Optimal payment policies for Medicare managed care enrollees that account for system-level spillovers may thus be higher than those that do not. PMID:27042687

Specific factors influencing information system/information and communication technology sourcing strategies in healthcare facilities.

Science.gov (United States)

Potančok, Martin; Voříšek, Jiří

2016-09-01

Healthcare facilities use a number of information system/information and communication technologies. Each healthcare facility faces a need to choose sourcing strategies most suitable to ensure provision of information system/information and communication technology services, processes and resources. Currently, it is possible to observe an expansion of sourcing possibilities in healthcare informatics, which creates new requirements for sourcing strategies. Thus, the aim of this article is to identify factors influencing information system/information and communication technology sourcing strategies in healthcare facilities. The identification was based on qualitative research, namely, a case study. This study provides a set of internal and external factors with their impact levels. The findings also show that not enough attention is paid to these factors during decision-making. © The Author(s) 2015.

[The quality of the German health-care system in an international comparison - a systematic review].

Science.gov (United States)

Lauerer, M; Emmert, M; Schöffski, O

2013-08-01

Studies assessing the quality of the German health-care system in an international comparison come to different results. Therefore, this review aims to investigate how the German health-care system is evaluated in comparison to other health-care systems by reviewing international publications. Results show starting points for ways to improve the German health-care system, to maintain and expand its strengths as well as to derive strategies for solving identified problems. A systematic review searching different databases [library catalogues, WorldCat (including MEDLINE and OAIster-search), German National Library, Google Scholar and others]. Search requests were addressed to English or German language publications for the time period 2000-2010 (an informal search was conducted in October 2011 for an update). Results of the identified studies were aggregated and main statements derived. In total, 13 publications assessing the German health-care system in an international comparison were identified. These comparisons are based on 377 measures. After aggregation, 244 substantially different indicators remained, which were dedicated to 14 categories. It became apparent that the German health-care system can be characterised by a high level of expenses, a well-developed health-care infrastructure as well as a high availability of personal and material resources. Outcome measures demonstrate heterogeneous results. It can be stated that, particularly in this field, there is potential for further improvement. The utilisation of health-care services is high, the access is mostly not regulated and out of pocket payments can pose a barrier for patients. Waiting times are not regarded as a major weakness. Although civic satisfaction seems to be acceptable, a large portion of the citizens calls for elementary modifications. Especially, more patient-centred health-care delivery should be addressed as well as management of information and the adoption of meaningful electronic

Incentives for vertical integration in healthcare: the effect of reimbursement systems.

Science.gov (United States)

Byrne, M M; Ashton, C M

1999-01-01

In the United States, many healthcare organizations are being transformed into large integrated delivery systems, even though currently available empirical evidence does not provide strong or unequivocal support for or against vertical integration. Unfortunately, the manager cannot delay organizational changes until further research has been completed, especially when further research is not likely to reveal a single, correct solution for the diverse healthcare systems in existence. Managers must therefore carefully evaluate the expected effects of integration on their individual organizations. Vertical integration may be appropriate if conditions facing the healthcare organization provide opportunities for efficiency gains through reorganization strategies. Managers must consider (1) how changes in the healthcare market have affected the dynamics of production efficiency and transaction costs; (2) the likelihood that integration strategies will achieve increases in efficiency or reductions in transaction costs; and (3) how vertical integration will affect other costs, and whether the benefits gained will outweigh additional costs and efficiency losses. This article presents reimbursement systems as an example of how recent changes in the industry may have changed the dynamics and efficiency of production. Evaluation of the effects of vertical integration should allow for reasonable adjustment time, but obviously unsuccessful strategies should not be followed or maintained.

Is there a role for social technologies in collaborative healthcare?

Science.gov (United States)

Bacigalupe, Gonzalo

2011-03-01

The exponential growth, variety, and sophistication of the information communication technologies (ICTs) plus their growing accessibility are transforming how clinical practitioners, patients, and their families can work together. Social technologies are the ICTs tools that augment the ability of people to communicate and collaborate despite obstacles of geography and time. There is still little empirical research on the impact of social technologies in the case of collaborative health. Defining a set of social technologies with potential for developing, sustaining, and strengthening the collaborative health agenda should prove useful for practitioners and researchers. This paper is based on an extensive review of the literature focusing on emerging technologies and the experience of the author as a consultant to health care professionals learning about social technologies. A note of caution is required: the phenomenon is complex and hard to describe in writing (a medium very different from the technologies themselves). Hardware and software are in continuous development and the iterative adaptation of the emergent social technologies for new forms of virtual communication. (c) 2011 APA, all rights reserved

Designing a Safer Interactive Healthcare System - The Impact of Authentic User Participation

Science.gov (United States)

Went, Kathryn L.; Gregor, Peter; Ricketts, Ian W.

Information technology has been widely promoted in the healthcare sector to improve current practice and patient safety. However, end users are seldom involved extensively in the design and development of healthcare systems, with lip service often paid to the idea of true user involvement. In this case study the impact of sustained authentic user participation was explored using an interdisciplinary team, consisting of experts both in interaction and healthcare design and consultant anaesthetists, nurses, and pharmacists, to create an electronic prescribing and administration system. This paper details the interface that was created and provides examples of the way in which the design evolved in response to the sustained authentic user participation methods. The working prototype both reduced the opportunity for user error and was preferred by its users to the existing manual system.

Model of care for a changing healthcare system: are there foundational pillars for design?

Science.gov (United States)

Booker, Catriona; Turbutt, Adam; Fox, Robyn

2016-04-01

Currently, healthcare organisations are being challenged to provide optimal clinical services within budget limitations while simultaneously being confronted by aging consumers and labour and skill shortages. Within this dynamic and changing environment, the ability to remain responsive to patient needs while managing these issues poses further challenges. Development or review of the model of care (MOC) may provide a possible solution to support efficiencies in service provision. Although MOC are not readily understood or appreciated as an efficiency strategy, they can be more easily explained by considering several recurring pillars when developing or redesigning an MOC. Generic and recurring foundational pillars include integrated care models, team functioning and communication, leadership, change management and lean thinking. These foundational pillars should be incorporated into the development and application of MOC in order to achieve desired outcomes. However, sustainability requires continuous review to enable improvement and must be integrated into routine business. Moreover, successful review of MOC requires collaboration and commitment by all stakeholders. Leaders are critical to motivating clinicians and stakeholders in the review process. Further, it is imperative that leaders engage stakeholders to commit to support the agreed strategies designed to provide efficient and comprehensive healthcare services. Redesign of MOC can significantly improve patient care by applying the agreed strategies. In the current healthcare environment, these strategies can favourably affect healthcare expenditure and, at the same time, improve the quality of interprofessional health services.

Seeking perfection in healthcare. A case study in adopting Toyota Production System methods.

Science.gov (United States)

Kaplan, Gary S; Patterson, Sarah H

2008-01-01

Virginia Mason Health System's vision to be the quality leader in healthcare means continually adopting new ways of thinking. One change has been shifting from believing defects are to be expected to believing zero defects in healthcare is not only possible, but also necessary. Generally, healthcare has advanced in technology and understanding of disease, but its business and management systems have changed little since the 1950s. Virginia Mason realized it needed a management method to help make real and measurable improvements in safety, quality, service and staff satisfaction.

Quality improvement in healthcare delivery utilizing the patient-centered medical home model.

Science.gov (United States)

Akinci, Fevzi; Patel, Poonam M

2014-01-01

Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.

Private investment in hospitals: a comparison of three healthcare systems and possible implications for real estate strategies.

Science.gov (United States)

van der Zwart, Johan; van der Voordt, Theo; Jonge, Hans de

2010-01-01

This article explores lessons to be learned from three different healthcare systems and the possible implications for the management of healthcare real estate, in particular in connection to the Dutch system. It discusses similarities and differences among the different systems, in search of possible consequences on cost, financing, and design innovation. To keep healthcare affordable in the future, the Dutch government is currently in the process of changing legislation to move from a centrally directed system to a so-called regulated market system. The deregulation of real estate investment that accompanies the new healthcare delivery system offers healthcare organizations new opportunities, but also more responsibility and greater risk in return on investment. Consequently, healthcare organizations must find new methods of financing. Private investment is one of the options. Three healthcare systems were analyzed on the basis of a literature review and document analysis, then schematized to show similarities and dissimilarities with regard to private investment in hospitals. Observations are based on a selection of recently published articles on private-sector financing and its implications for healthcare real estate decision making in the Netherlands, the United Kingdom, and Germany. The strengths and weaknesses of three healthcare systems with differing proportions of private and public investment in hospitals were explored. Research revealed a gap between intended effects and actual effects with regard to quality and cost. Costly private finance does not necessarily lead to "value for money." Transferring real estate decisions to private investors decreases the influence of the healthcare organization on future costs and quality. The three healthcare systems show substantial differences between public and private responsibilities. Less governmental involvement affords both opportunities and risks for hospitals. Private investment may lead to innovation

Interprofessional care collaboration for patients with heart failure.

Science.gov (United States)

Boykin, Amanda; Wright, Danielle; Stevens, Lydia; Gardner, Lauren

2018-01-01

An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF. The team consists of 5 TOC pharmacists, 4 community paramedics, and 4 advanced care practitioners (ACPs) who collaborate to coordinate care and prevent 30-day readmissions among patients with HF transitioning from the hospital to the community setting. Each team member plays an integral role in providing high-quality postdischarge care. The TOC pharmacist ensures that patients have access to all needed medications, provides in-home medication reconciliation services, makes medication recommendations, and alerts the team of potential medication-related issues. Community paramedics conduct home visits consisting of physical and mental health assessments, diet and disease state education, reviews of medication bottles and education on proper medication use, and administration of i.v. diuretics to correct volume status under provider orders. The ACPs offer close clinic follow-up (typically initiated within 7 days of discharge) as well as long-term HF management and education. At NHRMC, collaboration among healthcare professionals, including a TOC pharmacist, community paramedics, and ACPs, has assisted in the growth and expansion of services provided to patients with HF. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Lean healthcare.

Science.gov (United States)

Weinstock, Donna

2008-01-01

As healthcare organizations look for new and improved ways to reduce costs and still offer quality healthcare, many are turning to the Toyota Production System of doing business. Rather than focusing on cutting personnel and assets, "lean healthcare" looks to improve patient satisfaction through improved actions and processes.

Sustainability of midwifery practice within the South African healthcare system

OpenAIRE

2012-01-01

M.Cur. The study on ‘Sustainability of midwifery practice within the South African healthcare system’ is stimulated by the lack of research that influences policy to support midwifery practice in South Africa. The poor database and health information systems for midwives result in the poor performance of maternal healthcare in the public sector (Parkhurst, Penn- Kekana, Blaauw, Balabanova, Danishevski, Rahman, Onama, & Ssengooba 2005) in spite of meeting the Safe Motherhood Initiative of t...

Collaboration support system for "Phobos-Soil" space mission.

Science.gov (United States)

Nazarov, V.; Nazirov, R.; Zakharov, A.

2009-04-01

Rapid development of communication facilities leads growth of interactions done via electronic means. However we can see some paradox in this segment in last times: Extending of communication facilities increases collaboration chaos. And it is very sensitive for space missions in general and scientific space mission particularly because effective decision of this task provides successful realization of the missions and promises increasing the ratio of functional characteristic and cost of mission at all. Resolving of this problem may be found by using respective modern technologies and methods which widely used in different branches and not in the space researches only. Such approaches as Social Networking, Web 2.0 and Enterprise 2.0 look most prospective in this context. The primary goal of the "Phobos-Soil" mission is an investigation of the Phobos which is the Martian moon and particularly its regolith, internal structure, peculiarities of the orbital and proper motion, as well as a number of different scientific measurements and experiments for investigation of the Martian environment. A lot of investigators involved in the mission. Effective collaboration system is key facility for information support of the mission therefore. Further to main goal: communication between users of the system, modern approaches allows using such capabilities as self-organizing community, user generated content, centralized and federative control of the system. Also it may have one unique possibility - knowledge management which is very important for space mission realization. Therefore collaboration support system for "Phobos-Soil" mission designed on the base of multilayer model which includes such levels as Communications, Announcement and Information, Data sharing and Knowledge management. The collaboration support system for "Phobos-Soil" mission will be used as prototype for prospective Russian scientific space missions and the presentation describes its architecture

Critical success factors in implementing an e-rostering system in a healthcare organisation.

Science.gov (United States)

Soomro, Zahoor A; Ahmed, Javed; Muhammad, Raza; Hayes, Dawn; Shah, Mahmood H

2017-01-01

Effective and efficient staff scheduling has always been a challenging issue, especially in health service organisations. Both the extremes of staff shortage and overage have an adverse impact on the performance of healthcare organisations. In this case, an electronic and systematic staff scheduling (e-rostering) system is the often seen as the best solution. Unless an organisation has an effective implementation of such a system, possible cost savings, efficiency, and benefits could be minimal. This study is aimed to research key success factors for the successful effective implementation of an electronic rostering system, especially at healthcare organisations. A case study research method was used to evaluate critical success factors for effectively implementing an e-rostering system. The data were collected through interviews and observations. The findings indicate that technical support, an effective policy, leadership, clear goals and objectives, gradual change, evidence of the advantages of the new system, senior management support, and effective communication are the critical success factors in implementing an e-rostering system in healthcare organisations. Prior to this study, no such factors were grounded in the current context, so this research would help in bridging the gap towards effective implementation of an e-rostering system in the healthcare sector. This research also suggests future studies in different cultures and contexts.

An integrated healthcare enterprise information portal and healthcare information system framework.

Science.gov (United States)

Hsieh, S L; Lai, Feipei; Cheng, P H; Chen, J L; Lee, H H; Tsai, W N; Weng, Y C; Hsieh, S H; Hsu, K P; Ko, L F; Yang, T H; Chen, C H

2006-01-01

The paper presents an integrated, distributed Healthcare Enterprise Information Portal (HEIP) and Hospital Information Systems (HIS) framework over wireless/wired infrastructure at National Taiwan University Hospital (NTUH). A single sign-on solution for the hospital customer relationship management (CRM) in HEIP has been established. The outcomes of the newly developed Outpatient Information Systems (OIS) in HIS are discussed. The future HEIP blueprints with CRM oriented features: e-Learning, Remote Consultation and Diagnosis (RCD), as well as on-Line Vaccination Services are addressed. Finally, the integrated HEIP and HIS architectures based on the middleware technologies are proposed along with the feasible approaches. The preliminary performance of multi-media, time-based data exchanges over the wireless HEIP side is collected to evaluate the efficiency of the architecture.

A multi-user selective undo/redo approach for collaborative CAD systems

Directory of Open Access Journals (Sweden)

Yuan Cheng

2014-04-01

Full Text Available The engineering design process is a creative process, and the designers must repeatedly apply Undo/Redo operations to modify CAD models to explore new solutions. Undo/Redo has become one of most important functions in interactive graphics and CAD systems. Undo/Redo in a collaborative CAD system is also very helpful for collaborative awareness among a group of cooperative designers to eliminate misunderstanding and to recover from design error. However, Undo/Redo in a collaborative CAD system is much more complicated. This is because a single erroneous operation is propagated to other remote sites, and operations are interleaved at different sites. This paper presents a multi-user selective Undo/Redo approach in full distributed collaborative CAD systems. We use site ID and State Vectors to locate the Undo/Redo target at each site. By analyzing the composition of the complex CAD model, a tree-like structure called Feature Combination Hierarchy is presented to describe the decomposition of a CAD model. Based on this structure, the dependency relationship among features is clarified. B-Rep re-evaluation is simplified with the assistance of the Feature Combination Hierarchy. It can be proven that the proposed Undo/Redo approach satisfies the intention preservation and consistency maintenance correctness criteria for collaborative systems.

Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups

Science.gov (United States)

Zachariadis, Markos; Oborn, Eivor; Barrett, Michael; Zollinger-Read, Paul

2013-01-01

Objective To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. Design Mixed-method, multisite and case study research. Setting Six clinical commissioning groups and local clusters in the East of England area, covering in total 208 GPs and 1 662 000 population. Methods Semistructured interviews with 56 lead GPs, practice managers and staff from the local health authorities (primary care trusts, PCT) as well as various healthcare professionals; 21 observations of clinical commissioning group (CCG) board and executive meetings; electronic survey of 58 CCG board members (these included GPs, practice managers, PCT employees, nurses and patient representatives) and subsequent social network analysis. Main outcome measures Collaborative relationships between CCG board members and stakeholders from their healthcare network; clarifying the role of GPs as network leaders; strengths and areas for development of CCGs. Results Drawing upon innovation network theory provides unique insights of the CCG leaders’ activities in establishing best practices and introducing new clinical pathways. In this context we identified three network leadership roles: managing knowledge flows, managing network coherence and managing network stability. Knowledge sharing and effective collaboration among GPs enable network stability and the alignment of CCG objectives with those of the wider health system (network coherence). Even though activities varied between commissioning groups, collaborative initiatives were common. However, there was significant variation among CCGs around the level of engagement with providers, patients and local authorities. Locality (sub) groups played an important role because they linked commissioning decisions with

Accounting System in Croatian Public Healthcare Organizations: an Empirical Analysis

Directory of Open Access Journals (Sweden)

Davor VAŠIČEK

2010-06-01

Full Text Available In considering the adequacy of adopting accruals and IPSASs, this paper tests the appropriateness of existing modified accrual accounting and financial reporting system in Croatian public healthcare sector. The paper indicates that accounting information system contains discrepancies and constraints in assuring true and fair view of organization’s financial position and performance. Our statistics confirms low level of cost and managerial accounting methods development, and external and internal financial reporting convergence.Having in mind its specificities, we argue that Croatian public healthcare sector represents a segmental accounting subsystem within the integral public sector accounting framework, where accruals implementation might prove justifiable.

Collaboration systems for classroom instruction

Science.gov (United States)

Chen, C. Y. Roger; Meliksetian, Dikran S.; Chang, Martin C.

1996-01-01

In this paper we discuss how classroom instruction can benefit from state-of-the-art technologies in networks, worldwide web access through Internet, multimedia, databases, and computing. Functional requirements for establishing such a high-tech classroom are identified, followed by descriptions of our current experimental implementations. The focus of the paper is on the capabilities of distributed collaboration, which supports both synchronous multimedia information sharing as well as a shared work environment for distributed teamwork and group decision making. Our ultimate goal is to achieve the concept of 'living world in a classroom' such that live and dynamic up-to-date information and material from all over the world can be integrated into classroom instruction on a real-time basis. We describe how we incorporate application developments in a geography study tool, worldwide web information retrievals, databases, and programming environments into the collaborative system.

Improving water, sanitation and hygiene in health-care facilities, Liberia.

Science.gov (United States)

Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar

2017-07-01

The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.

Healthcare systems, the State, and innovation in the pharmaceutical industry

Directory of Open Access Journals (Sweden)

Ignacio José Godinho Delgado

Full Text Available Abstract: This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist, in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry.

COLLABORATIVE NETWORK SECURITY MANAGEMENT SYSTEM BASED ON ASSOCIATION MINING RULE

Directory of Open Access Journals (Sweden)

Nisha Mariam Varughese

2014-07-01

Full Text Available Security is one of the major challenges in open network. There are so many types of attacks which follow fixed patterns or frequently change their patterns. It is difficult to find the malicious attack which does not have any fixed patterns. The Distributed Denial of Service (DDoS attacks like Botnets are used to slow down the system performance. To address such problems Collaborative Network Security Management System (CNSMS is proposed along with the association mining rule. CNSMS system is consists of collaborative Unified Threat Management (UTM, cloud based security centre and traffic prober. The traffic prober captures the internet traffic and given to the collaborative UTM. Traffic is analysed by the Collaborative UTM, to determine whether it contains any malicious attack or not. If any security event occurs, it will reports to the cloud based security centre. The security centre generates security rules based on association mining rule and distributes to the network. The cloud based security centre is used to store the huge amount of tragic, their logs and the security rule generated. The feedback is evaluated and the invalid rules are eliminated to improve the system efficiency.

PALLIATIVE CARE – ITS ROLE IN HEALTHCARE SYSTEMS

Directory of Open Access Journals (Sweden)

Urška Lunder

2003-11-01

Full Text Available Background. In the last decades a palliative care has been well established in the majority of West European countries. However, majority of these countries are not able to follow needs for palliative care because of demographic changes (older population, changes of morbidity pattern (increase of chronic progressive diseases and social changes (disability of families to care for their relatives at their homes. Research is showing evidence on palliative care effectiveness at end of life and in bereavement. There is still a great need for healthcare professionals’ change in their attitudes, knowledge and skills. In many National strategic plans (United Kingdom, Ireland, Sweden, Australia, New Zealand and Canada palliative care becomes a priority in the national public health. New organizational planning supports establishement of palliative care departments in hospitals and other healthcare settings and consultant teams at all levels of healthcare system. Hospices, caritative and independent organizations, will remain as a source of good clinical practice and philosophy of care at the end of life also in the future.

Healthcare Data Gateways: Found Healthcare Intelligence on Blockchain with Novel Privacy Risk Control.

Science.gov (United States)

Yue, Xiao; Wang, Huiju; Jin, Dawei; Li, Mingqiang; Jiang, Wei

2016-10-01

Healthcare data are a valuable source of healthcare intelligence. Sharing of healthcare data is one essential step to make healthcare system smarter and improve the quality of healthcare service. Healthcare data, one personal asset of patient, should be owned and controlled by patient, instead of being scattered in different healthcare systems, which prevents data sharing and puts patient privacy at risks. Blockchain is demonstrated in the financial field that trusted, auditable computing is possible using a decentralized network of peers accompanied by a public ledger. In this paper, we proposed an App (called Healthcare Data Gateway (HGD)) architecture based on blockchain to enable patient to own, control and share their own data easily and securely without violating privacy, which provides a new potential way to improve the intelligence of healthcare systems while keeping patient data private. Our proposed purpose-centric access model ensures patient own and control their healthcare data; simple unified Indicator-Centric Schema (ICS) makes it possible to organize all kinds of personal healthcare data practically and easily. We also point out that MPC (Secure Multi-Party Computing) is one promising solution to enable untrusted third-party to conduct computation over patient data without violating privacy.

BSNCare+: A Robust IoT-Oriented Healthcare System with Non-Repudiation Transactions

Directory of Open Access Journals (Sweden)

Kuo-Hui Yeh

2016-12-01

Full Text Available Recently, the rapid advancement in technologies of modern intelligent objects has led to a new network paradigm, called the Internet of Things (IoT, in which every networked and automated object has been connected in a pervasive manner. New types of IoT-based application services are thus presented. In a healthcare oriented environment, the usage of IoT has brought opportunities for assisting physicians (or nurses to provide on-demand and real-time body-care services to patients with higher accuracy and better efficiency. However, while IoT-oriented techniques deliver such advantages, they may encounter system security vulnerabilities and patient privacy threats not seen in the past. In this paper, we propose a robust IoT-based healthcare system, called BSNCare+, in which body sensor networks (BSNs are adopted as the underlying communication architecture. In the proposed healthcare system, we exploit lightweight crypto-primitives to construct a secure communication mechanism that does achieve data confidentiality and entity authentication among intelligent body sensors, the mobile gateway and the backend BSN-Care server. In addition, we evaluate the performance of the proposed healthcare system using the Raspberry PI series platform. The results show the practicability and feasibility of BSNCare+.

TULUNGAN: A Consensus-Independent Reputation System for Collaborative Web Filtering Systems

Directory of Open Access Journals (Sweden)

Alexis V. Pantola

2011-12-01

Full Text Available Web filtering systems allow or prohibit access to websites based on categories (e.g., pornography,violence, sports, etc.. Categorization of websites can be done automatically or manually. Automaticcategorization is prone to under- and over-blocking. On the other hand, manual approach is typicallyperformed by a limited number of people making it not scalable.Collaborative web filtering systems, a variation of manual categorization, allow anyone to categorizewebsites in order to determine which domain these sites belong (e.g., pornography, violence, sports,etc.. This attempts to solve the scalability issue of the typical manual method.The approach offered by collaborative web filtering relies heavily on the contribution of users in orderto make the system scalable and less prone to errors. However, its success is greatly dependent on usercooperation. To promote cooperation, reputation system can be used in web filtering.A previous study called Rater-Rating promotes cooperation and explores the use of a user-drivenreputation system that measures both the contributor and rater reputation of users of a collaborative websystem. However, Rater-Rating is consensus dependent. If the number of malicious users are more thantheir good counterparts, the reputation system can be defeated. In other words, the system canmistakenly give malicious users a high reputation value.This study discusses a reputation system called Tulungan that is consensus-independent. It can detectthe presence of malicious users even if the number of their good counterparts are fewer. A simulationresult that compares the effectiveness of Tulungan relative to Rater-Rating is presented in this paper.The simulation shows that Tulungan is still effective even with 25% good users while Rater-Ratingrequires at least 50% good users to be effective.

Executable Design Models for a Pervasive Healthcare Middleware System

DEFF Research Database (Denmark)

Jørgensen, Jens Bæk; Christensen, Søren

2002-01-01

 UML is applied in the design of a pervasive healthcare middleware system for the hospitals in Aarhus County, Denmark. It works well for the modelling of static aspects of the system, but with respect to describing the behaviour, UML is not sufficient. This paper explains why and, as a remedy, su...

An Introductory Interprofessional Exercise for Healthcare Students

Science.gov (United States)

Rege, Saumitra V.; Misto, Kara; Dollase, Richard; George, Paul

2012-01-01

Objective. To evaluate healthcare students’ perceptions of an introductory interprofessional exercise and their team dynamics. Design. A workshop was developed, combining second-year medical students, fourth-year nursing students, and third-year pharmacy students to work as an interdisciplinary team. The teams alternated between working together on patient cases focusing on chronic obstructive pulmonary disease and asthma, and on the evaluation of standardized pneumonia patients. Teams were given the patients' health information and no other instructions. A faculty member and the standardized patient evaluated the students using a teamwork global rating scale. Assessment. Student survey results showed a positive response to interprofessional teamwork. The faculty members and standardized patients reported that the students worked as a cohesive unit and demonstrated good team communication. Conclusions. This introductory interprofessional experience had a positive impact on the students’ understanding of collaboration and teamwork. This type of experience will help students foster future collaborations as healthcare providers. PMID:23129853

Ambient assisted living healthcare frameworks, platforms, standards, and quality attributes.

Science.gov (United States)

Memon, Mukhtiar; Wagner, Stefan Rahr; Pedersen, Christian Fischer; Beevi, Femina Hassan Aysha; Hansen, Finn Overgaard

2014-03-04

Ambient Assisted Living (AAL) is an emerging multi-disciplinary field aiming at exploiting information and communication technologies in personal healthcare and telehealth systems for countering the effects of growing elderly population. AAL systems are developed for personalized, adaptive, and anticipatory requirements, necessitating high quality-of-service to achieve interoperability, usability, security, and accuracy. The aim of this paper is to provide a comprehensive review of the AAL field with a focus on healthcare frameworks, platforms, standards, and quality attributes. To achieve this, we conducted a literature survey of state-of-the-art AAL frameworks, systems and platforms to identify the essential aspects of AAL systems and investigate the critical issues from the design, technology, quality-of-service, and user experience perspectives. In addition, we conducted an email-based survey for collecting usage data and current status of contemporary AAL systems. We found that most AAL systems are confined to a limited set of features ignoring many of the essential AAL system aspects. Standards and technologies are used in a limited and isolated manner, while quality attributes are often addressed insufficiently. In conclusion, we found that more inter-organizational collaboration, user-centered studies, increased standardization efforts, and a focus on open systems is needed to achieve more interoperable and synergetic AAL solutions.

Ambient Assisted Living Healthcare Frameworks, Platforms, Standards, and Quality Attributes

Directory of Open Access Journals (Sweden)

Mukhtiar Memon

2014-03-01

Full Text Available Ambient Assisted Living (AAL is an emerging multi-disciplinary field aiming at exploiting information and communication technologies in personal healthcare and telehealth systems for countering the effects of growing elderly population. AAL systems are developed for personalized, adaptive, and anticipatory requirements, necessitating high quality-of-service to achieve interoperability, usability, security, and accuracy. The aim of this paper is to provide a comprehensive review of the AAL field with a focus on healthcare frameworks, platforms, standards, and quality attributes. To achieve this, we conducted a literature survey of state-of-the-art AAL frameworks, systems and platforms to identify the essential aspects of AAL systems and investigate the critical issues from the design, technology, quality-of-service, and user experience perspectives. In addition, we conducted an email-based survey for collecting usage data and current status of contemporary AAL systems. We found that most AAL systems are confined to a limited set of features ignoring many of the essential AAL system aspects. Standards and technologies are used in a limited and isolated manner, while quality attributes are often addressed insufficiently. In conclusion, we found that more inter-organizational collaboration, user-centered studies, increased standardization efforts, and a focus on open systems is needed to achieve more interoperable and synergetic AAL solutions.

Simulation Research on an Electric Vehicle Chassis System Based on a Collaborative Control System

Directory of Open Access Journals (Sweden)

Nenglian Feng

2013-01-01

Full Text Available This paper presents a collaborative control system for an electric vehicle chassis based on a centralized and hierarchical control architecture. The centralized controller was designed for the suspension and steering system, which is used for improving ride comfort and handling stability; the hierarchical controller was designed for the braking system, which is used for distributing the proportion of hydraulic braking and regenerative braking to improve braking performance. These two sub-controllers function at the same level of the vehicle chassis control system. In order to reduce the potential conflict between the two sub-controllers and realize a coordination optimization of electric vehicle performance, a collaborative controller was built, which serves as the upper controller to carry out an overall coordination analysis according to vehicle signals and revises the decisions of sub-controllers. A simulation experiment was carried out with the MATLAB/Simulink software. The simulation results show that the proposed collaborative control system can achieve an optimized vehicle handling stability and braking safety.

Modelling the effect of perceived interdependence among mental healthcare professionals on their work role performance.

Science.gov (United States)

Markon, Marie-Pierre; Chiocchio, François; Fleury, Marie-Josée

2017-07-01

The purpose of mental healthcare system reform was to enhance service efficiency by strengthening primary mental healthcare and increasing service integration in communities. Reinforcing interprofessional teamwork also intended to address the extensive and multidimensional needs of patients with mental disorders by bringing together a broader array of expertise. In this context, mental healthcare professionals (MHCPs) from various health and social care professions are more interdependent in many aspects of their work (tasks, resources, and goals). We wanted to examine the effect of perceived interdependence among MHCPs on their work role performance in the context of mental healthcare. For this purpose, we developed and tested a model coherent with the Input-Mediator-Outcome-Input (IMOI) framework of team effectiveness. Data from questionnaires administered to 315 MHCPs from four local health service networks in Quebec, Canada were analysed through structural equation modelling and mediation analysis. The structural equation model provided a good fit for the data and explained 51% of the variance of work role performance. Perceived collaboration, confidence in the advantages of interprofessional collaboration, involvement in the decision process, knowledge sharing, and satisfaction with the nature of the work partially mediated the effect of perceived interdependence among team members on work role performance. Therefore, perceived interdependence among team members had a positive impact on the work role performance of MHCPs mostly through its effect on favourable team functioning features. This implies, in practice, that increased interdependence of MHCPs would be more likely to truly enhance work role performance if team-based interventions to promote collaborative work and interprofessional teaching and training programs to support work within interprofessional teams were jointly implemented. Participation in the decision process and knowledge sharing should

Yoga Therapy in the German Healthcare System.

Science.gov (United States)

Cramer, Holger

2018-05-09

An estimated 15.7 million Germans are currently practicing yoga or are at least interested in starting to practice, and they often perceive yoga as a therapeutic approach. From a healthcare system perspective, the situation is less clear. Here, yoga is only recognized as a recreational or preventive activity. When yoga teachers fulfill specific qualifications, their preventive yoga classes are covered by the statutory health insurances. Only those with additional qualifications in medicine or psychotherapy, however, can independently use and promote "yoga therapy." The general perception of yoga in Germany as a preventive practice is reflected in the professional organization of yoga providers. Most providers are considered to be yoga teachers rather than yoga therapists and are organized mainly in yoga teacher associations. Despite the uncertain legal framework, yoga is now considered in a number of medical guidelines; in a number of hospitals, yoga is part of multimodal inpatient treatment programs and is delivered by physical therapists or members of other health professions. An increasing number of yoga therapy clinical trials are conducted in Germany, and efforts are underway to establish yoga therapy as an accepted adjunct treatment approach for selected medical conditions within the German healthcare system.

Physicians' perspectives of pharmacist-physician collaboration in the United Arab Emirates: Findings from an exploratory study.

Science.gov (United States)

Hasan, S; Stewart, K; Chapman, C B; Kong, D C M

2018-03-28

Interprofessional collaborative care has been shown to improve patient outcomes. Physicians' views on collaboration with pharmacists give an insight into what contributes to a well-functioning team. Little is known about these views from low and ​middle-income countries and nothing from the United Arab Emirates (UAE). The purpose of this study is to investigate physicians' opinions on collaborative relationships with community pharmacists in the UAE. Semi-structured individual interviews and group discussions are conducted with a purposive sample of physicians. Thematic analysis based on the framework approach is used to generate themes. A total of 53 physicians participated. Three themes about collaboration emerged: perceived benefits of collaboration, facilitators of collaboration and perceived barriers to collaboration. Perceived benefits include reducing the burden on physicians, having the pharmacist as an extra safety check within the system, having the pharmacist assist patients to manage their medications: coping with side effects, reducing drug waste and costs, and attaining professional and health-system gains. Perceived facilitators included awareness and trust building, professional role definition, pharmacists' access to patient records and effective communication. Perceived barriers included patient and physician acceptance, logistic and financial issues and perceived pharmacist competence. This study has, for the first time, provided useful information to inform the future development of pharmacist-physician collaboration in the UAE and other countries with similar healthcare systems.

Health and health-care systems in southeast Asia: diversity and transitions.

Science.gov (United States)

Chongsuvivatwong, Virasakdi; Phua, Kai Hong; Yap, Mui Teng; Pocock, Nicola S; Hashim, Jamal H; Chhem, Rethy; Wilopo, Siswanto Agus; Lopez, Alan D

2011-01-29

Southeast Asia is a region of enormous social, economic, and political diversity, both across and within countries, shaped by its history, geography, and position as a major crossroad of trade and the movement of goods and services. These factors have not only contributed to the disparate health status of the region's diverse populations, but also to the diverse nature of its health systems, which are at varying stages of evolution. Rapid but inequitable socioeconomic development, coupled with differing rates of demographic and epidemiological transitions, have accentuated health disparities and posed great public health challenges for national health systems, particularly the control of emerging infectious diseases and the rise of non-communicable diseases within ageing populations. While novel forms of health care are evolving in the region, such as corporatised public health-care systems (government owned, but operating according to corporate principles and with private-sector participation) and financing mechanisms to achieve universal coverage, there are key lessons for health reforms and decentralisation. New challenges have emerged with rising trade in health services, migration of the health workforce, and medical tourism. Juxtaposed between the emerging giant economies of China and India, countries of the region are attempting to forge a common regional identity, despite their diversity, to seek mutually acceptable and effective solutions to key regional health challenges. In this first paper in the Lancet Series on health in southeast Asia, we present an overview of key demographic and epidemiological changes in the region, explore challenges facing health systems, and draw attention to the potential for regional collaboration in health. Copyright © 2011 Elsevier Ltd. All rights reserved.

Information resources assessment of a healthcare integrated delivery system.

Science.gov (United States)

Gadd, C. S.; Friedman, C. P.; Douglas, G.; Miller, D. J.

1999-01-01

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations. PMID:10566414

The chief nurse executive role in large healthcare systems.

Science.gov (United States)

Englebright, Jane; Perlin, Jonathan

2008-01-01

Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a council of facility CNEs. The increasingly competitive healthcare environment in which value-based purchasing of healthcare and pay-for-performance programs demand improved clinical performance for financial success has led to reconsideration of whether a council model can provide either the leadership or adequate attention to clinical (and operational) improvement. In turn, community hospitals and health systems look to CNE or chief nursing officer roles at the highest level of the organization as resources that are able to segue between the clinical and operational domains, translating clinical performance demands into operating strategies and tactics. This article explores CNE characteristics required for success in these increasingly responsible and visible roles.

Information resources assessment of a healthcare integrated delivery system.

Science.gov (United States)

Gadd, C S; Friedman, C P; Douglas, G; Miller, D J

1999-01-01

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations.

Interprofessional education and collaborative practice: Psychometric analysis of the Readiness for Interprofessional Learning Scale in undergraduate Serbian healthcare student context.

Science.gov (United States)

Milutinović, Dragana; Lovrić, Robert; Simin, Dragana

2018-06-01

There is an implicit expectation for medical sciences students to work together effectively as members of health-care team, and interprofessional education is therefore widely accepted. Students' attitudes, which are affected by various factors, have been recognized as the most important predictors of successful implementation of interprofessional education with the aim of developing collaborative practice. The Readiness for Interprofessional Learning Scale has often been used in studies to measure these perspectives. To describe the psychometric properties of the Serbian cross-culturally adapted version of the original Readiness for Interprofessional Learning Scale, to assess the attitudes of undergraduate health science students towards interprofessional education and to evaluate whether a professional group and student characteristics have influence on attitudes towards collaborative practice and shared learning. A descriptive/analytical and comparative cross-sectional study. Faculty of Medicine in Serbia. Nursing and medical students after completed first clinical rotations (n = 257). The Readiness for Interprofessional Learning Scale for assessing attitudes among students towards interprofessional learning, Professional Identity Questionnaire for Nursing Students for assessing professional identity in nursing students, Professional Nursing Image Survey for assessing attitudes of medical students towards the nursing profession, as well as a socio-demographic questionnaire were the instruments used in this research study. The data were analysed using descriptive and inferential statistics. Exploratory factor analysis on 19 items revealed two-factors accounting for 51.1% of the total variance with the internal reliability α = 0.90. The mean total score of the Readiness for Interprofessional Learning Scale was 73.5 (SD = 11.5) indicating that students are ready for interprofessional learning. Nursing students, female students; students in their first

Bringing Big Data to the Forefront of Healthcare Delivery: The Experience of Carolinas HealthCare System.

Science.gov (United States)

Dulin, Michael F; Lovin, Carol A; Wright, Jean A

2017-01-01

The use of big data to transform care delivery is rapidly becoming a reality. To deliver on the promise of value-based care, providers must know the key drivers of wellness at the patient and community levels, as well as understand resource constraints and opportunities to improve efficiency in the health-care system itself. Data are the linchpin. By gathering the right data and finding innovative ways to glean knowledge, we can improve clinical care, advance the health of our communities, improve the lives of our patients, and operate more efficiently. At Carolinas HealthCare System-one of the nation's largest health-care systems, with nearly 12 million patient encounters annually at more than 900 care locations-we have made substantial investments to establish a centralized data and analytics infrastructure that is transforming the way we deliver care across the continuum. Although the impetus and vision for our program have evolved over the past decade, our efforts coalesced into a strategic, centralized initiative with the launch of the Dickson Advanced Analytics (DA) group in 2012. DA has yielded significant gains in our ability to use data, not only for reporting purposes and understanding our business but also for predicting outcomes and informing action.While these efforts have been successful, the path has not been easy. Effectively harnessing big data requires navigating myriad technological, cultural, operational, and other hurdles. Building a program that is feasible, effective, and sustainable takes concerted effort and a rigorous process of continuous self-evaluation and strategic adaptation.

Bringing Big Data to the Forefront of Healthcare Delivery: The Experience of Carolinas HealthCare System.

Science.gov (United States)

Dulin, Michael F; Lovin, Carol A; Wright, Jean A

2016-01-01

The use of big data to transform care delivery is rapidly becoming a reality. To deliver on the promise of value-based care, providers must know the key drivers of wellness at the patient and community levels, as well as understand resource constraints and opportunities to improve efficiency in the healthcare system itself. Data are the linchpin. By gathering the right data and finding innovative ways to glean knowledge, we can improve clinical care, advance the health of our communities, improve the lives of our patients, and operate more efficiently. At Carolinas HealthCare System-one of the nation's largest healthcare systems, with nearly 12 million patient encounters annually at more than 900 care locations-we have made substantial investments to establish a centralized data and analytics infrastructure that is transforming the way we deliver care across the continuum. Although the impetus and vision for our program have evolved over the past decade, our efforts coalesced into a strategic, centralized initiative with the launch of the Dickson Advanced Analytics (DA2) group in 2012. DA2 has yielded significant gains in our ability to use data, not only for reporting purposes and understanding our business but also for predicting outcomes and informing action.While these efforts have been successful, the path has not been easy. Effectively harnessing big data requires navigating myriad technological, cultural, operational, and other hurdles. Building a program that is feasible, effective, and sustainable takes concerted effort and a rigorous process of continuous self-evaluation and strategic adaptation.

South African Teachers' Views of Collaboration within an Inclusive Education System

Science.gov (United States)

Nel, Mirna; Engelbrecht, Petra; Nel, Norma; Tlale, Dan

2014-01-01

The development of sustainable collaborative partnerships between different role players within an inclusive education system seems to be a continuous challenge in South Africa. The focus of this research study was to understand how teachers view collaboration within an inclusive education system. Open-ended questionnaires were completed by 85…

Pathways towards chronic care-focused healthcare systems: evidence from Spain.

Science.gov (United States)

García-Goñi, Manuel; Hernández-Quevedo, Cristina; Nuño-Solinís, Roberto; Paolucci, Francesco

2012-12-01

Increasing healthcare expenditure is a matter of concern in many countries, particularly in relation to the underlying drivers of such escalation that include ageing, medical innovation, and changes in the burden of disease, such as the growing prevalence of chronic diseases. Most healthcare systems in developed countries have been designed to 'cure' acute episodes, rather than to 'manage' chronic conditions, and therefore they are not suitably or efficiently organized to respond to the changing needs and preferences of users. New models of chronic care provision have been developed to respond to the changing burden of disease and there is already considerable practical experience in several different countries showing their advantages but also the difficulties associated with their implementation. In this paper, we focus on the Spanish experience in terms of policy changes and pilot studies focused on testing the feasibility of moving towards chronic care models. In particular, we discuss a framework that identifies and analyses ten key prerequisites to achieving high performing chronic care-based healthcare systems and apply it to the current Spanish National Health System (NHS). We find that the design of the Spanish NHS already meets some of these pre-requisites. However, other features are still in their early stages of development or are being applied only in limited geographical and clinical contexts. We outline the policies that are being implemented and the pathway that the Spanish NHS is taking to address the crucial challenge of the transition towards an optimal health system focused on chronic care. Given the current evidence and trends, we expect that the pathway for developing a chronicity strategy being followed by the Spanish NHS will significantly transform its current healthcare delivery model in the next few years. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The influence of empowerment, authentic leadership, and professional practice environments on nurses' perceived interprofessional collaboration.

Science.gov (United States)

Regan, Sandra; Laschinger, Heather K S; Wong, Carol A

2016-01-01

The aim of this study was to examine the influence of structural empowerment, authentic leadership and professional nursing practice environments on experienced nurses' perceptions of interprofessional collaboration. Enhanced interprofessional collaboration (IPC) is seen as one means of transforming the health-care system and addressing concerns about shortages of health-care workers. Organizational supports and resources are suggested as key to promoting IPC. A predictive non-experimental design was used to test the effects of structural empowerment, authentic leadership and professional nursing practice environments on perceived interprofessional collaboration. A random sample of experienced registered nurses (n = 220) in Ontario, Canada completed a mailed questionnaire. Hierarchical multiple regression analysis was used. Higher perceived structural empowerment, authentic leadership, and professional practice environments explained 45% of the variance in perceived IPC (Adj. R² = 0.452, F = 59.40, P authentic leadership and a professional nursing practice environment may enhance IPC. Nurse leaders who ensure access to resources such as knowledge of IPC, embody authenticity and build trust among nurses, and support the presence of a professional nursing practice environment can contribute to enhanced IPC. © 2015 John Wiley & Sons Ltd.

The Value That Infectious Diseases Physicians Bring to the Healthcare System.

Science.gov (United States)

McQuillen, Daniel P; MacIntyre, Ann T

2017-09-15

While a career in infectious diseases (ID) has always been challenging and exciting, recognition of the value that ID physicians provide to the healthcare system as a whole, over and above the value they provide to individual patients, has been poor in this system. In response to this disparity, the Infectious Diseases Society of America Clinical Affairs Committee has long endeavored to quantify the value of ID physicians to the system, which is challenging in part because of the many avenues through which they influence healthcare. We discuss data showing that ID physicians improve clinical outcomes, positively impact transitions of care, and direct system-level improvements through infection prevention and antimicrobial stewardship. We identify areas where value-based care provides additional future opportunities for ID physicians. A Clinical Affairs Committee-sponsored study of ID physicians' positive impact on patient outcomes shows that few medical specialties are better positioned to positively impact the Triple Aim approach-better health, better care, and lower per capita cost-that is the principle tenet of healthcare system reform. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A post-Bertalanffy Systemics Healthcare Competitive Framework Proposal.

Science.gov (United States)

Fiorini, Rodolfo A; Santacroce, Giulia F

2014-01-01

Health Information community can take advantage of a new evolutive categorization cybernetic framework. A systemic concept of principles organizing nature is proposed. It can be used as a multiscaling reference framework to develop successful and competitive antifragile system and new HRO information management strategies in advanced healthcare organization (HO) and high reliability organization (HRO) conveniently. Expected impacts are multifarious and quite articulated at different system scale level: major one is that, for the first time, Biomedical Engineering ideal system categorization levels can be matched exactly to practical system modeling interaction styles, with no paradigmatic operational ambiguity and information loss.

The Design and Analysis of a Secure Personal Healthcare System Based on Certificates

Directory of Open Access Journals (Sweden)

Jungho Kang

2016-11-01

Full Text Available Due to the development of information technology (IT, it has been applied to various fields such as the smart home, medicine, healthcare, and the smart car. For these fields, IT has been providing continuous prevention and management, including health conditions beyond the mere prevention of disease, improving the quality of life. e-Healthcare is a health management and medical service to provide prevention, diagnosis, treatment, and the follow-up management of diseases at any time and place in connection with information communication technology, without requiring patients to visit hospitals. However, e-Healthcare has been exposed to eavesdropping, manipulation, and the forgery of information that is personal, biological, medical, etc., and is a security threat from malicious attackers. This study suggests a security service model to exchange personal health records (PHRs for e-Healthcare environments. To be specific, this study suggests a scheme in which communicators are able to securely authorize and establish security channels by constituting the infrastructure each organization relies on. In addition, the possibility of establishing a security service model is indicated by suggesting an e-Healthcare system for a secure e-Healthcare environment as a secure personal health record system. This is anticipated to provide securer communication in e-Healthcare environments in the future through the scheme suggested in this study.

Transitioning from learning healthcare systems to learning health care communities.

Science.gov (United States)

Mullins, C Daniel; Wingate, La'Marcus T; Edwards, Hillary A; Tofade, Toyin; Wutoh, Anthony

2018-02-26

The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care. Addressing the LHS framework implementation challenges and utilizing community levers are requisite components of a learning health care community model, version two of the LHS archetype.

Healthcare system and the wealth-health gradient: a comparative study of older populations in six countries.

Science.gov (United States)

Maskileyson, Dina

2014-10-01

The present study provides a comparative analysis of the association between wealth and health in six healthcare systems (Sweden, the United Kingdom, Germany, the Czech Republic, Israel, the United States). National samples of individuals fifty years and over reveal considerable cross-country variations in health outcomes. In all six countries wealth and health are positively associated. The findings also show that state-based healthcare systems produce better population health outcomes than private-based healthcare systems. The results indicate that in five out of the six countries studied, the wealth-health gradients were remarkably similar, despite significant variations in healthcare system type. Only in the United States was the association between wealth and health substantially different from, and much greater than that in the other five countries. The findings suggest that private-based healthcare system in the U.S. is likely to promote stronger positive associations between wealth and health. Copyright © 2014 Elsevier Ltd. All rights reserved.

Medical student perceptions of an initial collaborative immersion experience.

Science.gov (United States)

House, Joseph B; Cedarbaum, Jacob; Haque, Fatema; Wheaton, Michael; Vredeveld, Jennifer; Purkiss, Joel; Moore, Laurel; Santen, Sally A; Daniel, Michelle

2018-03-01

Recent reviews of interprofessional education (IPE) highlight the need for innovative curricula focused on longitudinal clinical learning. We describe the development and early outcomes of the initial clinical experience (ICE), a longitudinal practice-based course for first-year medical students. While IPE courses focus on student-to-student interaction, ICE focuses on introducing students to interprofessional collaboration. Students attend 14 sessions at one of 18 different clinical sites. They work directly with different health professionals from among 17 possible professions, including nurses, pharmacists, social workers, and respiratory, occupational, and physical therapists. Between 2015 and 2016, 167 students completed the course, and 81 completed the end-of-course evaluation. Students agreed or strongly agreed that ICE meaningfully contributed to their understanding of healthcare teams and different professional roles (86%), improved their understanding of healthcare systems (84%), improved their ability to communicate with healthcare professionals (61%), and improved their ability to work on interprofessional teams (65%). Select themes from narrative comments suggest that clinical immersion improves understanding of professional roles, helps students understand their own future roles in healthcare teams, and increases awareness of and respect for other professionals, with the potential to change future practice. ICE may be a template for other schools wishing to expand their current educational offerings, by engaging learners in more authentic, longitudinal clinical experiences with practicing healthcare professionals.

X-PAT: a multiplatform patient referral data management system for small healthcare institution requirements.

Science.gov (United States)

Masseroli, Marco; Marchente, Mario

2008-07-01

We present X-PAT, a platform-independent software prototype that is able to manage patient referral multimedia data in an intranet network scenario according to the specific control procedures of a healthcare institution. It is a self-developed storage framework based on a file system, implemented in eXtensible Markup Language (XML) and PHP Hypertext Preprocessor Language, and addressed to the requirements of limited-dimension healthcare entities (small hospitals, private medical centers, outpatient clinics, and laboratories). In X-PAT, healthcare data descriptions, stored in a novel Referral Base Management System (RBMS) according to Health Level 7 Clinical Document Architecture Release 2 (CDA R2) standard, can be easily applied to the specific data and organizational procedures of a particular healthcare working environment thanks also to the use of standard clinical terminology. Managed data, centralized on a server, are structured in the RBMS schema using a flexible patient record and CDA healthcare referral document structures based on XML technology. A novel search engine allows defining and performing queries on stored data, whose rapid execution is ensured by expandable RBMS indexing structures. Healthcare personnel can interface the X-PAT system, according to applied state-of-the-art privacy and security measures, through friendly and intuitive Web pages that facilitate user acceptance.

Toward a Nationwide Mobile-Based Public Healthcare Service System with Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Chien-wen Shen

2016-01-01

Full Text Available This paper describes the development of a nationwide public healthcare service system with the integration of cloud technology, wireless sensor networks, and mobile technology to provide citizens with convenient and professional healthcare services. The basic framework of the system includes the architectures for the user end of wireless physiological examinations, for the regional healthcare cloud, and for national public healthcare service system. Citizens with chronic conditions or elderly people who are living alone can use the wireless physiological sensing devices to keep track of their health conditions and get warning if the system detects abnormal signals. Through mobile devices, citizens are able to get real-time health advice, prompt warning, health information, feedback, personalized support, and intervention ubiquitously. With the long-term tracking data for physiological sensing, reliable prediction models for epidemic diseases and chronic diseases can be developed for the government to respond to and control diseases immediately. Besides, such a nationwide approach enables government to have a holistic understanding of the public health information in real time, which is helpful to establish effective policies or strategies to prevent epidemic diseases or chronic diseases.

Healthcare Policy Statement on the Utility of Coronary Computed Tomography for Evaluation of Cardiovascular Conditions and Preventive Healthcare: From the Health Policy Working Group of the Society of Cardiovascular Computed Tomography.

Science.gov (United States)

Slim, Ahmad M; Jerome, Scott; Blankstein, Ron; Weigold, Wm Guy; Patel, Amit R; Kalra, Dinesh K; Miller, Ryan; Branch, Kelley; Rabbat, Mark G; Hecht, Harvey; Nicol, Edward D; Villines, Todd C; Shaw, Leslee J

The rising cost of healthcare is prompting numerous policy and advocacy discussions regarding strategies for constraining growth and creating a more efficient and effective healthcare system. Cardiovascular imaging is central to the care of patients at risk of, and living with, heart disease. Estimates are that utilization of cardiovascular imaging exceeds 20 million studies per year. The Society of Cardiovascular CT (SCCT), alongside Rush University Medical Center, and in collaboration with government agencies, regional payers, and industry healthcare experts met in November 2016 in Chicago, IL to evaluate obstacles and hurdles facing the cardiovascular imaging community and how they can contribute to efficacy while maintaining or even improving outcomes and quality. The summit incorporated inputs from payers, providers, and patients' perspectives, providing a platform for all voices to be heard, allowing for a constructive dialogue with potential solutions moving forward. This article outlines the proceedings from the summit, with a detailed review of past hurdles, current status, and potential solutions as we move forward in an ever-changing healthcare landscape. Copyright © 2017 Society of Cardiovascular Computed Tomography. All rights reserved.

Collaboration Mechanism for Equipment Instruction of Multiple Energy Systems

Science.gov (United States)

Wang, Dong; Wang, Tuo; Wang, Qi; Zhang, Zhao; Zhao, Mingyu; Wang, Yinghui

2018-01-01

When multiple energy systems execute optimization instructions simultaneously, and the same equipment is Shared, the instruction conflict may occur. Aiming at the above problems, taking into account the control objectives of each system, the characteristics of different systems, such as comprehensive clean energy, energy efficiency, and peak filling, etc., designed the instruction coordination mechanism for the daemon. This mechanism mainly acts on the main station of the system, and form a final optimization instruction. For some specific scenarios, the collaboration mechanism of unlocking the terminal is supplemented. The mechanism determines the specific execution instructions based on the arrival time of the instruction. Finally, the experiment in Tianjin eco-city shows that this algorithm can meet the instruction and collaboration requirements of multi-energy systems, and ensure the safe operation of the equipment.

The application of the unified modeling language in object-oriented analysis of healthcare information systems.

Science.gov (United States)

Aggarwal, Vinod

2002-10-01

This paper concerns itself with the beneficial effects of the Unified Modeling Language (UML), a nonproprietary object modeling standard, in specifying, visualizing, constructing, documenting, and communicating the model of a healthcare information system from the user's perspective. The author outlines the process of object-oriented analysis (OOA) using the UML and illustrates this with healthcare examples to demonstrate the practicality of application of the UML by healthcare personnel to real-world information system problems. The UML will accelerate advanced uses of object-orientation such as reuse technology, resulting in significantly higher software productivity. The UML is also applicable in the context of a component paradigm that promises to enhance the capabilities of healthcare information systems and simplify their management and maintenance.

Productivity changes in OECD healthcare systems: bias-corrected Malmquist productivity approach.

Science.gov (United States)

Kim, Younhee; Oh, Dong-Hyun; Kang, Minah

2016-10-01

This study evaluates productivity changes in the healthcare systems of 30 Organization for Economic Co-operation and Development (OECD) countries over the 2002-2012 periods. The bootstrapped Malmquist approach is used to estimate bias-corrected indices of healthcare performance in productivity, efficiency and technology by modifying the original distance functions. Two inputs (health expenditure and school life expectancy) and two outputs (life expectancy at birth and infant mortality rate) are used to calculate productivity growth. There are no perceptible trends in productivity changes over the 2002-2012 periods, but positive productivity improvement has been noticed for most OECD countries. The result also informs considerable variations in annual productivity scores across the countries. Average annual productivity growth is evenly yielded by efficiency and technical changes, but both changes run somewhat differently across the years. The results of this study assert that policy reforms in OECD countries have improved productivity growth in healthcare systems over the past decade. Countries that lag behind in productivity growth should benchmark peer countries' practices to increase performance by prioritizing an achievable trajectory based on socioeconomic conditions. For example, relatively inefficient countries in this study indicate higher income inequality, corresponding to inequality and health outcomes studies. Although income inequality and globalization are not direct measures to estimate healthcare productivity in this study, these issues could be latent factors to explain cross-country healthcare productivity for future research. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Methodology for developing evidence-based clinical imaging guidelines: Joint recommendations by Korea society of radiology and national evidence-based healthcare collaborating agency

Energy Technology Data Exchange (ETDEWEB)

Choi, Sol Ji; Jo, Ae Jeong; Choi, Jin A [Div. for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul (Korea, Republic of); and others

2017-01-15

This paper is a summary of the methodology including protocol used to develop evidence-based clinical imaging guidelines (CIGs) in Korea, led by the Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency. This is the first protocol to reflect the process of developing diagnostic guidelines in Korea. The development protocol is largely divided into the following sections: set-up, process of adaptation, and finalization. The working group is composed of clinical imaging experts, and the developmental committee is composed of multidisciplinary experts to validate the methodology. The Korean CIGs will continue to develop based on this protocol, and these guidelines will act for decision supporting tools for clinicians as well as reduce medical radiation exposure.

Methodology for developing evidence-based clinical imaging guidelines: Joint recommendations by Korea society of radiology and national evidence-based healthcare collaborating agency

International Nuclear Information System (INIS)

Choi, Sol Ji; Jo, Ae Jeong; Choi, Jin A

2017-01-01

This paper is a summary of the methodology including protocol used to develop evidence-based clinical imaging guidelines (CIGs) in Korea, led by the Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency. This is the first protocol to reflect the process of developing diagnostic guidelines in Korea. The development protocol is largely divided into the following sections: set-up, process of adaptation, and finalization. The working group is composed of clinical imaging experts, and the developmental committee is composed of multidisciplinary experts to validate the methodology. The Korean CIGs will continue to develop based on this protocol, and these guidelines will act for decision supporting tools for clinicians as well as reduce medical radiation exposure

A Functional Sketch For Resources Management In Collaborative Systems For Business

Directory of Open Access Journals (Sweden)

Moca Mircea

2008-04-01

Full Text Available This paper presents a functional design sketch for the resource management module of a highly scalable collaborative system. Small and medium enterprises require such tools in order to benefit from and develop innovative business ideas and technologies. As computing power is a modern increasing demand and no easy and cheap solutions are defined, especially small companies or emerging business projects abide a more accessible alternative. Our work targets to settle a model for how P2P architecture can be used as infrastructure for a collaborative system that delivers resource access services. We are focused on finding a workable collaborative strategy between peers so that the system offers a cheap, trustable and quality service. Thus, in this phase we are not concerned about solutions for a specific type of task to be executed by peers, but only considering CPU power as resource. This work concerns the resource management module as a part of a larger project in which we aim to build a collaborative system for businesses with important resource demands

SEIPS 2.0: A human factors framework for studying and improving the work of healthcare professionals and patients

Science.gov (United States)

Holden, Richard J.; Carayon, Pascale; Gurses, Ayse P.; Hoonakker, Peter; Hundt, Ann Schoofs; Ozok, A. Ant; Rivera-Rodriguez, A. Joy

2013-01-01

Healthcare practitioners, patient safety leaders, educators, and researchers increasingly recognize the value of human factors/ergonomics and make use of the discipline’s person-centered models of sociotechnical systems. This paper first reviews one of the most widely used healthcare human factors systems models, the Systems Engineering Initiative for Patient Safety (SEIPS) model, and then introduces an extended model, “SEIPS 2.0.” SEIPS 2.0 incorporates three novel concepts into the original model: configuration, engagement, and adaptation. The concept of configuration highlights the dynamic, hierarchical, and interactive properties of sociotechnical systems, making it possible to depict how health-related performance is shaped at “a moment in time.” Engagement conveys that various individuals and teams can perform health-related activities separately and collaboratively. Engaged individuals often include patients, family caregivers, and other non-professionals. Adaptation is introduced as a feedback mechanism that explains how dynamic systems evolve in planned and unplanned ways. Key implications and future directions for human factors research in healthcare are discussed. PMID:24088063

Transforming Power Systems Through Global Collaboration

Energy Technology Data Exchange (ETDEWEB)

2017-06-01

Ambitious and integrated policy and regulatory frameworks are crucial to achieve power system transformation. The 21st Century Power Partnership -- a multilateral initiative of the Clean Energy Ministerial -- serves as a platform for public-private collaboration to advance integrated solutions for the large-scale deployment of renewable energy in combination with energy efficiency and grid modernization.

Transforming Power Systems through Global Collaboration

Energy Technology Data Exchange (ETDEWEB)

None, None

2016-04-01

Ambitious and integrated policy and regulatory frameworks are crucial to achieve power system transformation. The 21st Century Power Partnership -- a multilateral initiative of the Clean Energy Ministerial -- serves as a platform for public-private collaboration to advance integrated solutions for the large-scale deployment of renewable energy in combination with energy efficiency and grid modernization.

Healthcare waste generation and its management system: the case ...

African Journals Online (AJOL)

Healthcare waste generation and its management system: the case of health ... of an environmental risk to health care workers, the public and the environment at large. ... Only four out of ten health centers used local type of incinerators, while ...

Towards the Reconciliation of Knowledge Management and e-Collaboration Systems

Science.gov (United States)

Le Dinh, Thang; Rinfret, Louis; Raymond, Louis; Dong Thi, Bich-Thuy

2013-01-01

Purpose: The purpose of this paper is to propose an intelligent infrastructure for the reconciliation of knowledge management and e-collaboration systems. Design/Methodology/Approach:Literature on e-collaboration, information management, knowledge management, learning process, and intellectual capital is mobilised in order to build the conceptual…

[Barriers to the normalization of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts].

Science.gov (United States)

Roig, Francesc; Saigí, Francesc

2011-01-01

Despite the clear political will to promote telemedicine and the large number of initiatives, the incorporation of this modality in clinical practice remains limited. The objective of this study was to identify the barriers perceived by key professionals who actively participate in the design and implementation of telemedicine in a healthcare system model based on purchasing of healthcare services using providers' contracts. We performed a qualitative study based on data from semi-structured interviews with 17 key informants belonging to distinct Catalan health organizations. The barriers identified were grouped in four areas: technological, organizational, human and economic. The main barriers identified were changes in the healthcare model caused by telemedicine, problems with strategic alignment, resistance to change in the (re)definition of roles, responsibilities and new skills, and lack of a business model that incorporates telemedicine in the services portfolio to ensure its sustainability. In addition to suitable management of change and of the necessary strategic alignment, the definitive normalization of telemedicine in a mixed healthcare model based on purchasing of healthcare services using providers' contracts requires a clear and stable business model that incorporates this modality in the services portfolio and allows healthcare organizations to obtain reimbursement from the payer. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Context-Aware Mobile Collaborative Systems: Conceptual Modeling and Case Study

Directory of Open Access Journals (Sweden)

Luis G. Montané-Jiménez

2012-10-01

Full Text Available A Mobile Collaborative System (MCOS enable the cooperation of the members of a team to achieve a common goal by using a combination of mobile and fixed technologies. MCOS can be enhanced if the context of the group of users is considered in the execution of activities. This paper proposes a novel model for Context-Aware Mobile COllaborative Systems (CAMCOS and a functional architecture based on that model. In order to validate both the model and the architecture, a prototype system in the tourism domain was implemented and evaluated.

Translational Research 2.0: a framework for accelerating collaborative discovery.

Science.gov (United States)

Asakiewicz, Chris

2014-05-01

The world wide web has revolutionized the conduct of global, cross-disciplinary research. In the life sciences, interdisciplinary approaches to problem solving and collaboration are becoming increasingly important in facilitating knowledge discovery and integration. Web 2.0 technologies promise to have a profound impact - enabling reproducibility, aiding in discovery, and accelerating and transforming medical and healthcare research across the healthcare ecosystem. However, knowledge integration and discovery require a consistent foundation upon which to operate. A foundation should be capable of addressing some of the critical issues associated with how research is conducted within the ecosystem today and how it should be conducted for the future. This article will discuss a framework for enhancing collaborative knowledge discovery across the medical and healthcare research ecosystem. A framework that could serve as a foundation upon which ecosystem stakeholders can enhance the way data, information and knowledge is created, shared and used to accelerate the translation of knowledge from one area of the ecosystem to another.

Infrastructuring Multicultural Healthcare Information Systems

DEFF Research Database (Denmark)

Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik

2017-01-01

This paper stresses the need for more research in the field of Participatory Design (PD) and in particular into how to design Health Information Technology (HIT) together with care providers and -receivers in multicultural settings. We contribute to this research by describing a case study...... of this study, we point to the need and the ways of taking spatio-historical aspects of a specific healthcare situation into account in the PD of HIT to support multicultural perspectives on healthcare....

Elements of a collaborative systems model within the aerospace industry

Science.gov (United States)

Westphalen, Bailee R.

2000-10-01

Scope and method of study. The purpose of this study was to determine the components of current aerospace collaborative efforts. There were 44 participants from two selected groups surveyed for this study. Nineteen were from the Oklahoma Air National Guard based in Oklahoma City representing the aviation group. Twenty-five participants were from the NASA Johnson Space Center in Houston representing the aerospace group. The surveys for the aviation group were completed in reference to planning missions necessary to their operations. The surveys for the aerospace group were completed in reference to a well-defined and focused goal from a current mission. A questionnaire was developed to survey active participants of collaborative systems in order to consider various components found within the literature. Results were analyzed and aggregated through a database along with content analysis of open-ended question comments from respondents. Findings and conclusions. This study found and determined elements of a collaborative systems model in the aerospace industry. The elements were (1) purpose or mission for the group or team; (2) commitment or dedication to the challenge; (3) group or team meetings and discussions; (4) constraints of deadlines and budgets; (5) tools and resources for project and simulations; (6) significant contributors to the collaboration; (7) decision-making formats; (8) reviews of project; (9) participants education and employment longevity; (10) cross functionality of team or group members; (11) training on the job plus teambuilding; (12) other key elements identified relevant by the respondents but not included in the model such as communication and teamwork; (13) individual and group accountability; (14) conflict, learning, and performance; along with (15) intraorganizational coordination. These elements supported and allowed multiple individuals working together to solve a common problem or to develop innovation that could not have been

Does advanced practice in radiography benefit the healthcare system? A literature review.

Science.gov (United States)

Thom, S E

2018-02-01

With ever-increasing demands on the National Health Service (NHS), members of staff are blurring their professional boundaries in the attempt to benefit the healthcare system. This review aims to establish whether advancing practice within radiography does benefit the healthcare system by examining published literature. Key words were input into databases such as: CINAHL, Science Direct and PubMed. Various filters were applied to narrow down the articles. Key themes were identified within the literature: cost, job satisfaction, patient benefits, restrictions and workload. Having advanced practitioners undertake some of the radiologists' workload was potentially cost effective whilst continuing/increasing the standard of quality. Patients benefitted from the quality of their examinations, the high accuracy of their reports and the speed those reports were attained. Evidence within the literature emphasises that advanced practice does benefit the healthcare system by means of: cost reduction, job satisfaction, patient benefits and workload. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Accounting Information Systems in Healthcare: A Review of the Literature.

Science.gov (United States)

Hammour, Hadal; Househ, Mowafa; Razzak, Hira Abdul

2017-01-01

As information technology progresses in Saudi Arabia, the manual accounting systems have become graduallyinadequate for decision needs. Subsequently, private and public healthcare divisions in Saudi Arabia perceive Computerized accounting information system (CAIS) as a vehicle to safeguard efficient and effective flow of information during the analysis, processes, and recording of financial data. Efficient and effective flow of information improvesthe decision making of staff, thereby improving the capability of health care sectors to reduce cost of the medical services.In this paper, we define computerized accounting systems from the point of view of health informatics. Also, the challenges and benefits of supporting CAIS applications in hospitals of Saudi Arabia. With these elements, we conclude that CAIS in Saudi Arabia can serve as a valuable tool for evaluating and controlling the cost of medical services in healthcare sectors. Supplementary education on the significance of having systems of computerized accounting within hospitals for nurses, doctors, and accountants with other health care staff is warranted in future.

Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis.

Science.gov (United States)

Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank

2016-01-01

The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.

A system dynamics approach for healthcare waste management: a case study in Istanbul Metropolitan City, Turkey.

Science.gov (United States)

Ciplak, Nesli; Barton, John R

2012-06-01

Healthcare waste consists of various types of waste materials generated at hospitals, medical research centres, clinics and laboratories. Although 75-90% of this waste is classified as 'domestic' in nature, 20-25% is deemed to be hazardous, which if not disposed of appropriately, poses a risk to healthcare workers, patients, the environment and even the whole community. As long as healthcare waste is mixed with municipal waste and not segregated prior to disposal, costs will increase substantially. In this study, healthcare waste increases along with the potential to decrease the amounts by implementing effective segregation at healthcare facilities are projected to 2040. Our long-term aim is to develop a system to support selection and planning of the future treatment capacity. Istanbul in Turkey was used as the case study area. In order to identify the factors affecting healthcare waste generation in Istanbul, observations were made and interviews conducted in Istanbul over a 3 month period. A system dynamics approach was adopted to build a healthcare waste management model using a software package, Vensim Ple Plus. Based on reported analysis, the non-hazardous municipal fraction co-disposed with healthcare waste is around 65%. Using the projected waste generation flows, reducing a municipal fraction to 30% has the potential to avoid some 8000 t year(-1) of healthcare waste by 2025 and almost 10 000 t year(-1) by 2035. Furthermore, if segregation practices ensured healthcare waste requiring incineration was also selectively managed, 77% of healthcare waste could be diverted to alternative treatment technologies. As the throughput capacity of the only existing healthcare waste treatment facility in Istanbul, Kemerburgaz Incinerator, has already been exceeded, it is evident that improved management could not only reduce overall flows and costs but also permit alternative and cheaper treatment systems (e.g. autoclaving) to be adopted for the healthcare waste.

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

Science.gov (United States)

Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.