Electronic healthcare information security

CERN Document Server

Dube, Kudakwashe; Shoniregun, Charles A

2010-01-01

The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency of patient care services are driving innovation in healthcare information management. The domain of healthcare has become a challenging testing ground for information security due to the complex nature of healthcare information and individual privacy. ""Electronic Healthcare Information Security"" explores the challenges of e-healthcare information and security policy technologies. It evaluates the effectiveness of security and privacy implementation systems for anonymization methods and techniqu

How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews

Directory of Open Access Journals (Sweden)

Delnoij Diana MJ

2009-11-01

Full Text Available Abstract Background To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods Using semi-structured cognitive interviews, interviewees (n = 20 were asked to think aloud and answer questions, as they were prompted with three Dutch web pages providing comparative healthcare information. Results We identified twelve themes from consumers' thoughts and evaluations. These themes were categorized under four important areas of interest: (1 a response to the design; (2 a response to the information content; (3 the use of the information, and (4 the purpose of the information. Conclusion Several barriers to an effective use of comparative healthcare information were identified, such as too much information and the ambiguity of terms presented on websites. Particularly important for future research is the question of how comparative healthcare information can be integrated with alternative information, such as patient reviews on the Internet. Furthermore, the readability of quality of care concepts is an issue that needs further attention, both from websites and communication experts.

Process-oriented integration and coordination of healthcare services across organizational boundaries.

Science.gov (United States)

Tello-Leal, Edgar; Chiotti, Omar; Villarreal, Pablo David

2012-12-01

The paper presents a methodology that follows a top-down approach based on a Model-Driven Architecture for integrating and coordinating healthcare services through cross-organizational processes to enable organizations providing high quality healthcare services and continuous process improvements. The methodology provides a modeling language that enables organizations conceptualizing an integration agreement, and identifying and designing cross-organizational process models. These models are used for the automatic generation of: the private view of processes each organization should perform to fulfill its role in cross-organizational processes, and Colored Petri Net specifications to implement these processes. A multi-agent system platform provides agents able to interpret Colored Petri-Nets to enable the communication between the Healthcare Information Systems for executing the cross-organizational processes. Clinical documents are defined using the HL7 Clinical Document Architecture. This methodology guarantees that important requirements for healthcare services integration and coordination are fulfilled: interoperability between heterogeneous Healthcare Information Systems; ability to cope with changes in cross-organizational processes; guarantee of alignment between the integrated healthcare service solution defined at the organizational level and the solution defined at technological level; and the distributed execution of cross-organizational processes keeping the organizations autonomy.

45 CFR 61.1 - The Healthcare Integrity and Protection Data Bank.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false The Healthcare Integrity and Protection Data Bank. 61.1 Section 61.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS...

Integration of Information Technologies in Enterprise Application Development

OpenAIRE

Iulia SURUGIU

2012-01-01

Healthcare enterprises are disconnected. In the era of integrated information systems and Internet explosion, the necessity of information systems integration reside from business process evolution, on the one hand, and from information technology tendencies, on the other hand. In order to become more efficient and adaptive to change, healthcare organizations are tremendously preoccupied of business process automation, flexibility and complexity. The need of information systems integration ar...

Ensuring the security and privacy of information in mobile health-care communication systems

Directory of Open Access Journals (Sweden)

Ademola P. Abidoye

2011-09-01

Full Text Available The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hospital. With the implementation of electronic patient records and the Internet and Intranets, medical information sharing amongst relevant health-care providers was made possible. But the vital issue in this method of information sharing is security: the patient’s privacy, as well as the confidentiality and integrity of the health-care information system, should not be compromised. We examine various ways of ensuring the security and privacy of a patient’s electronic medical information in order to ensure the integrity and confidentiality of the information.

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

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....

An Architecture for Health Information Exchange in Pervasive Healthcare Environment

NARCIS (Netherlands)

Cardoso de Moraes, J.L.; Lopes de Souza, Wanderley; Ferreira Pires, Luis; Francisco do Prado, Antonio; Hammoudi, S.; Cordeiro, J.; Maciaszek, L.A.; Filipe, J.

2014-01-01

This paper presents an architecture for health information exchange in pervasive healthcare environments meant to be generally applicable to different applications in the healthcare domain. Our architecture has been designed for message exchange by integrating ubiquitous computing technologies,

Integration of Information Technologies in Enterprise Application Development

Directory of Open Access Journals (Sweden)

Iulia SURUGIU

2012-05-01

Full Text Available Healthcare enterprises are disconnected. In the era of integrated information systems and Internet explosion, the necessity of information systems integration reside from business process evolution, on the one hand, and from information technology tendencies, on the other hand. In order to become more efficient and adaptive to change, healthcare organizations are tremendously preoccupied of business process automation, flexibility and complexity. The need of information systems integration arise from these goals, explaining, at the same time, the special interest in EAI. Extensible software integration architectures and business orientation of process modeling and information systems functionalities, the same as open-connectivity, accessibility and virtualization lead to most suitable integration solutions: SOA and BPM architectural styles in a cloud computing environment.

Develop security architecture for both in-house healthcare information systems and electronic patient record

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Zhang, Jianguo; Chen, Xiaomeng; Zhuang, Jun; Jiang, Jianrong; Zhang, Xiaoyan; Wu, Dongqing; Huang, H. K.

2003-05-01

In this paper, we presented a new security approach to provide security measures and features in both healthcare information systems (PACS, RIS/HIS), and electronic patient record (EPR). We introduced two security components, certificate authoring (CA) system and patient record digital signature management (DSPR) system, as well as electronic envelope technology, into the current hospital healthcare information infrastructure to provide security measures and functions such as confidential or privacy, authenticity, integrity, reliability, non-repudiation, and authentication for in-house healthcare information systems daily operating, and EPR exchanging among the hospitals or healthcare administration levels, and the DSPR component manages the all the digital signatures of patient medical records signed through using an-symmetry key encryption technologies. The electronic envelopes used for EPR exchanging are created based on the information of signers, digital signatures, and identifications of patient records stored in CAS and DSMS, as well as the destinations and the remote users. The CAS and DSMS were developed and integrated into a RIS-integrated PACS, and the integration of these new security components is seamless and painless. The electronic envelopes designed for EPR were used successfully in multimedia data transmission.

Healthcare delivery systems: designing quality into health information systems.

Science.gov (United States)

Joyce, Phil; Green, Rosamund; Winch, Graham

2007-01-01

To ensure that quality is 'engineered in' a holistic, integrated and quality approach is required, and Total Quality Management (TQM) principles are the obvious foundations for this. This paper describes a novel approach to viewing the operations of a healthcare provider where electronic means could be used to distribute information (including electronic fund settlements), building around the Full Service Provider core. Specifically, an approach called the "triple pair flow" model is used to provide a view of healthcare delivery that is integrated, yet detailed, and that combines the strategic enterprise view with a business process view.

Medical knowledge packages and their integration into health-care information systems and the World Wide Web.

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Adlassnig, Klaus-Peter; Rappelsberger, Andrea

2008-01-01

Software-based medical knowledge packages (MKPs) are packages of highly structured medical knowledge that can be integrated into various health-care information systems or the World Wide Web. They have been established to provide different forms of clinical decision support such as textual interpretation of combinations of laboratory rest results, generating diagnostic hypotheses as well as confirmed and excluded diagnoses to support differential diagnosis in internal medicine, or for early identification and automatic monitoring of hospital-acquired infections. Technically, an MKP may consist of a number of inter-connected Arden Medical Logic Modules. Several MKPs have been integrated thus far into hospital, laboratory, and departmental information systems. This has resulted in useful and widely accepted software-based clinical decision support for the benefit of the patient, the physician, and the organization funding the health care system.

Measurement of information and communication technology experience and attitudes to e-learning of students in the healthcare professions: integrative review.

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Wilkinson, Ann; While, Alison E; Roberts, Julia

2009-04-01

This paper is a report of a review to describe and discuss the psychometric properties of instruments used in healthcare education settings measuring experience and attitudes of healthcare students regarding their information and communication technology skills and their use of computers and the Internet for education. Healthcare professionals are expected to be computer and information literate at registration. A previous review of evaluative studies of computer-based learning suggests that methods of measuring learners' attitudes to computers and computer aided learning are problematic. A search of eight health and social science databases located 49 papers, the majority published between 1995 and January 2007, focusing on the experience and attitudes of students in the healthcare professions towards computers and e-learning. An integrative approach was adopted, with narrative description of findings. Criteria for inclusion were quantitative studies using survey tools with samples of healthcare students and concerning computer and information literacy skills, access to computers, experience with computers and use of computers and the Internet for education purposes. Since the 1980s a number of instruments have been developed, mostly in the United States of America, to measure attitudes to computers, anxiety about computer use, information and communication technology skills, satisfaction and more recently attitudes to the Internet and computers for education. The psychometric properties are poorly described. Advances in computers and technology mean that many earlier tools are no longer valid. Measures of the experience and attitudes of healthcare students to the increased use of e-learning require development in line with computer and technology advances.

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

IAIMS and JCAHO: implications for hospital librarians. Integrated Academic Information Management Systems. Joint Commission on Accreditation of Healthcare Organizations.

OpenAIRE

Doyle, J D

1999-01-01

The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relations...

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

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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

Healthcare succession planning: an integrative review.

Science.gov (United States)

Carriere, Brian K; Muise, Melanie; Cummings, Greta; Newburn-Cook, Chris

2009-12-01

Succession planning is a business strategy that has recently gained attention in the healthcare literature, primarily because of nursing shortage concerns and the demand for retaining knowledgeable personnel to meet organizational needs. Little research has been conducted in healthcare settings that clearly defines best practices for succession planning frameworks. To effectively carry out such organizational strategies during these challenging times, an integrative review of succession planning in healthcare was performed to identify consistencies in theoretical approaches and strategies for chief nursing officers and healthcare managers to initiate. Selected articles were compared with business succession planning to determine whether healthcare strategies were similar to best practices already established in business contexts. The results of this integrative review will aid leaders and managers to use succession planning as a tool in their recruitment, retention, mentoring, and administration activities and also provide insights for future development of healthcare succession planning frameworks.

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.

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.

[IHE (Integrating the Healthcare Enterprise): a new approach for the improvement of digital communication in healthcare].

Science.gov (United States)

Wein, B B

2003-02-01

Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information.

IHE (Integrating the Healthcare Enterprise): A new approach for the improvement of digital communication in healthcare

International Nuclear Information System (INIS)

Wein, B.B.

2003-01-01

Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information. (orig.) [de

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.

Leveraging Health Information Technology to Improve Quality in Federal Healthcare.

Science.gov (United States)

Weigel, Fred K; Switaj, Timothy L; Hamilton, Jessica

2015-01-01

implementation. The Veterans Administration is the only entity within the federal health system that has published research on the use of health information technology to improve quality. The federal healthcare system has existing systems in place with computerized physician order entry systems and clinical decision support systems, but these should be advanced. Particular focus and attention should be placed on data mining capabilities, integrating the electronic health record across all aspects of care, using the electronic health record to improve quality at the point of care, and developing interoperable and usable health information technology.

The value of information for decision-making in the healthcare environment.

Science.gov (United States)

Shabtai, Itamar; Leshno, Moshe; Blondheim, Orna; Kornbluth, Jonathan

2007-01-01

With their ever-growing importance and usability, the healthcare sector has been investing heavily in medical information systems in recent years, as part of the effort to improve medical decision-making and increase its efficiency through improved medical processes, reduced costs, integration of patients' data, etc. In light of these developments, this research aims to evaluate the contribution of information technology (IT) to improving the medical decision-making processes at the point of care of internal medicine and surgical departments and to evaluate the degree to which IT investments are worthwhile. This has been done by assessing the value of information to decision-makers (physicians) at the point of care by investigating whether the information systems improved the medical outcomes. The research included three steps (after a pilot study)--the assessment of the subjective value of information, the assessment of the realistic value of information, and the assessment of the normative value of information, the results of each step being used as the starting assumptions for the following steps. Following a discussion and integration of the results from the various steps, the results of the three assessment stages were summarized in a cost-effectiveness analysis and an overall return on investment (ROI) analysis. In addition, we tried to suggest IT strategies for decision-makers in the healthcare sector on the advisability of implementing such systems as well as the implications for managing them. This research is uniquely pioneering in the manner in which it combines an assessment of the three kinds of measures of value of information in the healthcare environment. Our aim in performing it was to contribute to researchers (by providing additional insight into the fields of decision theory, value of information and medical informatics, amongst others), practitioners (by promoting efficiency in the design of new medical IS and improving existing IS), physicians

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

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.

[Research on medical instrument information integration technology based on IHE PCD].

Science.gov (United States)

Zheng, Jianli; Liao, Yun; Yang, Yongyong

2014-06-01

Integrating medical instruments with medical information systems becomes more and more important in healthcare industry. To make medical instruments without standard communication interface possess the capability of interoperating and sharing information with medical information systems, we developed a medical instrument integration gateway based on Integrating the Healthcare Enterprise Patient Care Device (IHE PCD) integration profiles in this research. The core component is an integration engine which is implemented according to integration profiles and Health Level Seven (HL7) messages defined in IHE PCD. Working with instrument specific Javascripts, the engine transforms medical instrument data into HL7 ORU message. This research enables medical instruments to interoperate and exchange medical data with information systems in a standardized way, and is valuable for medical instrument integration, especially for traditional instruments.

Integrated secure solution for electronic healthcare records sharing

Science.gov (United States)

Yao, Yehong; Zhang, Chenghao; Sun, Jianyong; Jin, Jin; Zhang, Jianguo

2007-03-01

The EHR is a secure, real-time, point-of-care, patient-centric information resource for healthcare providers. Many countries and regional districts have set long-term goals to build EHRs, and most of EHRs are usually built based on the integration of different information systems with different information models and platforms. A number of hospitals in Shanghai are also piloting the development of an EHR solution based on IHE XDS/XDS-I profiles with a service-oriented architecture (SOA). The first phase of the project targets the Diagnostic Imaging domain and allows seamless sharing of images and reports across the multiple hospitals. To develop EHRs for regional coordinated healthcare, some factors should be considered in designing architecture, one of which is security issue. In this paper, we present some approaches and policies to improve and strengthen the security among the different hospitals' nodes, which are compliant with the security requirements defined by IHE IT Infrastructure (ITI) Technical Framework. Our security solution includes four components: Time Sync System (TSS), Digital Signature Manage System (DSMS), Data Exchange Control Component (DECC) and Single Sign-On (SSO) System. We give a design method and implementation strategy of these security components, and then evaluate the performance and overheads of the security services or features by integrating the security components into an image-based EHR system.

Six elements of integrated primary healthcare.

Science.gov (United States)

Brown, Lynsey J; Oliver-Baxter, Jodie

2016-03-01

Integrated care has the potential to deliver efficiencies and improvements in patient experiences and health outcomes. Efforts towards integrated care, especially at the primary and community health levels, have increasingly been under focus, both nationally and internationally. In Australia, regional integration is a priority, and integration of care is a task for meso-level organisations such as Primary Health Networks (PHNs). This paper seeks to provide a list of elements and questions for consideration by organisations working across primary healthcare settings, looking to enact and improve the delivery of integrated care. Six elements that consistently emerged during the development of a series of rapid reviews on integrated primary healthcare in Australia are presented in this paper. The elements identified are context, governance and leadership, infrastructure, financing, engagement, and communication. They offer a starting point for reflection in the planning and practices of organisations in their drive for continuous improvements in integrated care.

Ensuring the security and privacy of information in mobile health-care communication systems

OpenAIRE

Adesina, Ademola O.; Agbele, Kehinde K.; Februarie, Ronald; Abidoye, Ademola P.; Nyongesa, Henry O.

2011-01-01

The sensitivity of health-care information and its accessibility via the Internet and mobile technology systems is a cause for concern in these modern times. The privacy, integrity and confidentiality of a patient’s data are key factors to be considered in the transmission of medical information for use by authorised health-care personnel. Mobile communication has enabled medical consultancy, treatment, drug administration and the provision of laboratory results to take place outside the hosp...

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...

Healthcare information technology and medical-surgical nurses: the emergence of a new care partnership.

Science.gov (United States)

Moore, An'Nita; Fisher, Kathleen

2012-03-01

Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals.

Personal information documents for people with dementia: Healthcare staff 's perceptions and experiences.

Science.gov (United States)

Baillie, Lesley; Thomas, Nicola

2018-01-01

Person-centred care is internationally recognised as best practice for the care of people with dementia. Personal information documents for people with dementia are proposed as a way to support person-centred care in healthcare settings. However, there is little research about how they are used in practice. The aim of this study was to analyse healthcare staff 's perceptions and experiences of using personal information documents, mainly Alzheimer's Society's 'This is me', for people with dementia in healthcare settings. The method comprised a secondary thematic analysis of data from a qualitative study, of how a dementia awareness initiative affected care for people with dementia in one healthcare organisation. The data were collected through 12 focus groups (n = 58 participants) and 1 individual interview, conducted with a range of healthcare staff, both clinical and non-clinical. There are four themes presented: understanding the rationale for personal information documents; completing personal information documents; location for personal information documents and transfer between settings; impact of personal information documents in practice. The findings illuminated how healthcare staff use personal information documents in practice in ways that support person-centred care. Practical issues about the use of personal information documents were revealed and these may affect the optimal use of the documents in practice. The study indicated the need to complete personal information documents at an early stage following diagnosis of dementia, and the importance of embedding their use across care settings, to support communication and integrated care.

Using hub technology to facilitate information system integration in a health-care enterprise.

Science.gov (United States)

Gendler, S M; Friedman, B A; Henricks, W H

1996-04-01

The deployment and maintenance of multiple point-to-point interfaces between a clinical information system, such as a laboratory information system, and other systems within a healthcare enterprise is expensive and time consuming. Moreover, the demand for such interfaces is increasing as hospitals consolidate and clinical laboratories participate in the development of regional laboratory networks and create host-to-host links with laboratory outreach clients. An interface engine, also called a hub, is an evolving technology that could replace multiple point-to-point interfaces from a laboratory information system with a single interface to the hub, preferably HL7 based. The hub then routes and translates laboratory information to other systems within the enterprise. Changes in application systems in an enterprise where a centralized interface engine has been implemented then amount to thorough analysis, an update of the enterprise's data dictionary, purchase of a single new vendor-supported interface, and table-based parameter changes on the hub. Two other features of an interface engine, support for structured query language and information store-and-forward, will facilitate the development of clinical data repositories and provide flexibility when interacting with other host systems. This article describes the advantages and disadvantages of an interface engine and lists some problems not solved by the technology. Finally, early developmental experience with an interface engine at the University of Michigan Medical Center and the benefits of the project on system integration efforts are described, not the least of which has been the enthusiastic adoption of the HL7 standard for all future interface projects.

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.

Measurement of integrated healthcare delivery: a systematic review of methods and future research directions

Directory of Open Access Journals (Sweden)

Martin Strandberg-Larsen

2009-02-01

Full Text Available Background: Integrated healthcare delivery is a policy goal of healthcare systems. There is no consensus on how to measure the concept, which makes it difficult to monitor progress. Purpose: To identify the different types of methods used to measure integrated healthcare delivery with emphasis on structural, cultural and process aspects. Methods: Medline/Pubmed, EMBASE, Web of Science, Cochrane Library, WHOLIS, and conventional internet search engines were systematically searched for methods to measure integrated healthcare delivery (published – April 2008. Results: Twenty-four published scientific papers and documents met the inclusion criteria. In the 24 references we identified 24 different measurement methods; however, 5 methods shared theoretical framework. The methods can be categorized according to type of data source: a questionnaire survey data, b automated register data, or c mixed data sources. The variety of concepts measured reflects the significant conceptual diversity within the field, and most methods lack information regarding validity and reliability. Conclusion: Several methods have been developed to measure integrated healthcare delivery; 24 methods are available and some are highly developed. The objective governs the method best used. Criteria for sound measures are suggested and further developments should be based on an explicit conceptual framework and focus on simplifying and validating existing methods.

IHE (Integrating the Healthcare Enterprise): A new approach for the improvement of digital communication in healthcare; IHE (Integrating the Healthcare Enterprise): Ein neuer Ansatz zur Verbesserung der digitalen Kommunikation im Gesundheitswesen

Energy Technology Data Exchange (ETDEWEB)

Wein, B.B. [Universitaetsklinikum Aachen (Germany). Klinik fuer Radiologische Diagnostik

2003-02-01

Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information. (orig.) [German] Parallel zur Einfuehrung der DRG (Diagnosis Related Groups) zur Krankenhausfinanzierung findet eine deutliche Reduktion von Finanzmitteln im Gesundheitssystem statt. Bei der Anpassung der Arbeitsprozesse an die neuen Bedingungen wird dem Einsatz informationsverarbeitender Systeme eine zunehmende Bedeutung zuteil. Allerdings bestehen in der heutigen Alltagswirklichkeit erhebliche Schwierigkeiten, Informationen zwischen unterschiedlichen Systemen sicher und ohne grossen Aufwand auszutauschen. Die Sicherstellung einer hohen Interoperabilitaet bietet IHE (Integrating the Healthcare Enterprise). Die in einer konzertierten Aktion zwischen Anwendern und Industrie ins Leben gerufene Bewegung bietet darueber hinaus eine Zukunftssicherung bei Beschaffungsmassnahmen von Informationssystemen sowie eine allgemeine Verbesserung der Patientenversorgung. IHE ist kein Standard

Sharing Elderly Healthcare information on Cloud Computing

OpenAIRE

Lu, Fangjie; Khan, Israr

2012-01-01

Context: Due to rapid increase in the population of elderly people, sharing healthcare information has become an essential requirement for the development of e-health system. By conducting a research in e-health and cloud computing we have explored the advantages and disadvantages of sharing healthcare information for elderly people through cloud computing. Objectives: The main purpose of this research is to investigate the suitability of cloud computing to share healthcare information. The s...

Integration of social media with healthcare big data for improved service delivery

Directory of Open Access Journals (Sweden)

Sibulela Mgudlwa

2018-04-01

Full Text Available Background: In the last decade, social media users across the world have crossed 1 billion, making it one of the fastest growing sources of big data. Also, people needing healthcare continue to increase in every society. Through accessibility, communication and interaction between health practitioners and patients, this type of ever-growing, social media subscriber–based platform can be of significant use in improving healthcare delivery to society. However, users encounter serious challenges in their attempts to make use of social media and big data for health-related services. The challenges are primarily caused by factors such as integration, complexity, security and privacy. The challenges are mainly owing to the sensitive nature of the healthcare environment, as a result of personalisation and privacy of information.   Objectives: The objectives of the study were to examine and gain a better understanding of the complexities that are associated with the use of social media and healthcare big data, through influencing factors, and to develop a framework that can be used to improve health-related services to the patients.   Methods: The interpretivist approach was employed, within which qualitative data were collected. This included documents and existing literature in the areas of social media and healthcare big data. To have a good spread of both previous and current state of events within the phenomena being studied, literature published between 2006 and 2016 were gathered. The data were interpretively analysed.   Results: Based on the analysis of the data, factors of influence were found, which were used to develop a model. The model illustrates how the factors of influence can enable and at the same time constrain the use of social media for healthcare services. The factors were interpreted from which a framework was developed. The framework is intended to guide integration of social media with healthcare big data through which

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.

FHIR Healthcare Directories: Adopting Shared Interfaces to Achieve Interoperable Medical Device Data Integration.

Science.gov (United States)

Tyndall, Timothy; Tyndall, Ayami

2018-01-01

Healthcare directories are vital for interoperability among healthcare providers, researchers and patients. Past efforts at directory services have not provided the tools to allow integration of the diverse data sources. Many are overly strict, incompatible with legacy databases, and do not provide Data Provenance. A more architecture-independent system is needed to enable secure, GDPR-compatible (8) service discovery across organizational boundaries. We review our development of a portable Data Provenance Toolkit supporting provenance within Health Information Exchange (HIE) systems. The Toolkit has been integrated with client software and successfully leveraged in clinical data integration. The Toolkit validates provenance stored in a Blockchain or Directory record and creates provenance signatures, providing standardized provenance that moves with the data. This healthcare directory suite implements discovery of healthcare data by HIE and EHR systems via FHIR. Shortcomings of past directory efforts include the ability to map complex datasets and enabling interoperability via exchange endpoint discovery. By delivering data without dictating how it is stored we improve exchange and facilitate discovery on a multi-national level through open source, fully interoperable tools. With the development of Data Provenance resources we enhance exchange and improve security and usability throughout the health data continuum.

National healthcare information system in Croatian primary care: the foundation for improvement of quality and efficiency in patient care

Directory of Open Access Journals (Sweden)

Darko Gvozdanovi_

2007-09-01

Full Text Available In order to improve the quality of patient care, while at the same time keeping up with the pace of increased needs of the population for healthcare services that directly impacts on the cost of care delivery processes, the Republic of Croatia, under the leadership of the Ministry of Health and Social Welfare, has formed a strategy and campaign for national public healthcare system reform. The strategy is very comprehensive and addresses all niches of care delivery processes; it is founded on the enterprise information systems that will aim to support end-to-end business processes in the healthcare domain. Two major requirements are in focus: (1 to provide efficient healthcare-related data management in support of decision-making processes; (2 to support a continuous process of healthcare resource spending optimisation. The first project is the Integrated Healthcare Information System (IHCIS on the primary care level; this encompasses the integration of all primary point-of-care facilities and subjects with the Croatian Institute for Health Insurance and Croatian National Institute of Public Health. In years to come, IHCIS will serve as the main integration platform for connecting all other stakeholders and levels of health care (that is, hospitals, pharmacies, laboratories into a single enterprise healthcare network. This article gives an overview of Croatian public healthcare system strategy aims and goals, and focuses on properties and characteristics of the primary care project implementation that started in 2003; it achieved a major milestone in early 2007 - the official grand opening of the project with 350 GPs already fully connected to the integrated healthcare information infrastructure based on the IHCIS solution.

The Relationship between Hospital Financial Performance and Information Technology Integration Strategy Selection

Science.gov (United States)

Xie, Yue

2012-01-01

In light of the new healthcare regulations, hospitals are increasingly reevaluating their IT integration strategies to meet expanded healthcare information exchange requirements. Nevertheless, hospital executives do not have all the information they need to differentiate between the available strategies and recognize what may better fit their…

Factors affecting the adoption of healthcare information technology

OpenAIRE

Naenna, Thanakorn; Phichitchaisopa, Nisakorn

2013-01-01

In order to improve the quality and performance of healthcare services, healthcare information technology is among the most important technology in healthcare supply chain management. This study sets out to apply and test the Unified Theory of Acceptance and Use of Technology (UTAUT), to examine the factors influencing healthcare Information Technology (IT) services. A structured questionnaire was developed and distributed to healthcare representatives in each province surveyed in Thailand...

Factors affecting the adoption of healthcare information technology

OpenAIRE

Phichitchaisopa, Nisakorn; Naenna, Thanakorn

2013-01-01

In order to improve the quality and performance of healthcare services, healthcare information technology is among the most important technology in healthcare supply chain management. This study sets out to apply and test the Unified Theory of Acceptance and Use of Technology (UTAUT), to examine the factors influencing healthcare Information Technology (IT) services. A structured questionnaire was developed and distributed to healthcare representatives in each province surveyed in Thailand. D...

Article Commentary: Integral Healthcare: The Benefits and Challenges of Integrating Complementary and Alternative Medicine with a Conventional Healthcare Practice

Directory of Open Access Journals (Sweden)

Christina L. Ross PhD

2009-01-01

Full Text Available Today's medicine is in the midst of an undeniable crisis. Calls to reform healthcare are in the forefront of economic and political discussions worldwide. Economic pressures reduce the amount of time physicians can spend with patients contributing to burnout among medical staff and endangering the patient iatrogenically. Politicians are getting involved as the public is calling for more affordable healthcare. A new paradigm must be embraced in order to address all aspects of this dilemma. It is clear that science and technology have resulted in vastly improved understanding, diagnosis, and treatment of disease, but the emphasis on science and technology to the exclusion of other elements of healing has also served to limit the development of a model that humanizes healthcare. The healing of a patient must include more than the biology and chemistry of their physical body; by necessity, it must include the mental, emotional and spiritual aspects. Because of these challenges, the development of an integral healthcare system that is rooted in appropriate regulation and supported by rigorous scientific evidence is the direction that many models of integrative healthcare are moving towards in the 21st century.

Integrated Environment for Ubiquitous Healthcare and Mobile IPv6 Networks

Science.gov (United States)

Cagalaban, Giovanni; Kim, Seoksoo

The development of Internet technologies based on the IPv6 protocol will allow real-time monitoring of people with health deficiencies and improve the independence of elderly people. This paper proposed a ubiquitous healthcare system for the personalized healthcare services with the support of mobile IPv6 networks. Specifically, this paper discusses the integration of ubiquitous healthcare and wireless networks and its functional requirements. This allow an integrated environment where heterogeneous devices such a mobile devices and body sensors can continuously monitor patient status and communicate remotely with healthcare servers, physicians, and family members to effectively deliver healthcare services.

Why (just) information is not enough: The contributions of information services in the management of healthcare information

Science.gov (United States)

Kostagiolas, P.; Lappa, E.

2015-02-01

Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services' contributions to hospital environment is presented.

Why (just) information is not enough: The contributions of information services in the management of healthcare information

Energy Technology Data Exchange (ETDEWEB)

Kostagiolas, P., E-mail: pkostagiolas@ionio.gr [Assistant Professor Department of Archives, Library Science and Museology, Ionian University, CORFU 49100 (Greece); Lappa, E., E-mail: evlappa@med.uoa.gr [Director of Medical Library of General Hospital Attikis KAT, Nikis 2 str, 14564 KIFFISIA-ATHENS (Greece)

2015-02-09

Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services’ contributions to hospital environment is presented.

Why (just) information is not enough: The contributions of information services in the management of healthcare information

International Nuclear Information System (INIS)

Kostagiolas, P.; Lappa, E.

2015-01-01

Information is at the centre of every hospital activity including clinical decisions and healthcare service delivery systems. Although information is an important hospital asset, several issues related to its management and organization needs to be addressed within the hospitals. The management of healthcare information is a strategic goal related to the reduction of healthcare service provision costs, and to the improvement of quality and safety of healthcare services. By discussing the rather obvious necessity for information organization and management in the healthcare domain, this work aims at the role of healthcare information services, i.e. hospital libraries and patient medical records. Finally, a typology of information services’ contributions to hospital environment is presented

Factors affecting the adoption of healthcare information technology.

Science.gov (United States)

Phichitchaisopa, Nisakorn; Naenna, Thanakorn

2013-01-01

In order to improve the quality and performance of healthcare services, healthcare information technology is among the most important technology in healthcare supply chain management. This study sets out to apply and test the Unified Theory of Acceptance and Use of Technology (UTAUT), to examine the factors influencing healthcare Information Technology (IT) services. A structured questionnaire was developed and distributed to healthcare representatives in each province surveyed in Thailand. Data collected from 400 employees including physicians, nurses, and hospital staff members were tested the model using structural equation modeling technique. The results found that the factors with a significant effect are performance expectancy, effort expectancy and facilitating conditions. They were also found to have a significant impact on behavioral intention to use the acceptance healthcare technology. In addition, in Thai provincial areas, positive significance was found with two factors: social influence on behavioral intention and facilitating conditions to direct using behavior. Based on research findings, in order for healthcare information technology to be widely adopted and used by healthcare staffs in healthcare supply chain management, the healthcare organizational management should improve healthcare staffs' behavioral intention and facilitating conditions.

Factors affecting the adoption of healthcare information technology

Science.gov (United States)

Phichitchaisopa, Nisakorn; Naenna, Thanakorn

2013-01-01

In order to improve the quality and performance of healthcare services, healthcare information technology is among the most important technology in healthcare supply chain management. This study sets out to apply and test the Unified Theory of Acceptance and Use of Technology (UTAUT), to examine the factors influencing healthcare Information Technology (IT) services. A structured questionnaire was developed and distributed to healthcare representatives in each province surveyed in Thailand. Data collected from 400 employees including physicians, nurses, and hospital staff members were tested the model using structural equation modeling technique. The results found that the factors with a significant effect are performance expectancy, effort expectancy and facilitating conditions. They were also found to have a significant impact on behavioral intention to use the acceptance healthcare technology. In addition, in Thai provincial areas, positive significance was found with two factors: social influence on behavioral intention and facilitating conditions to direct using behavior. Based on research findings, in order for healthcare information technology to be widely adopted and used by healthcare staffs in healthcare supply chain management, the healthcare organizational management should improve healthcare staffs' behavioral intention and facilitating conditions. PMID:26417235

Integrating mental health in primary healthcare in low-income countries

DEFF Research Database (Denmark)

Sørensen, Carina Winkler; Bæk, Ole; Kallestrup, Per

2017-01-01

. AIMS: This paper seeks to explore the rationale behind the WHO recommendations for improving mental health services in LICs. At the core of these recommendations is an integration of mental health services into existing primary healthcare. This article presents available research supporting...... from LICs that investigate mental health interventions is scarce. The evidence that does exist favours integration into primary healthcare. There is evidence that collaborative- and stepped-care interventions can provide viable treatment options for patients. CONCLUSION: Integration of mental health...... services into primary healthcare seems like a viable solution to ensure that treatment becomes more available, even though the evidence is limited. Locally conducted research is needed to guide the development of sustainable evidence-based mental health treatment, involving relevant healthcare providers...

Improvement attributes in healthcare: implications for integrated care.

Science.gov (United States)

Harnett, Patrick John

2018-04-16

Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

Integrated palliative care is about professional networking rather than standardisation of care: A qualitative study with healthcare professionals in 19 integrated palliative care initiatives in five European countries.

Science.gov (United States)

den Herder-van der Eerden, Marlieke; van Wijngaarden, Jeroen; Payne, Sheila; Preston, Nancy; Linge-Dahl, Lisa; Radbruch, Lukas; Van Beek, Karen; Menten, Johan; Busa, Csilla; Csikos, Agnes; Vissers, Kris; van Gurp, Jelle; Hasselaar, Jeroen

2018-06-01

Integrated palliative care aims at improving coordination of palliative care services around patients' anticipated needs. However, international comparisons of how integrated palliative care is implemented across four key domains of integrated care (content of care, patient flow, information logistics and availability of (human) resources and material) are lacking. To examine how integrated palliative care takes shape in practice across abovementioned key domains within several integrated palliative care initiatives in Europe. Qualitative group interview design. A total of 19 group interviews were conducted (2 in Belgium, 4 in the Netherlands, 4 in the United Kingdom, 4 in Germany and 5 in Hungary) with 142 healthcare professionals from several integrated palliative care initiatives in five European countries. The majority were nurses ( n = 66; 46%) and physicians ( n = 50; 35%). The dominant strategy for fostering integrated palliative care is building core teams of palliative care specialists and extended professional networks based on personal relationships, shared norms, values and mutual trust, rather than developing standardised information exchange and referral pathways. Providing integrated palliative care with healthcare professionals in the wider professional community appears difficult, as a shared proactive multidisciplinary palliative care approach is lacking, and healthcare professionals often do not know palliative care professionals or services. Achieving better palliative care integration into regular healthcare and convincing the wider professional community is a difficult task that will take time and effort. Enhancing standardisation of palliative care into education, referral pathways and guidelines and standardised information exchange may be necessary. External authority (policy makers, insurance companies and professional bodies) may be needed to support integrated palliative care practices across settings.

Standards to support information systems integration in anatomic pathology.

Science.gov (United States)

Daniel, Christel; García Rojo, Marcial; Bourquard, Karima; Henin, Dominique; Schrader, Thomas; Della Mea, Vincenzo; Gilbertson, John; Beckwith, Bruce A

2009-11-01

Integrating anatomic pathology information- text and images-into electronic health care records is a key challenge for enhancing clinical information exchange between anatomic pathologists and clinicians. The aim of the Integrating the Healthcare Enterprise (IHE) international initiative is precisely to ensure interoperability of clinical information systems by using existing widespread industry standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7). To define standard-based informatics transactions to integrate anatomic pathology information to the Healthcare Enterprise. We used the methodology of the IHE initiative. Working groups from IHE, HL7, and DICOM, with special interest in anatomic pathology, defined consensual technical solutions to provide end-users with improved access to consistent information across multiple information systems. The IHE anatomic pathology technical framework describes a first integration profile, "Anatomic Pathology Workflow," dedicated to the diagnostic process including basic image acquisition and reporting solutions. This integration profile relies on 10 transactions based on HL7 or DICOM standards. A common specimen model was defined to consistently identify and describe specimens in both HL7 and DICOM transactions. The IHE anatomic pathology working group has defined standard-based informatics transactions to support the basic diagnostic workflow in anatomic pathology laboratories. In further stages, the technical framework will be completed to manage whole-slide images and semantically rich structured reports in the diagnostic workflow and to integrate systems used for patient care and those used for research activities (such as tissue bank databases or tissue microarrayers).

Process-aware information system development for the healthcare domain : consistency, reliability and effectiveness

NARCIS (Netherlands)

Mans, R.S.; Aalst, van der W.M.P.; Russell, N.C.; Bakker, P.J.M.; Moleman, A.J.; Rinderle-Ma, S.; Sadiq, S.; Leymann, F.

2010-01-01

Optimal support for complex healthcare processes cannot be provided by a single out-of-the-box Process-Aware Information System and necessitates the construction of customized applications based on these systems. In order to allow for the seamless integration of the new technology into the existing

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.

Fully integrated biochip platforms for advanced healthcare.

Science.gov (United States)

Carrara, Sandro; Ghoreishizadeh, Sara; Olivo, Jacopo; Taurino, Irene; Baj-Rossi, Camilla; Cavallini, Andrea; de Beeck, Maaike Op; Dehollain, Catherine; Burleson, Wayne; Moussy, Francis Gabriel; Guiseppi-Elie, Anthony; De Micheli, Giovanni

2012-01-01

Recent advances in microelectronics and biosensors are enabling developments of innovative biochips for advanced healthcare by providing fully integrated platforms for continuous monitoring of a large set of human disease biomarkers. Continuous monitoring of several human metabolites can be addressed by using fully integrated and minimally invasive devices located in the sub-cutis, typically in the peritoneal region. This extends the techniques of continuous monitoring of glucose currently being pursued with diabetic patients. However, several issues have to be considered in order to succeed in developing fully integrated and minimally invasive implantable devices. These innovative devices require a high-degree of integration, minimal invasive surgery, long-term biocompatibility, security and privacy in data transmission, high reliability, high reproducibility, high specificity, low detection limit and high sensitivity. Recent advances in the field have already proposed possible solutions for several of these issues. The aim of the present paper is to present a broad spectrum of recent results and to propose future directions of development in order to obtain fully implantable systems for the continuous monitoring of the human metabolism in advanced healthcare applications.

How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews.

OpenAIRE

Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.; Groenewegen, P.

2009-01-01

Abstract Background To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods Using semi-structured cognitive interviews, interviewees (n = 20) were asked to think aloud and answer questions, as they were prompted with three Dutch web pages providing comparative healthcare information. Results We identified twelve themes fr...

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....

The Integration of It Governance, Information Security Leadership and Strategic Alignment in Healthcare: A Correlational Study

Science.gov (United States)

Taft, Tiffany H.

2017-01-01

This dissertation is a study of the relationship between Information Technology Governance (ITG), information security leadership, and strategic alignment within a healthcare organization. Strong organizational leadership and adherence to the process are vital to the formulation and management of performance and implementation of key directives.…

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.

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....

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.

Authorization & security aspects in the middleware-based healthcare information system.

Science.gov (United States)

Andany, J; Bjorkendal, C; Ferrara, F M; Scherrer, J R; Spahni, S

1999-01-01

The integration and evolution of existing systems represents one of the most urgent priorities of health care information systems in order to allow the whole organisation to meet the increasing clinical organisational and managerial needs. The CEN ENV 12967-1 'Healthcare Information Systems Architecture'(HISA) standard defines an architectural approach based on a middleware of business-specific common services, enabling all parts of the local and geographical system to operate on the common information heritage of the organisation and on exploiting a set of common business-oriented functionality. After an overview on the key aspects of HISA, this paper discusses the positioning of the authorization and security aspects in the overall architecture. A global security framework is finally proposed.

Fully Integrated Biochip Platforms for Advanced Healthcare

Directory of Open Access Journals (Sweden)

Giovanni De Micheli

2012-08-01

Full Text Available Recent advances in microelectronics and biosensors are enabling developments of innovative biochips for advanced healthcare by providing fully integrated platforms for continuous monitoring of a large set of human disease biomarkers. Continuous monitoring of several human metabolites can be addressed by using fully integrated and minimally invasive devices located in the sub-cutis, typically in the peritoneal region. This extends the techniques of continuous monitoring of glucose currently being pursued with diabetic patients. However, several issues have to be considered in order to succeed in developing fully integrated and minimally invasive implantable devices. These innovative devices require a high-degree of integration, minimal invasive surgery, long-term biocompatibility, security and privacy in data transmission, high reliability, high reproducibility, high specificity, low detection limit and high sensitivity. Recent advances in the field have already proposed possible solutions for several of these issues. The aim of the present paper is to present a broad spectrum of recent results and to propose future directions of development in order to obtain fully implantable systems for the continuous monitoring of the human metabolism in advanced healthcare applications.

Transforming Healthcare Delivery: Integrating Dynamic Simulation Modelling and Big Data in Health Economics and Outcomes Research.

Science.gov (United States)

Marshall, Deborah A; Burgos-Liz, Lina; Pasupathy, Kalyan S; Padula, William V; IJzerman, Maarten J; Wong, Peter K; Higashi, Mitchell K; Engbers, Jordan; Wiebe, Samuel; Crown, William; Osgood, Nathaniel D

2016-02-01

In the era of the Information Age and personalized medicine, healthcare delivery systems need to be efficient and patient-centred. The health system must be responsive to individual patient choices and preferences about their care, while considering the system consequences. While dynamic simulation modelling (DSM) and big data share characteristics, they present distinct and complementary value in healthcare. Big data and DSM are synergistic-big data offer support to enhance the application of dynamic models, but DSM also can greatly enhance the value conferred by big data. Big data can inform patient-centred care with its high velocity, volume, and variety (the three Vs) over traditional data analytics; however, big data are not sufficient to extract meaningful insights to inform approaches to improve healthcare delivery. DSM can serve as a natural bridge between the wealth of evidence offered by big data and informed decision making as a means of faster, deeper, more consistent learning from that evidence. We discuss the synergies between big data and DSM, practical considerations and challenges, and how integrating big data and DSM can be useful to decision makers to address complex, systemic health economics and outcomes questions and to transform healthcare delivery.

Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

Science.gov (United States)

Stucki, Gerold; Bickenbach, Jerome; Melvin, John

2017-09-01

A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

Integrating Healthcare Ethical Issues into IS Education

Science.gov (United States)

Cellucci, Leigh W.; Layman, Elizabeth J.; Campbell, Robert; Zeng, Xiaoming

2011-01-01

Federal initiatives are encouraging the increase of IS graduates to work in the healthcare environment because they possess knowledge of datasets and dataset management that are key to effective management of electronic health records (EHRs) and health information technology (IT). IS graduates will be members of the healthcare team, and as such,…

Assessing healthcare professionals' experiences of integrated care: do surveys tell the full story?

Science.gov (United States)

Stephenson, Matthew D; Campbell, Jared M; Lisy, Karolina; Aromataris, Edoardo C

2017-09-01

Integrated care is the combination of different healthcare services with the goal to provide comprehensive, seamless, effective and efficient patient care. Assessing the experiences of healthcare professionals (HCPs) is an important aspect when evaluating integrated care strategies. The aim of this rapid review was to investigate if quantitative surveys used to assess HCPs' experiences with integrated care capture all the aspects highlighted as being important in qualitative research, with a view to informing future survey development. The review considered all types of health professionals in primary care, and hospital and specialist services, with a specific focus on the provision of integrated care aimed at improving the patient journey. PubMed, CINAHL and grey literature sources were searched for relevant surveys/program evaluations and qualitative research studies. Full text articles deemed to be of relevance to the review were appraised for methodological quality using abridged critical appraisal instruments from the Joanna Briggs Institute. Data were extracted from included studies using standardized data extraction templates. Findings from included studies were grouped into domains based on similarity of meaning. Similarities and differences in the domains covered in quantitative surveys and those identified as being important in qualitative research were explored. A total of 37 studies (19 quantitative surveys, 14 qualitative studies and four mixed-method studies) were included in the review. A range of healthcare professions participated in the included studies, the majority being primary care providers. Common domains identified from quantitative surveys and qualitative studies included Communication, Agreement on Clear Roles and Responsibilities, Facilities, Information Systems, and Coordination of Care and Access. Qualitative research highlighted domains identified by HCPs as being relevant to their experiences with integrated care that have not

Design and implementation of a smart card based healthcare information system.

Science.gov (United States)

Kardas, Geylani; Tunali, E Turhan

2006-01-01

Smart cards are used in information technologies as portable integrated devices with data storage and data processing capabilities. As in other fields, smart card use in health systems became popular due to their increased capacity and performance. Their efficient use with easy and fast data access facilities leads to implementation particularly widespread in security systems. In this paper, a smart card based healthcare information system is developed. The system uses smart card for personal identification and transfer of health data and provides data communication via a distributed protocol which is particularly developed for this study. Two smart card software modules are implemented that run on patient and healthcare professional smart cards, respectively. In addition to personal information, general health information about the patient is also loaded to patient smart card. Health care providers use their own smart cards to be authenticated on the system and to access data on patient cards. Encryption keys and digital signature keys stored on smart cards of the system are used for secure and authenticated data communication between clients and database servers over distributed object protocol. System is developed on Java platform by using object oriented architecture and design patterns.

Interprofessional Competencies in Integrative Primary Healthcare

Science.gov (United States)

Brooks, Audrey J.; Maizes, Victoria; Goldblatt, Elizabeth; Klatt, Maryanna; Koithan, Mary S.; Kreitzer, Mary Jo; Lee, Jeannie K.; Lopez, Ana Marie; McClafferty, Hilary; Rhode, Robert; Sandvold, Irene; Saper, Robert; Taren, Douglas; Wells, Eden; Lebensohn, Patricia

2015-01-01

In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH is to develop a core set of integrative healthcare (IH) competencies and educational programs that will span the interprofessional primary care training and practice spectra and ultimately become a required part of primary care education. This article reports on the first phase of the NCIPH effort, which focused on the development of a shared set of competencies in IH for primary care disciplines. The process of development, refinement, and adoption of 10 “meta-competencies” through a collaborative process involving a diverse interprofessional team is described. Team members represent nursing, the primary care medicine professions, pharmacy, public health, acupuncture, naturopathy, chiropractic, nutrition, and behavioral medicine. Examples of the discipline-specific sub-competencies being developed within each of the participating professions are provided, along with initial results of an assessment of potential barriers and facilitators of adoption within each discipline. The competencies presented here will form the basis of a 45-hour online curriculum produced by the NCIPH for use in primary care training programs that will be piloted in a wide range of programs in early 2016 and then revised for wider use over the following year. PMID:26421232

Federated health information architecture: Enabling healthcare providers and policymakers to use data for decision-making.

Science.gov (United States)

Kumar, Manish; Mostafa, Javed; Ramaswamy, Rohit

2018-05-01

Health information systems (HIS) in India, as in most other developing countries, support public health management but fail to enable healthcare providers to use data for delivering quality services. Such a failure is surprising, given that the population healthcare data that the system collects are aggregated from patient records. An important reason for this failure is that the health information architecture (HIA) of the HIS is designed primarily to serve the information needs of policymakers and program managers. India has recognised the architectural gaps in its HIS and proposes to develop an integrated HIA. An enabling HIA that attempts to balance the autonomy of local systems with the requirements of a centralised monitoring agency could meet the diverse information needs of various stakeholders. Given the lack of in-country knowledge and experience in designing such an HIA, this case study was undertaken to analyse HIS in the Bihar state of India and to understand whether it would enable healthcare providers, program managers and policymakers to use data for decision-making. Based on a literature review and data collected from interviews with key informants, this article proposes a federated HIA, which has the potential to improve HIS efficiency; provide flexibility for local innovation; cater to the diverse information needs of healthcare providers, program managers and policymakers; and encourage data-based decision-making.

Expert Search Strategies: The Information Retrieval Practices of Healthcare Information Professionals

OpenAIRE

Russell-Rose, Tony; Chamberlain, Jon

2017-01-01

Background Healthcare information professionals play a key role in closing the knowledge gap between medical research and clinical practice. Their work involves meticulous searching of literature databases using complex search strategies that can consist of hundreds of keywords, operators, and ontology terms. This process is prone to error and can lead to inefficiency and bias if performed incorrectly. Objective The aim of this study was to investigate the search behavior of healthcare inform...

Integrating Identity Management With Federated Healthcare Data Models

Science.gov (United States)

Hu, Jun; Peyton, Liam

In order to manage performance and provide integrated services, health care data needs to be linked and aggregated across data sources from different organizations. The Internet and secure B2B networks offer the possibility of providing near real-time integration. However, there are three major stumbling blocks. One is to standardize and agree upon a common data model across organizations. The second is to match identities between different locations in order to link and aggregate records. The third is to protect identity and ensure compliance with privacy laws. In this paper, we analyze three main approaches to the problem and use a healthcare scenario to illustrate how each one addresses different aspects of the problem while failing to address others. We then present a systematic framework in which the different approaches can be flexibly combined for a more comprehensive approach to integrate identity management with federated healthcare data models.

A Case Study - On Patient Empowerment and Integration of Telemedicine to National Healthcare Services

DEFF Research Database (Denmark)

Urazimbetova, Surayya

Patient empowerment in the digitalized healthcare can be supported by means of telemedicine. As opposed to Electronic Patient Records developed by a few large business suppliers for healthcare professionals, telemedical applications include innovative solutions of small-medium size suppliers...... and are targeted at specific groups of patients (e.g., hip operated or dermatology patients) and their care network. Based on an integration experiment we argue that in order to support the national visions for patient empowerment and connectedness of healthcare at the same time, it is necessary to achieve...... the integration of telemedicine to the national healthcare services on a business logic (functional) integration level. In this paper, (1) we identify the lack of business logic (functional) level integration opportunities for patient oriented telemedical applications with national healthcare services; (2) we...

Using a logical information model-driven design process in healthcare.

Science.gov (United States)

Cheong, Yu Chye; Bird, Linda; Tun, Nwe Ni; Brooks, Colleen

2011-01-01

A hybrid standards-based approach has been adopted in Singapore to develop a Logical Information Model (LIM) for healthcare information exchange. The Singapore LIM uses a combination of international standards, including ISO13606-1 (a reference model for electronic health record communication), ISO21090 (healthcare datatypes), SNOMED CT (healthcare terminology) and HL7 v2 (healthcare messaging). This logic-based design approach also incorporates mechanisms for achieving bi-directional semantic interoperability.

How do healthcare consumers process and evaluate comparative healthcare information? A qualitive study using cognitive interviews

NARCIS (Netherlands)

Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.M.J.; Groenewegen, P.P.

2009-01-01

Background: To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods: Using semi-structured cognitive interviews, interviewees

How do healthcare consumers process and evaluate comparative healthcare information? A qualitative study using cognitive interviews.

NARCIS (Netherlands)

Damman, O.C.; Hendriks, M.; Rademakers, J.; Delnoij, D.; Groenewegen, P.

2009-01-01

Background: To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods: Using semi-structured cognitive interviews, interviewees

Agent-Oriented Privacy-Based Information Brokering Architecture for Healthcare Environments

Directory of Open Access Journals (Sweden)

Abdulmutalib Masaud-Wahaishi

2009-01-01

Full Text Available Healthcare industry is facing a major reform at all levels—locally, regionally, nationally, and internationally. Healthcare services and systems become very complex and comprise of a vast number of components (software systems, doctors, patients, etc. that are characterized by shared, distributed and heterogeneous information sources with varieties of clinical and other settings. The challenge now faced with decision making, and management of care is to operate effectively in order to meet the information needs of healthcare personnel. Currently, researchers, developers, and systems engineers are working toward achieving better efficiency and quality of service in various sectors of healthcare, such as hospital management, patient care, and treatment. This paper presents a novel information brokering architecture that supports privacy-based information gathering in healthcare. Architecturally, the brokering is viewed as a layer of services where a brokering service is modeled as an agent with a specific architecture and interaction protocol that are appropriate to serve various requests. Within the context of brokering, we model privacy in terms of the entities ability to hide or reveal information related to its identities, requests, and/or capabilities. A prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform JADE.

Agent-oriented privacy-based information brokering architecture for healthcare environments.

Science.gov (United States)

Masaud-Wahaishi, Abdulmutalib; Ghenniwa, Hamada

2009-01-01

Healthcare industry is facing a major reform at all levels-locally, regionally, nationally, and internationally. Healthcare services and systems become very complex and comprise of a vast number of components (software systems, doctors, patients, etc.) that are characterized by shared, distributed and heterogeneous information sources with varieties of clinical and other settings. The challenge now faced with decision making, and management of care is to operate effectively in order to meet the information needs of healthcare personnel. Currently, researchers, developers, and systems engineers are working toward achieving better efficiency and quality of service in various sectors of healthcare, such as hospital management, patient care, and treatment. This paper presents a novel information brokering architecture that supports privacy-based information gathering in healthcare. Architecturally, the brokering is viewed as a layer of services where a brokering service is modeled as an agent with a specific architecture and interaction protocol that are appropriate to serve various requests. Within the context of brokering, we model privacy in terms of the entities ability to hide or reveal information related to its identities, requests, and/or capabilities. A prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform JADE.

Impact of Healthcare Information Technology on Nursing Practice.

Science.gov (United States)

Piscotty, Ronald J; Kalisch, Beatrice; Gracey-Thomas, Angel

2015-07-01

To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care. The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included. The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables. Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage. Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes. © 2015 Sigma Theta Tau International.

Integrated healthcare networks' performance: a growth curve modeling approach.

Science.gov (United States)

Wan, Thomas T H; Wang, Bill B L

2003-05-01

This study examines the effects of integration on the performance ratings of the top 100 integrated healthcare networks (IHNs) in the United States. A strategic-contingency theory is used to identify the relationship of IHNs' performance to their structural and operational characteristics and integration strategies. To create a database for the panel study, the top 100 IHNs selected by the SMG Marketing Group in 1998 were followed up in 1999 and 2000. The data were merged with the Dorenfest data on information system integration. A growth curve model was developed and validated by the Mplus statistical program. Factors influencing the top 100 IHNs' performance in 1998 and their subsequent rankings in the consecutive years were analyzed. IHNs' initial performance scores were positively influenced by network size, number of affiliated physicians and profit margin, and were negatively associated with average length of stay and technical efficiency. The continuing high performance, judged by maintaining higher performance scores, tended to be enhanced by the use of more managerial or executive decision-support systems. Future studies should include time-varying operational indicators to serve as predictors of network performance.

Expert Search Strategies: The Information Retrieval Practices of Healthcare Information Professionals.

Science.gov (United States)

Russell-Rose, Tony; Chamberlain, Jon

2017-10-02

Healthcare information professionals play a key role in closing the knowledge gap between medical research and clinical practice. Their work involves meticulous searching of literature databases using complex search strategies that can consist of hundreds of keywords, operators, and ontology terms. This process is prone to error and can lead to inefficiency and bias if performed incorrectly. The aim of this study was to investigate the search behavior of healthcare information professionals, uncovering their needs, goals, and requirements for information retrieval systems. A survey was distributed to healthcare information professionals via professional association email discussion lists. It investigated the search tasks they undertake, their techniques for search strategy formulation, their approaches to evaluating search results, and their preferred functionality for searching library-style databases. The popular literature search system PubMed was then evaluated to determine the extent to which their needs were met. The 107 respondents indicated that their information retrieval process relied on the use of complex, repeatable, and transparent search strategies. On average it took 60 minutes to formulate a search strategy, with a search task taking 4 hours and consisting of 15 strategy lines. Respondents reviewed a median of 175 results per search task, far more than they would ideally like (100). The most desired features of a search system were merging search queries and combining search results. Healthcare information professionals routinely address some of the most challenging information retrieval problems of any profession. However, their needs are not fully supported by current literature search systems and there is demand for improved functionality, in particular regarding the development and management of search strategies. ©Tony Russell-Rose, Jon Chamberlain. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 02.10.2017.

[Indicators of communication and degree of professional integration in healthcare].

Science.gov (United States)

Mola, Ernesto; Maggio, Anna; Vantaggiato, Lucia

2009-01-01

According to the chronic care model, improving the management of chronic illness requires efficient communication between health care professionals and the creation of a web of integrated healthcare The aim of this study was to identify an efficient methodology for evaluating the degree of professional integration through indicators related to communication between healthcare professionals. The following types of indicators were identified:-structure indicators to evaluate the presence of prerequisites necessary for implementing the procedures -functional indicators to quantitatively evaluate the use of communications instruments-performance indicators Defining specific indicators may be an appropriate methodology for evaluating the degree of integration and communication between health professionals, available for a bargaining system of incentives.

Integration of healthcare rehabilitation in chronic conditions

DEFF Research Database (Denmark)

Frølich, Anne; Høst, Dorte; Schnor, Helle

2010-01-01

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 prov...... 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....

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.

A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

Science.gov (United States)

Juhnke, Christin; Bethge, Susanne

2016-01-01

Introduction: Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems. The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed. Theory and methods: A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines. Results: In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status. Conclusions and discussion: After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts. PMID:28316544

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.

A Theoretical Approach to Information Needs Across Different Healthcare Stakeholders

Science.gov (United States)

Raitoharju, Reetta; Aarnio, Eeva

Increased access to medical information can lead to information overload among both the employees in the healthcare sector as well as among healthcare consumers. Moreover, medical information can be hard to understand for consumers who have no prerequisites for interpreting and understanding it. Information systems (e.g. electronic patient records) are normally designed to meet the demands of one professional group, for instance those of physicians. Therefore, the same information in the same form is presented to all the users of the systems regardless of the actual need or prerequisites. The purpose of this article is to illustrate the differences in information needs across different stakeholders in healthcare. A literature review was conducted to collect examples of these different information needs. Based on the findings the role of more user specific information systems is discussed.

Institutionalization of evidence-informed practices in healthcare settings.

Science.gov (United States)

Novotná, Gabriela; Dobbins, Maureen; Henderson, Joanna

2012-11-21

The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs.

Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review.

Science.gov (United States)

Pentland, Duncan; Forsyth, Kirsty; Maciver, Donald; Walsh, Mike; Murray, Richard; Irvine, Linda; Sikora, Simon

2011-07-01

This paper presents the results of a review of literature relating to knowledge transfer and exchange in healthcare. Treatment, planning and policy decisions in contemporary nursing and healthcare should be based on sound evidence wherever possible, but research knowledge remains generally underused. Knowledge transfer and exchange initiatives aim to facilitate the accessibility, application and production of evidence and may provide solutions to this challenge. This review was conducted to help inform the design and implementation of knowledge transfer and exchange activities for a large healthcare organization. Databases: ASSIA, Business Source Premier, CINAHL, PsychInfo, Medline and the Cochrane Database of Systematic Reviews. An integrative literature review was carried out including an extensive literature search. English language systematic reviews, literature reviews, primary quantitative and qualitative papers and grey literature of high relevance evaluating, describing or discussing knowledge transfer or exchange activities in healthcare were included for review (January 1990-September 2009). Thirty-three papers were reviewed (four systematic reviews, nine literature reviews, one environmental scan, nine empirical studies and ten case studies). Robust research into knowledge transfer and exchange in healthcare is limited. Analysis of a wide range of evidence indicates a number of commonly featured characteristics but further evaluation of these activities would benefit their application in facilitating evidence-based practice in nursing. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

The interplay between formal and informal contracting in integrated project delivery

NARCIS (Netherlands)

Bygballe, L.E.; Dewulf, Geert P.M.R.; Levitt, R.

2015-01-01

This research examines the interplay between formal and informal contracting in integrated project delivery (IPD). It investigates how the interplay enables parties in health-care construction projects to cope with uncertainty and complexities, due to, among others, changing demands. New delivery

Integration and the performance of healthcare networks: do integration strategies enhance efficiency, profitability, and image?

Directory of Open Access Journals (Sweden)

Thomas T.H. Wan

2001-06-01

Full Text Available Purpose: This study examines the integration effects on efficiency and financial viability of the top 100 integrated healthcare networks (IHNs in the United States. Theory: A contingency- strategic theory is used to identify the relationship of IHNs' performance to their structural and operational characteristics and integration strategies. Methods: The lists of the top 100 IHNs ranked in two years, 1998 and 1999, by the SMG Marketing Group were merged to create a database for the study. Multiple indicators were used to examine the relationship between IHNs' characteristics and their performance in efficiency and financial viability. A path analytical model was developed and validated by the Mplus statistical program. Factors influencing the top 100 IHNs' images, represented by attaining ranking among the top 100 in two consecutive years, were analysed. Results and conclusion: No positive associations were found between integration and network performance in efficiency or profits. Longitudinal data are needed to investigate the effect of integration on healthcare networks' financial performance.

An EFQM excellence model for integrated healthcare governance.

Science.gov (United States)

Favaretti, Carlo; De Pieri, Paolo; Torri, Emanuele; Guarrera, Giovanni; Fontana, Fabrizio; Debiasi, Franco; Flor, Luciano

2015-01-01

The purpose of this paper is to account for a ten-year experience with the European Foundation for Quality Management (EFQM) Excellence Model implemented in the Trento Healthcare Trust. Since 2000, the EFQM Excellence Model provided an overarching framework to streamline business process governance, to support and improve its enablers and results. From 2000 to 2009, staff performed four internal (self) and four external EFQM-based assessments that provided guidance for an integrated management system. Over the years, key controls and assurances improved service quality through business planning, learning and practice cycles. Rising assessment ratings and improving results characterized the journey. The average self-assessment score (on a 1,000 points scale) was 290 in 2001, which increased to 610 in 2008. Since 2006, the Trust has been Recognized for Excellence (four stars). The organization improved significantly on customer satisfaction, people results and key service delivery and outcomes. The EFQM Model can act as an effective tool to meet governance demands and promote system-level results. The approach to integrated governance discussed here may support similar change processes in comparable organizations. The paper describes a unique experience when implementing EFQM within a large Italian healthcare system, which had a broader reach and lasted longer than any experience in Italian healthcare.

Communication in Healthcare: Opportunities for information technology and concerns for patient safety

NARCIS (Netherlands)

H. Pirnejad (Habibollah)

2008-01-01

textabstractUnderstanding healthcare workflow is fundamental for design and implementation of information systems. Communication and information exchange between healthcare professionals plays a pivotal role in developing smooth workflow within and between healthcare organizations. The study in this

Augmented reality in healthcare education: an integrative review

Directory of Open Access Journals (Sweden)

Egui Zhu

2014-07-01

Full Text Available Background. The effective development of healthcare competencies poses great educational challenges. A possible approach to provide learning opportunities is the use of augmented reality (AR where virtual learning experiences can be embedded in a real physical context. The aim of this study was to provide a comprehensive overview of the current state of the art in terms of user acceptance, the AR applications developed and the effect of AR on the development of competencies in healthcare.Methods. We conducted an integrative review. Integrative reviews are the broadest type of research review methods allowing for the inclusion of various research designs to more fully understand a phenomenon of concern. Our review included multi-disciplinary research publications in English reported until 2012.Results. 2529 research papers were found from ERIC, CINAHL, Medline, PubMed, Web of Science and Springer-link. Three qualitative, 20 quantitative and 2 mixed studies were included. Using a thematic analysis, we’ve described three aspects related to the research, technology and education. This study showed that AR was applied in a wide range of topics in healthcare education. Furthermore acceptance for AR as a learning technology was reported among the learners and its potential for improving different types of competencies.Discussion. AR is still considered as a novelty in the literature. Most of the studies reported early prototypes. Also the designed AR applications lacked an explicit pedagogical theoretical framework. Finally the learning strategies adopted were of the traditional style ‘see one, do one and teach one’ and do not integrate clinical competencies to ensure patients’ safety.

Augmented reality in healthcare education: an integrative review

Science.gov (United States)

Zhu, Egui; Hadadgar, Arash; Masiello, Italo

2014-01-01

Background. The effective development of healthcare competencies poses great educational challenges. A possible approach to provide learning opportunities is the use of augmented reality (AR) where virtual learning experiences can be embedded in a real physical context. The aim of this study was to provide a comprehensive overview of the current state of the art in terms of user acceptance, the AR applications developed and the effect of AR on the development of competencies in healthcare. Methods. We conducted an integrative review. Integrative reviews are the broadest type of research review methods allowing for the inclusion of various research designs to more fully understand a phenomenon of concern. Our review included multi-disciplinary research publications in English reported until 2012. Results. 2529 research papers were found from ERIC, CINAHL, Medline, PubMed, Web of Science and Springer-link. Three qualitative, 20 quantitative and 2 mixed studies were included. Using a thematic analysis, we’ve described three aspects related to the research, technology and education. This study showed that AR was applied in a wide range of topics in healthcare education. Furthermore acceptance for AR as a learning technology was reported among the learners and its potential for improving different types of competencies. Discussion. AR is still considered as a novelty in the literature. Most of the studies reported early prototypes. Also the designed AR applications lacked an explicit pedagogical theoretical framework. Finally the learning strategies adopted were of the traditional style ‘see one, do one and teach one’ and do not integrate clinical competencies to ensure patients’ safety. PMID:25071992

Augmented reality in healthcare education: an integrative review.

Science.gov (United States)

Zhu, Egui; Hadadgar, Arash; Masiello, Italo; Zary, Nabil

2014-01-01

Background. The effective development of healthcare competencies poses great educational challenges. A possible approach to provide learning opportunities is the use of augmented reality (AR) where virtual learning experiences can be embedded in a real physical context. The aim of this study was to provide a comprehensive overview of the current state of the art in terms of user acceptance, the AR applications developed and the effect of AR on the development of competencies in healthcare. Methods. We conducted an integrative review. Integrative reviews are the broadest type of research review methods allowing for the inclusion of various research designs to more fully understand a phenomenon of concern. Our review included multi-disciplinary research publications in English reported until 2012. Results. 2529 research papers were found from ERIC, CINAHL, Medline, PubMed, Web of Science and Springer-link. Three qualitative, 20 quantitative and 2 mixed studies were included. Using a thematic analysis, we've described three aspects related to the research, technology and education. This study showed that AR was applied in a wide range of topics in healthcare education. Furthermore acceptance for AR as a learning technology was reported among the learners and its potential for improving different types of competencies. Discussion. AR is still considered as a novelty in the literature. Most of the studies reported early prototypes. Also the designed AR applications lacked an explicit pedagogical theoretical framework. Finally the learning strategies adopted were of the traditional style 'see one, do one and teach one' and do not integrate clinical competencies to ensure patients' safety.

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...

Healthcare information on YouTube: A systematic review.

Science.gov (United States)

Madathil, Kapil Chalil; Rivera-Rodriguez, A Joy; Greenstein, Joel S; Gramopadhye, Anand K

2015-09-01

This article reviews the peer-reviewed literature addressing the healthcare information available on YouTube. Inclusion and exclusion criteria were determined, and the online databases PubMed and Web of Knowledge were searched using the search phrases: (1) YouTube* AND Health* and (2) YouTube* AND Healthcare*. In all, 18 articles were reviewed, with the results suggesting that (1) YouTube is increasingly being used as a platform for disseminating health information; (2) content and frame analysis were the primary techniques employed by researchers to analyze the characteristics of this information; (3) YouTube contains misleading information, primarily anecdotal, that contradicts the reference standards and the probability of a lay user finding such content is relatively high; (4) the retrieval of relevant videos is dependent on the search term used; and (5) videos from government organizations and professional associations contained trustworthy and high-quality information. YouTube is used as a medium for promoting unscientific therapies and drugs that are yet to be approved by the appropriate agencies and has the potential to change the beliefs of patients concerning controversial topics such as vaccinations. This review recognizes the need to design interventions to enable consumers to critically assimilate the information posted on YouTube with more authoritative information sources to make effective healthcare decisions. © The Author(s) 2014.

Implementing healthcare information security: standards can help.

Science.gov (United States)

Orel, Andrej; Bernik, Igor

2013-01-01

Using widely spread common approaches to systems security in health dedicated controlled environments, a level of awareness, confidence and acceptance of relevant standardisation is evaluated. Patients' information is sensitive, so putting appropriate organisational techniques as well as modern technology in place to secure health information is of paramount importance. Mobile devices are becoming the top priorities in advanced information security planning with healthcare environments being no exception. There are less and less application areas in healthcare without having a need for a mobile functionality which represents an even greater information security challenge. This is also true in emergency treatments, rehabilitation and homecare just to mention a few areas outside hospital controlled environments. Unfortunately quite often traditional unsecured communications principles are still in routine use for communicating sensitive health related information. The security awareness level with users, patients and care professionals is not high enough so potential threats and risks may not be addressed and the respective information security management is therefore weak. Standards like ISO/IEC 27000 ISMS family, the ISO/IEC 27799 information security guidelines in health are often not well known, but together with legislation principles such as HIPAA, they can help.

Healthcare Services Managers: What Information do They Need and Use?

Directory of Open Access Journals (Sweden)

Andrew Booth

2008-09-01

Full Text Available Objectives – The purpose of this research project was to gain insight into the information behaviour of healthcare services managers as they use information while engaged in decision-making unrelated to individual patient care. Methods – This small-scale, exploratory, multiple case study used the critical incident technique in nineteen semi-structured interviews. Responses were analyzed using ‘Framework,’ a matrix-based content analysis system. Results – This paper presents findings related to the internal information that healthcare services managers need and use. Their decisions are influenced by a wide variety of factors. They must often make decisions without all of the information they would prefer to have. Internal information and practical experience set the context for new research-based information, so they are generally considered first.Conclusions – Healthcare services managers support decisions with both facts and value-based information. These results may inform both delivery of health library services delivery and strategic health information management planning. They may also support librarians who extend their skills beyond managing library collections and teaching published information retrieval skills, to managing internal and external information, teaching information literacy, and supporting information sharing.

Designing healthcare information technology to catalyse change in clinical care

Directory of Open Access Journals (Sweden)

William Lester

2008-05-01

Full Text Available The gap between best practice and actual patient care continues to be a pervasive problem in our healthcare system. Efforts to improve on this knowledge_performance gap have included computerised disease management programs designed to improve guideline adherence. However, current computerised reminder and decision support interventions directed at changing physician behaviour have had only a limited and variable effect on clinical outcomes. Further, immediate pay-for-performance financial pressures on institutions have created an environmentwhere disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their realworld effectiveness. The authors present a review of disease management as well as a conceptual framework to guide the development of more effective health information technology (HIT tools for translating clinical information into clinical action.

Scaling of an information system in a public healthcare market--infrastructuring from the vendor's perspective.

Science.gov (United States)

Johannessen, Liv Karen; Obstfelder, Aud; Lotherington, Ann Therese

2013-05-01

The purpose of this paper is to explore the making and scaling of information infrastructures, as well as how the conditions for scaling a component may change for the vendor. The first research question is how the making and scaling of a healthcare information infrastructure can be done and by whom. The second question is what scope for manoeuvre there might be for vendors aiming to expand their market. This case study is based on an interpretive approach, whereby data is gathered through participant observation and semi-structured interviews. A case study of the making and scaling of an electronic system for general practitioners ordering laboratory services from hospitals is described as comprising two distinct phases. The first may be characterized as an evolving phase, when development, integration and implementation were achieved in small steps, and the vendor, together with end users, had considerable freedom to create the solution according to the users' needs. The second phase was characterized by a large-scale procurement process over which regional healthcare authorities exercised much more control and the needs of groups other than the end users influenced the design. The making and scaling of healthcare information infrastructures is not simply a process of evolution, in which the end users use and change the technology. It also consists of large steps, during which different actors, including vendors and healthcare authorities, may make substantial contributions. This process requires work, negotiation and strategies. The conditions for the vendor may change dramatically, from considerable freedom and close relationships with users and customers in the small-scale development, to losing control of the product and being required to engage in more formal relations with customers in the wider public healthcare market. Onerous procurement processes may be one of the reasons why large-scale implementation of information projects in healthcare is difficult

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.

An eConsent-based System Architecture Supporting Cooperation in Integrated Healthcare Networks.

Science.gov (United States)

Bergmann, Joachim; Bott, Oliver J; Hoffmann, Ina; Pretschner, Dietrich P

2005-01-01

The economical need for efficient healthcare leads to cooperative shared care networks. A virtual electronic health record is required, which integrates patient related information but reflects the distributed infrastructure and restricts access only to those health professionals involved into the care process. Our work aims on specification and development of a system architecture fulfilling these requirements to be used in concrete regional pilot studies. Methodical analysis and specification have been performed in a healthcare network using the formal method and modelling tool MOSAIK-M. The complexity of the application field was reduced by focusing on the scenario of thyroid disease care, which still includes various interdisciplinary cooperation. Result is an architecture for a secure distributed electronic health record for integrated care networks, specified in terms of a MOSAIK-M-based system model. The architecture proposes business processes, application services, and a sophisticated security concept, providing a platform for distributed document-based, patient-centred, and secure cooperation. A corresponding system prototype has been developed for pilot studies, using advanced application server technologies. The architecture combines a consolidated patient-centred document management with a decentralized system structure without needs for replication management. An eConsent-based approach assures, that access to the distributed health record remains under control of the patient. The proposed architecture replaces message-based communication approaches, because it implements a virtual health record providing complete and current information. Acceptance of the new communication services depends on compatibility with the clinical routine. Unique and cross-institutional identification of a patient is also a challenge, but will loose significance with establishing common patient cards.

The role of information and communication technology in the transformation of the healthcare business model: a case study of Slovenia.

Science.gov (United States)

Stanimirovic, Dalibor; Vintar, Mirko

The Slovenian healthcare business model (BM) has largely failed to integrate information and communication technologies (ICT) into its operational context, instead maintaining its rigid structure and traditional 'way of doing business'wo managers of public clinics). Findings present a roadmap for the redefinition of BM elements and the transformation of the Slovenian healthcare BM. It includes the specific reconfiguration of BM actors and their interactions, and the application of advanced ICT solutions, which could facilitate more effective utilisation of healthcare resources and promote an improved delivery of healthcare services and products. The presented development approach and derived conceptual solution could be transferable to other countries with similar socio-economic characteristics and comparable healthcare systems, subject to certain adjustments and inclusion of national specifics.

Healthcare Lean.

Science.gov (United States)

Long, John C

2003-01-01

Lean Thinking is an integrated approach to designing, doing and improving the work of people that have come together to produce and deliver goods, services and information. Healthcare Lean is based on the Toyota production system and applies concepts and techniques of Lean Thinking to hospitals and physician practices.

The construction of a public key infrastructure for healthcare information networks in Japan.

Science.gov (United States)

Sakamoto, N

2001-01-01

The digital signature is a key technology in the forthcoming Internet society for electronic healthcare as well as for electronic commerce. Efficient exchanges of authorized information with a digital signature in healthcare information networks require a construction of a public key infrastructure (PKI). In order to introduce a PKI to healthcare information networks in Japan, we proposed a development of a user authentication system based on a PKI for user management, user authentication and privilege management of healthcare information systems. In this paper, we describe the design of the user authentication system and its implementation. The user authentication system provides a certification authority service and a privilege management service while it is comprised of a user authentication client and user authentication serves. It is designed on a basis of an X.509 PKI and is implemented with using OpenSSL and OpenLDAP. It was incorporated into the financial information management system for the national university hospitals and has been successfully working for about one year. The hospitals plan to use it as a user authentication method for their whole healthcare information systems. One implementation of the system is free to the national university hospitals with permission of the Japanese Ministry of Education, Culture, Sports, Science and Technology. Another implementation is open to the other healthcare institutes by support of the Medical Information System Development Center (MEDIS-DC). We are moving forward to a nation-wide construction of a PKI for healthcare information networks based on it.

Understanding requirements of novel healthcare information systems for management of advanced prostate cancer.

Science.gov (United States)

Wagholikar, Amol S; Fung, Maggie; Nelson, Colleen C

2012-01-01

Effective management of chronic diseases is a global health priority. A healthcare information system offers opportunities to address challenges of chronic disease management. However, the requirements of health information systems are often not well understood. The accuracy of requirements has a direct impact on the successful design and implementation of a health information system. Our research describes methods used to understand the requirements of health information systems for advanced prostate cancer management. The research conducted a survey to identify heterogeneous sources of clinical records. Our research showed that the General Practitioner was the common source of patient's clinical records (41%) followed by the Urologist (14%) and other clinicians (14%). Our research describes a method to identify diverse data sources and proposes a novel patient journey browser prototype that integrates disparate data sources.

Sensing behaviour in healthcare design

DEFF Research Database (Denmark)

Thorpe, Julia Rosemary; Hysse Forchhammer, Birgitte; Maier, Anja

2017-01-01

We are entering an era of distributed healthcare that should fit and respond to individual needs, behaviour and lifestyles. Designing such systems is a challenging task that requires continuous information about human behaviour on a large scale, for which pervasive sensing (e.g. using smartphones...... specifically on activity and location data that can easily be obtained from smartphones or wearables. We further demonstrate how these are applied in healthcare design using an example from dementia care. Comparing a current and proposed scenario exemplifies how integrating sensor-derived information about...... user behaviour can support the healthcare design goals of personalisation, adaptability and scalability, while emphasising patient quality of life....

A Semantic Big Data Platform for Integrating Heterogeneous Wearable Data in Healthcare.

Science.gov (United States)

Mezghani, Emna; Exposito, Ernesto; Drira, Khalil; Da Silveira, Marcos; Pruski, Cédric

2015-12-01

Advances supported by emerging wearable technologies in healthcare promise patients a provision of high quality of care. Wearable computing systems represent one of the most thrust areas used to transform traditional healthcare systems into active systems able to continuously monitor and control the patients' health in order to manage their care at an early stage. However, their proliferation creates challenges related to data management and integration. The diversity and variety of wearable data related to healthcare, their huge volume and their distribution make data processing and analytics more difficult. In this paper, we propose a generic semantic big data architecture based on the "Knowledge as a Service" approach to cope with heterogeneity and scalability challenges. Our main contribution focuses on enriching the NIST Big Data model with semantics in order to smartly understand the collected data, and generate more accurate and valuable information by correlating scattered medical data stemming from multiple wearable devices or/and from other distributed data sources. We have implemented and evaluated a Wearable KaaS platform to smartly manage heterogeneous data coming from wearable devices in order to assist the physicians in supervising the patient health evolution and keep the patient up-to-date about his/her status.

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-01-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. PMID:26178332

A Systematic Investigation on Barriers and Critical Success Factors for Clinical Information Systems in Integrated Care Settings.

Science.gov (United States)

Hoerbst, A; Schweitzer, M

2015-08-13

Clinical Information Systems (CIS) have ever since the introduction of information technology in healthcare played an important role to support healthcare professionals and the process of treatment. With the rise of the concept of integrated care organizational borders, the sole focus on data aggregation or healthcare professionals as users disappear more and more. The manuscript discusses the concept of CISs and investigates critical success factors for CISs in the context of integrated care and in the course of time. In order to identify critical success factors and barriers for CISs a systematic literature review was conducted based on the results from PubMed and Cochrane, using MaxQDA. Search results were thereby limited to reviews or meta-analysis. We have found 1919 references of which 40 met the inclusion criteria. The analysis of the manuscripts resulted in a comprehensive list of success factors and barriers related to CISs in integrated care settings. Most barriers were user-related whereas for the success factors an even distribution of organizational, technical and user-related factors was observed. The vast majority of publications was focused on healthcare professionals. It is important to incorporate experiences made/ collected over time, as the problems encountered seem to remain almost unvaried. In order to support further systematic investigations on the topic it is necessary to rethink existing concepts and definitions to realign them with the ideas of integrated care.

Use of information on the shared customers of healthcare services to support care pathway planning

Directory of Open Access Journals (Sweden)

Olli Nylander

2002-09-01

Conclusions The level of integration in the Finnish social welfare and healthcare system is high and seems to be increasing, especially in health centres. Within one year a client uses many kinds of inpatient services. This may at best represent a functioning system of care pathways and at worst mean overlapping work and lack of coordination. This information is of great importance to senior officers in care pathway planning.

An integrated healthcare system for personalized chronic disease care in home-hospital environments.

Science.gov (United States)

Jeong, Sangjin; Youn, Chan-Hyun; Shim, Eun Bo; Kim, Moonjung; Cho, Young Min; Peng, Limei

2012-07-01

Facing the increasing demands and challenges in the area of chronic disease care, various studies on the healthcare system which can, whenever and wherever, extract and process patient data have been conducted. Chronic diseases are the long-term diseases and require the processes of the real-time monitoring, multidimensional quantitative analysis, and the classification of patients' diagnostic information. A healthcare system for chronic diseases is characterized as an at-hospital and at-home service according to a targeted environment. Both services basically aim to provide patients with accurate diagnoses of disease by monitoring a variety of physical states with a number of monitoring methods, but there are differences between home and hospital environments, and the different characteristics should be considered in order to provide more accurate diagnoses for patients, especially, patients having chronic diseases. In this paper, we propose a patient status classification method for effectively identifying and classifying chronic diseases and show the validity of the proposed method. Furthermore, we present a new healthcare system architecture that integrates the at-home and at-hospital environment and discuss the applicability of the architecture using practical target services.

How users adopt healthcare information: An empirical study of an online Q&A community.

Science.gov (United States)

Jin, Jiahua; Yan, Xiangbin; Li, Yijun; Li, Yumei

2016-02-01

The emergence of social media technology has led to the creation of many online healthcare communities, where patients can easily share and look for healthcare-related information from peers who have experienced a similar problem. However, with increased user-generated content, there is a need to constantly analyse which content should be trusted as one sifts through enormous amounts of healthcare information. This study aims to explore patients' healthcare information seeking behavior in online communities. Based on dual-process theory and the knowledge adoption model, we proposed a healthcare information adoption model for online communities. This model highlights that information quality, emotional support, and source credibility are antecedent variables of adoption likelihood of healthcare information, and competition among repliers and involvement of recipients moderate the relationship between the antecedent variables and adoption likelihood. Empirical data were collected from the healthcare module of China's biggest Q&A community-Baidu Knows. Text mining techniques were adopted to calculate the information quality and emotional support contained in each reply text. A binary logistics regression model and hierarchical regression approach were employed to test the proposed conceptual model. Information quality, emotional support, and source credibility have significant and positive impact on healthcare information adoption likelihood, and among these factors, information quality has the biggest impact on a patient's adoption decision. In addition, competition among repliers and involvement of recipients were tested as moderating effects between these antecedent factors and the adoption likelihood. Results indicate competition among repliers positively moderates the relationship between source credibility and adoption likelihood, and recipients' involvement positively moderates the relationship between information quality, source credibility, and adoption

Innovative use of the integrative review to evaluate evidence of technology transformation in healthcare.

Science.gov (United States)

Phillips, Andrew B; Merrill, Jacqueline A

2015-12-01

Healthcare is in a period significant transformational activity through the accelerated adoption of healthcare technologies, new reimbursement systems that emphasize shared savings and care coordination, and the common place use of mobile technologies by patients, providers, and others. The complexity of healthcare creates barriers to transformational activity and has the potential to inhibit the desired paths toward change envisioned by policymakers. Methods for understanding how change is occurring within this complex environment are important to the evaluation of delivery system reform and the role of technology in healthcare transformation. This study examines the use on an integrative review methodology to evaluate the healthcare literature for evidence of technology transformation in healthcare. The methodology integrates the evaluation of a broad set of literature with an established evaluative framework to develop a more complete understanding of a particular topic. We applied this methodology and the framework of punctuated equilibrium (PEq) to the analysis of the healthcare literature from 2004 to 2012 for evidence of technology transformation, a time during which technology was at the forefront of healthcare policy. The analysis demonstrated that the established PEq framework applied to the literature showed considerable potential for evaluating the progress of policies that encourage healthcare transformation. Significant inhibitors to change were identified through the integrative review and categorized into ten themes that describe the resistant structure of healthcare delivery: variations in the environment; market complexity; regulations; flawed risks and rewards; change theories; barriers; ethical considerations; competition and sustainability; environmental elements, and internal elements. We hypothesize that the resistant nature of the healthcare system described by this study creates barriers to the direct consumer involvement and engagement

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.

Electronic information sources access and use for healthcare ...

African Journals Online (AJOL)

Background: Access to and use of electronic information sources for clinical decision is the key to the attainment of health related sustainable goals. Therefore, this study was to assess Electronic Information Sources (EIS) access and use for healthcare service among hospitals of Western Oromia, Ethiopia, 2013. Materials ...

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...

Integrated Framework for Patient Safety and Energy Efficiency in Healthcare Facilities Retrofit Projects.

Science.gov (United States)

Mohammadpour, Atefeh; Anumba, Chimay J; Messner, John I

2016-07-01

There is a growing focus on enhancing energy efficiency in healthcare facilities, many of which are decades old. Since replacement of all aging healthcare facilities is not economically feasible, the retrofitting of these facilities is an appropriate path, which also provides an opportunity to incorporate energy efficiency measures. In undertaking energy efficiency retrofits, it is vital that the safety of the patients in these facilities is maintained or enhanced. However, the interactions between patient safety and energy efficiency have not been adequately addressed to realize the full benefits of retrofitting healthcare facilities. To address this, an innovative integrated framework, the Patient Safety and Energy Efficiency (PATSiE) framework, was developed to simultaneously enhance patient safety and energy efficiency. The framework includes a step -: by -: step procedure for enhancing both patient safety and energy efficiency. It provides a structured overview of the different stages involved in retrofitting healthcare facilities and improves understanding of the intricacies associated with integrating patient safety improvements with energy efficiency enhancements. Evaluation of the PATSiE framework was conducted through focus groups with the key stakeholders in two case study healthcare facilities. The feedback from these stakeholders was generally positive, as they considered the framework useful and applicable to retrofit projects in the healthcare industry. © The Author(s) 2016.

Parent's use of the Internet in the search for healthcare information and subsequent impact on the doctor-patient relationship.

Science.gov (United States)

Harvey, S; Memon, A; Khan, R; Yasin, F

2017-11-01

The Internet is an unavoidable source of healthcare information. This information, both reliable and unreliable, has previously been shown to influence carer's decisions. Our aim was to evaluate this information seeking behavior among parents and its subsequent potential impact on the doctor-patient relationship. We undertook a cross-sectional questionnaire-based survey of paediatric outpatients. Enrollment took place over 4 weeks in March 2015. There were no inclusion or exclusion criteria and enrollment was voluntary. In total 100 questionnaires were completed. General Practitioners were the most common source of healthcare information. The Internet ranked third as a reliable source of healthcare information. The Internet was commonly used as an educational resource to learn about causes, treatment, and medications. A significant percentage of our population expressed concern regarding Internet information reliability. A small percentage of parents were concerned that disclosing Internet usage may worsen the relationship with their doctor. Parents showed a willingness to learn about diseases and treatments, and felt that the Internet was a good resource to do so. This study shows that open discussion about Internet usage between parents and doctors is not common and carers feel at risk of judgment should they admit to Internet usage. The Internet should be seen as a positive adjunct to patient education which can improve understanding, thus strengthening the doctor-patient relationship. The Internet will never replace the role of healthcare professionals but must be seen as an integral part of a multi-disciplinary approach.

How Can Information and Communication Technology Improve Healthcare Inequalities and Healthcare Inequity? The Concept of Context Driven Care.

Science.gov (United States)

Yee, Kwang Chien; Bettiol, Silvana; Nash, Rosie; Macintyrne, Kate; Wong, Ming Chao; Nøhr, Christian

2018-01-01

Advances in medicine have improved health and healthcare for many around the world. The challenge is achieving the best outcomes of health via healthcare delivery to every individual. Healthcare inequalities exist within a country and between countries. Health information technology (HIT) has provided a mean to deliver equal access to healthcare services regardless of social context and physical location. In order to achieve better health outcomes for every individual, socio-cultural factors, such as literacy and social context need to consider. This paper argues that HIT while improves healthcare inequalities by providing access, might worsen healthcare inequity. In order to improve healthcare inequity using HIT, this paper argues that we need to consider patients and context, and hence the concept of context driven care. To improve healthcare inequity, we need to conceptually consider the patient's view and methodologically consider design methods that achieve participatory outcomes.

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...

The Electronic Healthcare Record for Clinical Research (EHR4CR) information model and terminology.

Science.gov (United States)

Ouagne, David; Hussain, Sajjad; Sadou, Eric; Jaulent, Marie-Christine; Daniel, Christel

2012-01-01

A major barrier to repurposing routinely collected data for clinical research is the heterogeneity of healthcare information systems. Electronic Healthcare Record for Clinical Research (EHR4CR) is a European platform designed to improve the efficiency of conducting clinical trials. In this paper, we propose an initial architecture of the EHR4CR Semantic Interoperability Framework. We used a model-driven engineering approach to build a reference HL7-based multidimensional model bound to a set of reference clinical terminologies acting as a global as view model. We then conducted an evaluation of its expressiveness for patient eligibility. The EHR4CR information model consists in one fact table dedicated to clinical statement and 4 dimensions. The EHR4CR terminology integrates reference terminologies used in patient care (e.g LOINC, ICD-10, SNOMED CT, etc). We used the Object Constraint Language (OCL) to represent patterns of eligibility criteria as constraints on the EHR4CR model to be further transformed in SQL statements executed on different clinical data warehouses.

Determinants of patient loyalty to healthcare providers: An integrative review.

Science.gov (United States)

Zhou, Wei-Jiao; Wan, Qiao-Qin; Liu, Cong-Ying; Feng, Xiao-Lin; Shang, Shao-Mei

2017-08-01

Patient loyalty is key to business success for healthcare providers and also for patient health outcomes. This study aims to identify determinants influencing patient loyalty to healthcare providers and propose an integrative conceptual model of the influencing factors. PubMed, CINAHL, OVID, ProQuest and Elsevier Science Direct databases were searched. Publications about determinants of patient loyalty to health providers were screened, and 13 articles were included. Date of publication, location of the research, sample details, objectives and findings/conclusions were extracted for 13 articles. Thirteen studies explored eight determinants: satisfaction, quality, value, hospital brand image, trust, commitment, organizational citizenship behavior and customer complaints. The integrated conceptual model comprising all the determinants demonstrated the significant positive direct impact of quality on satisfaction and value, satisfaction on trust and commitment, trust on commitment and loyalty, and brand image on quality and loyalty. This review identifies and models the determinants of patient loyalty to healthcare providers. Further studies are needed to explore the influence of trust, commitment, and switching barriers on patient loyalty. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

Infrastructuring Multicultural Healthcare Information Systems.

Science.gov (United States)

Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik; Hendriks, Niels

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, the 'Health-Cultures' project, in which we designed HIT for the context of home care of older people with a migration background. The Health-Cultures project is located in the city of Genk, Belgium, which is known for its multicultural population, formed by three historical migration waves of people coming to work in the nowadays closed coal mines. Via a PD approach, we studied existing means of dialogue and designed HIT that both care receivers and care providers in Genk can use in their daily exchanges between cultures in home care contexts. In discussing relevant literature as well as the results 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.

Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider's Choice.

Science.gov (United States)

Quan-Hoang, Vuong

2016-10-01

Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.

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...

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.

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

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.

Medical informatics: A boon to the healthcare industry

Directory of Open Access Journals (Sweden)

Dinesh Bhatia

2010-01-01

Full Text Available Newer healthcare technologies and treatment procedures are being developed rapidly, and clinicians are incorporating them into their daily practice. They are integrating the past and the present knowledge for better patient healthcare. Previously, it had been difficult to organize, store and retrieve medical and patient information. But, today, with the advent of computers and, moreover, information technology has led to the development of medical informatics that is helping physicians to overcome these challenges. Medical informatics deals with all aspects of understanding and promoting the effective organization analysis, management and use of information in healthcare, which are being highlighted in this review paper.

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes.

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-10-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Integrated Conceptual Framework for RFID Enabled Healthcare

Directory of Open Access Journals (Sweden)

Gaurav Gupta

2015-12-01

Full Text Available Radio frequency identification (RFID technology is a wireless communication technology that facilitates automatic identification and data capture without human intervention. Since 2000s, RFID applications in the health care industry are increasing.  RFID has brought many improvements in areas like patient care, patient safety, equipment tracking, resource utilization, processing time reduction and so on. On the other hand, often deployment of RFID is questioned on the issues like high capital investment, technological complexity, and privacy concerns. Exploration of existing literature indicates the presence of works on the topics like asset management, patient management, staff management, institutional advantages, and organizational issues. However, most of the works are focused on a particular issue. Still now, scholarly attempts to integrate all the facades of RFID-enabled healthcare are limited. In this paper, we propose a conceptual framework that represents the scope for implementation of this technology and the various dimensions of RFID-enabled healthcare and demonstrate them in detail. Also, we have discussed the critical issues that can prove to be potential barriers to its successful implementation and current approaches to resolving these. We also discuss some of the regulatory initiatives encouraging its adoption in the healthcare industry. Also, we have highlighted the future research opportunities in this domain.

Specification of an integrated information architecture for a mobile teleoperated robot for home telecare.

Science.gov (United States)

Iannuzzi, David; Grant, Andrew; Corriveau, Hélène; Boissy, Patrick; Michaud, Francois

2016-12-01

The objective of this study was to design effectively integrated information architecture for a mobile teleoperated robot in remote assistance to the delivery of home health care. Three role classes were identified related to the deployment of a telerobot, namely, engineer, technology integrator, and health professional. Patients and natural caregivers were indirectly considered, this being a component of future field studies. Interviewing representatives of each class provided the functions, and information content and flows for each function. Interview transcripts enabled the formulation of UML (Universal Modeling Language) diagrams for feedback from participants. The proposed information architecture was validated with a use-case scenario. The integrated information architecture incorporates progressive design, ergonomic integration, and the home care needs from medical specialist, nursing, physiotherapy, occupational therapy, and social worker care perspectives. The integrated architecture iterative process promoted insight among participants. The use-case scenario evaluation showed the design's robustness. Complex innovation such as a telerobot must coherently mesh with health-care service delivery needs. The deployment of integrated information architecture bridging development, with specialist and home care applications, is necessary for home care technology innovation. It enables continuing evolution of robot and novel health information design in the same integrated architecture, while accounting for patient ecological need.

[Perception of Primary Care physicians on the integration with cardiology through continuity of healthcare programs in secondary prevention].

Science.gov (United States)

Cosin-Sales, J; Orozco Beltrán, D; Ledesma Rodríguez, R; Barbon Ortiz Casado, A; Fernández, G

2018-02-17

To determine the perception of Primary Care (PC) physicians on the integration with cardiology (CA) through continuity of healthcare programs. A cross-sectional and multicentre study was conducted, in which a total of 200 PC physicians from all over Spain completed a qualitative survey that evaluated the level of integration with CA in secondary prevention. Physicians were grouped according to the level of PC-CA integration. The integration between CA and PC was good, but it was better in those centres with a higher integration (74.0% vs. 60.0%; p=.02) and in general, physicians considered that integration had improved (92.0% vs. 73.0%; pintegration. In 55.8%, 63.6%, and 51.3% of hospital discharge reports, indications were given on when to perform the follow-up blood analysis, as well as information about returning to working life and sexual activity, respectively. The most common communication method was the paper-based report (75 vs. 84%; p=NS). The communication between healthcare levels was greater in those Primary Care centres with a higher level of integration, as well as periodicity of the communication and the satisfaction of physicians (80.0% vs. 63.0%; p=.005). The level of integration between PC and CA is, in general, satisfactory, but those centres with a higher level of integration benefit more from a greater communication and satisfaction. Copyright © 2018 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Health Information Technology in Healthcare Quality and Patient Safety: Literature Review.

Science.gov (United States)

Feldman, Sue S; Buchalter, Scott; Hayes, Leslie W

2018-06-04

The area of healthcare quality and patient safety is starting to use health information technology to prevent reportable events, identify them before they become issues, and act on events that are thought to be unavoidable. As healthcare organizations begin to explore the use of health information technology in this realm, it is often unclear where fiscal and human efforts should be focused. The purpose of this study was to provide a foundation for understanding where to focus health information technology fiscal and human resources as well as expectations for the use of health information technology in healthcare quality and patient safety. A literature review was conducted to identify peer-reviewed publications reporting on the actual use of health information technology in healthcare quality and patient safety. Inductive thematic analysis with open coding was used to categorize a total of 41 studies. Three pre-set categories were used: prevention, identification, and action. Three additional categories were formed through coding: challenges, outcomes, and location. This study identifies five main categories across seven study settings. A majority of the studies used health IT for identification and prevention of healthcare quality and patient safety issues. In this realm, alerts, clinical decision support, and customized health IT solutions were most often implemented. Implementation, interface design, and culture were most often noted as challenges. This study provides valuable information as organizations determine where they stand to get the most "bang for their buck" relative to health IT for quality and patient safety. Knowing what implementations are being effectivity used by other organizations helps with fiscal and human resource planning as well as managing expectations relative to cost, scope, and outcomes. The findings from this scan of the literature suggest that having organizational champion leaders that can shepherd implementation, impact culture

A Lexical-Ontological Resource for Consumer Healthcare

Science.gov (United States)

Cardillo, Elena; Serafini, Luciano; Tamilin, Andrei

In Consumer Healthcare Informatics it is still difficult for laypeople to find, understand and act on health information, due to the persistent communication gap between specialized medical terminology and that used by healthcare consumers. Furthermore, existing clinically-oriented terminologies cannot provide sufficient support when integrated into consumer-oriented applications, so there is a need to create consumer-friendly terminologies reflecting the different ways healthcare consumers express and think about health topics. Following this direction, this work suggests a way to support the design of an ontology-based system that mitigates this gap, using knowledge engineering and semantic web technologies. The system is based on the development of a consumer-oriented medical terminology that will be integrated with other medical domain ontologies and terminologies into a medical ontology repository. This will support consumer-oriented healthcare systems, such as Personal Health Records, by providing many knowledge services to help users in accessing and managing their healthcare data.

Information Security in Distributed Healthcare : Exploring the Needs for Achieving Patient Safety and Patient Privacy

OpenAIRE

Åhlfeldt, Rose-Mharie

2008-01-01

In healthcare, patient information is a critical factor. The right information at the right time is a necessity in order to provide the best possible care for a patient. Patient information must also be protected from unauthorized access in order to protect patient privacy. It is furthermore common for patients to visit more than one healthcare provider, which implies a need for cross border healthcare and continuity in the patient process. This thesis is focused on information security in he...

Healthcare information systems: data mining methods in the creation of a clinical recommender system

Science.gov (United States)

Duan, L.; Street, W. N.; Xu, E.

2011-05-01

Recommender systems have been extensively studied to present items, such as movies, music and books that are likely of interest to the user. Researchers have indicated that integrated medical information systems are becoming an essential part of the modern healthcare systems. Such systems have evolved to an integrated enterprise-wide system. In particular, such systems are considered as a type of enterprise information systems or ERP system addressing healthcare industry sector needs. As part of efforts, nursing care plan recommender systems can provide clinical decision support, nursing education, clinical quality control, and serve as a complement to existing practice guidelines. We propose to use correlations among nursing diagnoses, outcomes and interventions to create a recommender system for constructing nursing care plans. In the current study, we used nursing diagnosis data to develop the methodology. Our system utilises a prefix-tree structure common in itemset mining to construct a ranked list of suggested care plan items based on previously-entered items. Unlike common commercial systems, our system makes sequential recommendations based on user interaction, modifying a ranked list of suggested items at each step in care plan construction. We rank items based on traditional association-rule measures such as support and confidence, as well as a novel measure that anticipates which selections might improve the quality of future rankings. Since the multi-step nature of our recommendations presents problems for traditional evaluation measures, we also present a new evaluation method based on average ranking position and use it to test the effectiveness of different recommendation strategies.

[Digital health as a motor for change towards new healthcare models and the relationship between patients and healthcare professionals. Disruption of healthcare processes].

Science.gov (United States)

Garcia-Cuyàs, Francesc; de San Pedro, Marc; Martínez Roldan, Jordi

2015-11-01

We find ourselves at the end of an era of asymmetry in the domain of health information where the majority of this data is in the hands of the healthcare system. Increasingly, the public are calling for a more central role in the new paradigm that enables them to duly exercise their right of access to their health data while availing of more reliable and safer technologies which contribute to the management of their condition and promote healthy lifestyles. So far, the TIC Salud strategic plan has been developed independently from the Generalitat de Catalunya Health Department's Healthcare Plan, which sets out health policy strategy in Catalonia. However, from its initial design stage the new Healthcare Plan (2016- 2020) envisages incorporating a new strategic Information and communications technology (ICT) line called "Digital Health". Incorporating ICT into the Health Plan will allow these technologies to become integral part of all strategic healthcare processes, acting as a driving force for a shift towards a new healthcare models and an innovative relationship between the public and healthcare professionals. The Digital Health implies a disruption in itself, by way of the convergence of several technologies and their positive impact on health and healthcare procedures, by way of the public's access to information concerning their health, and by creating new opportunities for promoting health and the salutogenic paradigm which empowers people to develop their health, welfare and quality of life. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

A conceptual persistent healthcare quality improvement process for software development management.

Science.gov (United States)

Lin, Jen-Chiun; Su, Mei-Ju; Cheng, Po-Hsun; Weng, Yung-Chien; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei

2007-01-01

This paper illustrates a sustained conceptual service quality improvement process for the management of software development within a healthcare enterprise. Our proposed process is revised from Niland's healthcare quality information system (HQIS). This process includes functions to survey the satisfaction of system functions, describe the operation bylaws on-line, and provide on-demand training. To achieve these goals, we integrate five information systems in National Taiwan University Hospital, including healthcare information systems, health quality information system, requirement management system, executive information system, and digital learning system, to form a full Deming cycle. A preliminary user satisfaction survey showed that our outpatient information system scored an average of 71.31 in 2006.

Integrating the Healthcare Enterprise in Radiation Oncology Plug and Play-The Future of Radiation Oncology?

International Nuclear Information System (INIS)

Abdel-Wahab, May; Rengan, Ramesh; Curran, Bruce; Swerdloff, Stuart; Miettinen, Mika; Field, Colin; Ranjitkar, Sunita; Palta, Jatinder; Tripuraneni, Prabhakar

2010-01-01

Purpose: To describe the processes and benefits of the integrating healthcare enterprises in radiation oncology (IHE-RO). Methods: The IHE-RO process includes five basic steps. The first step is to identify common interoperability issues encountered in radiation treatment planning and the delivery process. IHE-RO committees partner with vendors to develop solutions (integration profiles) to interoperability problems. The broad application of these integration profiles across a variety of vender platforms is tested annually at the Connectathon event. Demonstration of the seamless integration and transfer of patient data to the potential users are then presented by vendors at the public demonstration event. Users can then integrate these profiles into requests for proposals and vendor contracts by institutions. Results: Incorporation of completed integration profiles into requests for proposals can be done when purchasing new equipment. Vendors can publish IHE integration statements to document the integration profiles supported by their products. As a result, users can reference integration profiles in requests for proposals, simplifying the systems acquisition process. These IHE-RO solutions are now available in many of the commercial radiation oncology-related treatment planning, delivery, and information systems. They are also implemented at cancer care sites around the world. Conclusions: IHE-RO serves an important purpose for the radiation oncology community at large.

[Information, knowledge and healthcare practice: professionals participation as the key element of the gear].

Science.gov (United States)

Adam, Paula; Permanyer-Miralda, Gaietà; Solà-Morales, Oriol; Canela-Soler, Jaume

2010-02-01

This article analyzes the role of ICT within the complicated gear between information, knowledge and healthcare practices, which particular focus on two specific cases: the digitalization process of the healthcare system and the application of knowledge into the healthcare practices. In both cases, international and local experiences suggest, and sometimes demonstrate the importance of the participation, capacity-building and empowerment of healthcare practitioners for the generation, transfer and use of information and knowledge empowered by the digital tools which should bring into the system better performance, more efficacy, efficiency, equity, equality, security, quality. 2010 Elsevier España S.L. All rights reserved.

Constructing RBAC based security model in u-healthcare service platform.

Science.gov (United States)

Shin, Moon Sun; Jeon, Heung Seok; Ju, Yong Wan; Lee, Bum Ju; Jeong, Seon-Phil

2015-01-01

In today's era of aging society, people want to handle personal health care by themselves in everyday life. In particular, the evolution of medical and IT convergence technology and mobile smart devices has made it possible for people to gather information on their health status anytime and anywhere easily using biometric information acquisition devices. Healthcare information systems can contribute to the improvement of the nation's healthcare quality and the reduction of related cost. However, there are no perfect security models or mechanisms for healthcare service applications, and privacy information can therefore be leaked. In this paper, we examine security requirements related to privacy protection in u-healthcare service and propose an extended RBAC based security model. We propose and design u-healthcare service integration platform (u-HCSIP) applying RBAC security model. The proposed u-HCSIP performs four main functions: storing and exchanging personal health records (PHR), recommending meals and exercise, buying/selling private health information or experience, and managing personal health data using smart devices.

Constructing RBAC Based Security Model in u-Healthcare Service Platform

Science.gov (United States)

Shin, Moon Sun; Jeon, Heung Seok; Ju, Yong Wan; Lee, Bum Ju; Jeong, Seon-Phil

2015-01-01

In today's era of aging society, people want to handle personal health care by themselves in everyday life. In particular, the evolution of medical and IT convergence technology and mobile smart devices has made it possible for people to gather information on their health status anytime and anywhere easily using biometric information acquisition devices. Healthcare information systems can contribute to the improvement of the nation's healthcare quality and the reduction of related cost. However, there are no perfect security models or mechanisms for healthcare service applications, and privacy information can therefore be leaked. In this paper, we examine security requirements related to privacy protection in u-healthcare service and propose an extended RBAC based security model. We propose and design u-healthcare service integration platform (u-HCSIP) applying RBAC security model. The proposed u-HCSIP performs four main functions: storing and exchanging personal health records (PHR), recommending meals and exercise, buying/selling private health information or experience, and managing personal health data using smart devices. PMID:25695104

Measuring integrated care

DEFF Research Database (Denmark)

Strandberg-Larsen, Martin

2011-01-01

respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser...... differences were found in the perception of clinical integration in the two settings. More primary care clinicians in the Northern California region of Kaiser Permanente reported being part of a clinical integrated environment than did Danish general practitioners. By measuring the level of clinical...... and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine...

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.

Data mining in healthcare: decision making and precision

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Ionuţ ŢĂRANU

2016-05-01

Full Text Available The trend of application of data mining in healthcare today is increased because the health sector is rich with information and data mining has become a necessity. Healthcare organizations generate and collect large volumes of information to a daily basis. Use of information technology enables automation of data mining and knowledge that help bring some interesting patterns which means eliminating manual tasks and easy data extraction directly from electronic records, electronic transfer system that will secure medical records, save lives and reduce the cost of medical services as well as enabling early detection of infectious diseases on the basis of advanced data collection. Data mining can enable healthcare organizations to anticipate trends in the patient's medical condition and behaviour proved by analysis of prospects different and by making connections between seemingly unrelated information. The raw data from healthcare organizations are voluminous and heterogeneous. It needs to be collected and stored in organized form and their integration allows the formation unite medical information system. Data mining in health offers unlimited possibilities for analyzing different data models less visible or hidden to common analysis techniques. These patterns can be used by healthcare practitioners to make forecasts, put diagnoses, and set treatments for patients in healthcare organizations.

Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review.

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Rasoal, Dara; Skovdahl, Kirsti; Gifford, Mervyn; Kihlgren, Annica

2017-12-01

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a "bottom-up" perspective might give healthcare personnel opportunities to think and reflect more than a "top-down" perspective. A "bottom-up" approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a "top-down" approach risks removing such moral responsibility.

Pros and cons of healthcare information technology implementation: the pros win.

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Maffei, Roxana

2006-01-01

Countless studies and investigations have been performed siding either for or against the implementation of technology in the healthcare setting. This article presents both sides of this debate, with an obvious conclusion that the pros of this debate win. The practice of information technology in the medical domain lags behind its knowledge and discovery by at least 7 years. The key to closing this gap is to show, through various studies, how information technology systems provide decision support to users at the point in time when decisions are needed. What the reader will obtain from this article is that the pros for information technology implementation in healthcare settings weigh much more and have a greater effect than the cons.

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

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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.

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

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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.

Organizational structures during SOA implementation: the case of a Greek healthcare organization

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Koumaditis, Konstantinos; Themistocleous, Marinos

2015-01-01

The purpose of this paper is to investigate service-oriented architecture organizational studies (SOA OS) in healthcare through a rigorous literature review, development and testing in an eGovernment health-care setting. The application of SOA paradigm to integrate information systems has been...... and expand the capabilities of their health-care information system. Yet, literature indicates that eHealth government strategies, including SOA, require the support of SOA OS to be successfully implemented....

User-centered applications: Use of mobile information technologies to promote sustainable school healthcare services

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Alida Veldsman

2015-07-01

Full Text Available The youth, especially school going children, are the future of any society. It is therefore important that children should receive adequate healthcare support at an early age in order to strive to preserve and ensure better education and welfare of the children and continuity in societal success. Despite the strategic initiatives that aim at improving the general health of school going children, such as South Africa’s Integrated School Health Policy, there still exist challenges in support programmes meant to alleviate the barriers to effective healthcare towards improved education for the school children. Advances in ICT enable a fundamental redesign of healthcare processes based on the use and integration of electronic communication at all levels. New communication technologies can support a transition from institution centric to user-centric applications. This paper defines key principles and challenges for designers, policy makers, and evaluators of user-centred technologies for healthcare in schools. The paper employs the User Experience Management Model (UXM2 to review the current and emerging trends, and highlights challenges related to the design of a typical m-ICT application that supports delivery of healthcare in schools. The paper reaches conclusions for next steps that will advance the domain.

Stroke survivors' and informal caregivers' experiences of primary care and community healthcare services - A systematic review and meta-ethnography.

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Pindus, Dominika M; Mullis, Ricky; Lim, Lisa; Wellwood, Ian; Rundell, A Viona; Abd Aziz, Noor Azah; Mant, Jonathan

2018-01-01

To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. Systematic review and meta-ethnography. Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not

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

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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 model with use of information and communication technology for patients with chronic disease.

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Lisiecka-Biełanowicz, Mira; Wawrzyniak, Zbigniew

2016-07-15

The healthcare system is positioned in the patient's environment and works with other determinants of the treatment. Patient care requires a whole system compatible to the needs of organizational and technical solutions. The purpose of this study is to present a new model of patient-oriented care, in which the use of information and communication technology (ICT) can improve the effectiveness of healthcare for patients with chronic diseases. The study material is the process of healthcare for chronically ill patients. Knowledge of the circumstances surrounding ecosystem and of the patients' needs, taking into account the fundamental healthcare goals allows us to build a new models of care, starting with the economic assumptions. The method used is modeling the construction of efficient healthcare system with the patient-centered model using ICT tools. We present a new systemic concept of building patient's environment in which he is the central figure of the healthcare organization - so called patient centered system. The use of ICT in the model of chronic patient's healthcare can improve the effectiveness of this kind of care. The concept is a vision to making wide platform of information management in chronic disease in a real environment ecosystem of patient using ICT tools. On the basis of a systematic approach to the model of chronic disease, and the knowledge of the patient itself, a model of the ecosystem impacts and interactions through information feedback and the provision of services can be constructed. ICT assisted techniques will increase the effectiveness of patient care, in which nowadays information exchange plays a key role.

Predicting Personal Healthcare Management: Impact of Individual Characteristics on Patient Use of Health Information Technology

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Sandefer, Ryan Heath

2017-01-01

The use of health information and health information technology by consumers is a major factor in the current healthcare systems' effort to address issues related to quality, cost, and access. Patient engagement in the healthcare process through access to information related to diagnoses, procedures, and treatment has the potential to improve…

Charting a path for health sciences librarians in an integrated information environment.

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Jones, C J

1993-10-01

Changes in the health information environment present a major challenge to health sciences librarians. To successfully meet this challenge, librarians must apply the concepts of informal, self-directed, lifelong learning to their own carers. The Joint Commission on Accreditation of Healthcare Organizations is creating an integrated information environment in health care organizations. The health sciences librarian brings unique knowledge and skills to this environment. The reference technique, a methodology that closely parallels other problem-solving approaches such as the physician's diagnostic technique, equips librarians with the conceptual skills to develop creative solutions to information management problems. Each health sciences librarian must assume responsibility for extending professional skills and abilities and demonstrating them in the workplace.

Predicting nurses' use of healthcare technology using the technology acceptance model: an integrative review.

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Strudwick, Gillian

2015-05-01

The benefits of healthcare technologies can only be attained if nurses accept and intend to fully use them. One of the most common models utilized to understand user acceptance of technology is the Technology Acceptance Model. This model and modified versions of it have only recently been applied in the healthcare literature among nurse participants. An integrative literature review was conducted on this topic. Ovid/MEDLINE, PubMed, Google Scholar, and CINAHL were searched yielding a total of 982 references. Upon eliminating duplicates and applying the inclusion and exclusion criteria, the review included a total of four dissertations, three symposium proceedings, and 13 peer-reviewed journal articles. These documents were appraised and reviewed. The results show that a modified Technology Acceptance Model with added variables could provide a better explanation of nurses' acceptance of healthcare technology. These added variables to modified versions of the Technology Acceptance Model are discussed, and the studies' methodologies are critiqued. Limitations of the studies included in the integrative review are also examined.

Role of data warehousing in healthcare epidemiology.

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Wyllie, D; Davies, J

2015-04-01

Electronic storage of healthcare data, including individual-level risk factors for both infectious and other diseases, is increasing. These data can be integrated at hospital, regional and national levels. Data sources that contain risk factor and outcome information for a wide range of conditions offer the potential for efficient epidemiological analysis of multiple diseases. Opportunities may also arise for monitoring healthcare processes. Integrating diverse data sources presents epidemiological, practical, and ethical challenges. For example, diagnostic criteria, outcome definitions, and ascertainment methods may differ across the data sources. Data volumes may be very large, requiring sophisticated computing technology. Given the large populations involved, perhaps the most challenging aspect is how informed consent can be obtained for the development of integrated databases, particularly when it is not easy to demonstrate their potential. In this article, we discuss some of the ups and downs of recent projects as well as the potential of data warehousing for antimicrobial resistance monitoring. Copyright © 2015. Published by Elsevier Ltd.

Healthcare professionals' use of health clouds: Integrating technology acceptance and status quo bias perspectives.

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Hsieh, Pi-Jung

2015-07-01

Cloud computing technology has recently been seen as an important milestone in medical informatics development. Despite its great potential, there are gaps in our understanding of how users evaluate change in relation to the health cloud and how they decide to resist it. Integrating technology acceptance and status quo bias perspectives, this study develops an integrated model to explain healthcare professionals' intention to use the health cloud service and their intention to resist it. A field survey was conducted in Taiwan to collect data from healthcare professionals; a structural equation model was used to examine the data. A valid sample of 209 healthcare professionals was collected for data analysis. The results show that healthcare professionals' resistance to the use of the health cloud is the result of regret avoidance, inertia, perceived value, switching costs, and perceived threat. Attitude, subjective norm, and perceived behavior control are shown to have positive and direct effects on healthcare professionals' intention to use the health cloud. The results also indicate a significant negative effect in the relationship between healthcare professionals' intention and resistance to using the health cloud. Our study illustrates the importance of incorporating user resistance in technology acceptance studies in general and in health technology usage studies in particular. This study also identifies key factors for practitioners and hospitals to make adoption decisions in relation to the health cloud. Further, the study provides a useful reference for future studies in this subject field. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

What is found positive in healthcare information and communication technology implementation?-the results of a nationwide survey in Finland.

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Winblad, Ilkka; Hämäläinen, Päivi; Reponen, Jarmo

2011-03-01

Considerable expectations have been placed on information and communication technology (ICT) in improving the processes and quality of healthcare. Our purpose was to find out which element is found positive in healthcare ICT implementation. An online questionnaire on e-Health implementation submitted to all Finnish public health service providers and a sample from the private sector included an open question about which the electronic working methods, systems, or applications have most positively influenced the fluency or quality of service processes. The electronic health record was mentioned as an item that has positive influence by 52% of the respondents from the hospital districts, 27% of those from the primary healthcare centers, and 38% of those from the private providers. Digital radiology systems (including teleradiology) were mentioned by 52% of the hospital districts and 27% of the primary healthcare centers. The figures for digital laboratory systems (including telelaboratory) were 5% and 11%, respectively. The figures for teleradiology itself were 5% for the hospital districts and 15% for the primary healthcare centers; the figures for telelaboratory systems were 5% and 9%, respectively. The specialized healthcare seem to experience intraorganizational electronic services integrated to the electronic health record, such as digital radiology and laboratory services as exerting a positive influence, whereas the primary healthcare find such influence from different functions such as interorganizational data exchange and telemedicine services. These might indicate where the efforts should be focused when implementing ICT in healthcare.

What constitutes information integrity?

Directory of Open Access Journals (Sweden)

S. Flowerday

2008-01-01

Full Text Available This research focused on what constitutes information integrity as this is a problem facing companies today. Moreover, information integrity is a pillar of information security and is required in order to have a sound security management programme. However, it is acknowledged that 100% information integrity is not currently achievable due to various limitations and therefore the auditing concept of reasonable assurance is adopted. This is in line with the concept that 100% information security is not achievable and the notion that adequate security is the goal, using appropriate countermeasures. The main contribution of this article is to illustrate the importance of and provide a macro view of what constitutes information integrity. The findings are in harmony with Samuel Johnson's words (1751: 'Integrity without knowledge is weak and useless, and knowledge without integrity is dangerous and dreadful.'

What constitutes information integrity?

Directory of Open Access Journals (Sweden)

S. Flowerday

2007-12-01

Full Text Available This research focused on what constitutes information integrity as this is a problem facing companies today. Moreover, information integrity is a pillar of information security and is required in order to have a sound security management programme. However, it is acknowledged that 100% information integrity is not currently achievable due to various limitations and therefore the auditing concept of reasonable assurance is adopted. This is in line with the concept that 100% information security is not achievable and the notion that adequate security is the goal, using appropriate countermeasures. The main contribution of this article is to illustrate the importance of and provide a macro view of what constitutes information integrity. The findings are in harmony with Samuel Johnson's words (1751: 'Integrity without knowledge is weak and useless, and knowledge without integrity is dangerous and dreadful.'

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

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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.

The deployment of information systems and information technology in field hospitals.

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Crowe, Ian R J; Naguib, Raouf N G

2010-01-01

Information systems and related technologies continue to develop and have become an integral part of healthcare provision and hospital care in particular. Field hospitals typically operate in the most austere and difficult of conditions and have yet to fully exploit related technologies. This paper addresses those aspects of healthcare informatics, healthcare knowledge management and lean healthcare that can be applied to field hospitals, with a view to improving patient care. The aim is to provide a vision for the deployment of information systems and information technology in field hospitals, using the British Army's field hospital as a representative model.

Success of HIS DICOM interfaces in the integration of the healthcare enterprise at the Department of Veterans Affairs

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Kuzmak, Peter M.; Dayhoff, Ruth E.

1999-07-01

The US Department of Veterans Affairs (VA) is integrating imaging into the healthcare enterprise using the Digital Imaging and Communication in Medicine (DICOM) standard protocols. Image management is directly integrated into the VistA Hospital Information System (HIS) software and the clinical database. Radiology images are acquired via DICOM, and are stored directly in the HIS database. Images can be displayed on low-cost clinician's workstations throughout the medical center. High-resolution diagnostic quality multi-monitor VistA workstations with specialized viewing software can be used for reading radiology images. Two approaches are used to acquire and handle imags within the radiology department. Some sties have a commercial Picture Archiving and Communications System (PACS) interfaced to the VistA HIS, while other sites use the direct image acquisition and integrated diagnostic reading capabilities of VistA itself. A small set of DICOM services have been implemented by VistA to allow patient and study text data to be transmitted to image producing modalities and the commercial PACS, and to enable images and study data to be transferred back. The VistA DICOM capabilities are now used to interface seven different commercial PACS products and over twenty different radiology modalities. The communications capabilities of DICOM and the VA wide area network are begin used to support reading of radiology images form remote sites. DICOM has been the cornerstone in the ability to integrate imaging functionality into the Healthcare Enterprise. Because of its openness, it allows the integration of system component from commercial and non- commercial sources to work together to provide functional cost-effective solutions. As DICOM expands to non-radiology devices, integration must occur with the specialty information subsystems that handle orders and reports, their associated DICOM image capture systems, and the computer- based patient record. The mode and concepts of

[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

Integration of footprints information systems in palliative care: the case of Medical Center of Central Georgia.

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Tsavatewa, Christopher; Musa, Philip F; Ramsingh, Isaac

2012-06-01

Healthcare in America continues to be of paramount importance, and one of the most highly debated public policy issues of our time. With annual expenditures already exceeding $2.4 trillion, and yielding less than optimal results, it stands to reason that we must turn to promising tools and solutions, such as information technology (IT), to improve service efficiency and quality of care. Presidential addresses in 2004 and 2008 laid out an agenda, framework, and timeline for national health information technology investment and development. A national initiative was long overdue. This report we show that advancements in both medical technologies and information systems can be capitalized upon, hence extending information systems usage beyond data collection to include administrative and decision support, care plan development, quality improvement, etc. In this paper we focus on healthcare services for palliative patients. We present the development and preliminary accounts of a successful initiative in the Medical Center of Central Georgia where footprints information technology was modified and integrated into the hospital's palliative care service and existing EMR systems. The project provides evidence that there are a plethora of areas in healthcare in which innovative application of information systems could significantly enhance the care delivered to loved ones, and improve operations at the same time..

Constructing RBAC Based Security Model in u-Healthcare Service Platform

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Moon Sun Shin

2015-01-01

Full Text Available In today’s era of aging society, people want to handle personal health care by themselves in everyday life. In particular, the evolution of medical and IT convergence technology and mobile smart devices has made it possible for people to gather information on their health status anytime and anywhere easily using biometric information acquisition devices. Healthcare information systems can contribute to the improvement of the nation’s healthcare quality and the reduction of related cost. However, there are no perfect security models or mechanisms for healthcare service applications, and privacy information can therefore be leaked. In this paper, we examine security requirements related to privacy protection in u-healthcare service and propose an extended RBAC based security model. We propose and design u-healthcare service integration platform (u-HCSIP applying RBAC security model. The proposed u-HCSIP performs four main functions: storing and exchanging personal health records (PHR, recommending meals and exercise, buying/selling private health information or experience, and managing personal health data using smart devices.

How secure is your information system? An investigation into actual healthcare worker password practices.

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Cazier, Joseph A; Medlin, B Dawn

2006-09-27

For most healthcare information systems, passwords are the first line of defense in keeping patient and administrative records private and secure. However, this defense is only as strong as the passwords employees chose to use. A weak or easily guessed password is like an open door to the medical records room, allowing unauthorized access to sensitive information. In this paper, we present the results of a study of actual healthcare workers' password practices. In general, the vast majority of these passwords have significant security problems on several dimensions. Implications for healthcare professionals are discussed.

Inside help: An integrative review of champions in healthcare-related implementation.

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Miech, Edward J; Rattray, Nicholas A; Flanagan, Mindy E; Damschroder, Laura; Schmid, Arlene A; Damush, Teresa M

2018-01-01

The idea that champions are crucial to effective healthcare-related implementation has gained broad acceptance; yet the champion construct has been hampered by inconsistent use across the published literature. This integrative review sought to establish the current state of the literature on champions in healthcare settings and bring greater clarity to this important construct. This integrative review was limited to research articles in peer-reviewed, English-language journals published from 1980 to 2016. Searches were conducted on the online MEDLINE database via OVID and PubMed using the keyword "champion." Several additional terms often describe champions and were also included as keywords: implementation leader, opinion leader, facilitator, and change agent. Bibliographies of full-text articles that met inclusion criteria were reviewed for additional references not yet identified via the main strategy of conducting keyword searches in MEDLINE. A five-member team abstracted all full-text articles meeting inclusion criteria. The final dataset for the integrative review consisted of 199 unique articles. Use of the term champion varied widely across the articles with respect to topic, specific job positions, or broader organizational roles. The most common method for operationalizing champion for purposes of analysis was the use of a dichotomous variable designating champion presence or absence. Four studies randomly allocated of the presence or absence of champions. The number of published champion-related articles has markedly increased: more articles were published during the last two years of this review (i.e. 2015-2016) than during its first 30 years (i.e. 1980-2009).The number of champion-related articles has continued to increase sharply since the year 2000. Individual studies consistently found that champions were important positive influences on implementation effectiveness. Although few in number, the randomized trials of champions that have been

Protecting personal information: Implications of the Protection of Personal Information (POPI) Act for healthcare professionals.

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Buys, M

2017-10-31

Careless handling of patient information in daily medical practice can result in Health Professions Council of South Africa sanction, breach of privacy lawsuits and, in extreme cases, serious monetary penalty or even imprisonment. This review will focus on the Protection of Personal Information (POPI) Act (No. 4 of 2013) and the implications thereof for healthcare professionals in daily practice. Recommendations regarding the safeguarding of information are made.

The role of privacy protection in healthcare information systems adoption.

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Hsu, Chien-Lung; Lee, Ming-Ren; Su, Chien-Hui

2013-10-01

Privacy protection is an important issue and challenge in healthcare information systems (HISs). Recently, some privacy-enhanced HISs are proposed. Users' privacy perception, intention, and attitude might affect the adoption of such systems. This paper aims to propose a privacy-enhanced HIS framework and investigate the role of privacy protection in HISs adoption. In the proposed framework, privacy protection, access control, and secure transmission modules are designed to enhance the privacy protection of a HIS. An experimental privacy-enhanced HIS is also implemented. Furthermore, we proposed a research model extending the unified theory of acceptance and use of technology by considering perceived security and information security literacy and then investigate user adoption of a privacy-enhanced HIS. The experimental results and analyses showed that user adoption of a privacy-enhanced HIS is directly affected by social influence, performance expectancy, facilitating conditions, and perceived security. Perceived security has a mediating effect between information security literacy and user adoption. This study proposes several implications for research and practice to improve designing, development, and promotion of a good healthcare information system with privacy protection.

Mechanical Model of Traditional Thai Massage for Integrated Healthcare

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Salinee Rattanaphan

2015-01-01

Full Text Available In this study, a mechanical model was developed, aiming to provide standardized and programmable traditional Thai massage (TTM therapy to patients. The TTM was modeled and integrated into a mechanical hand (MH system, and a prototype massage chair was built and tested for user satisfaction. Three fundamental principles of Thai massage were integrated: pull, press, and pin. Based on these principles, the mechanics of Thai massage was studied and a mathematical model was developed to describe the dynamics and conditions for the design and prototyping of an MH. On average, it was found that users were satisfied with the treatment and felt that the treatment was similar to that performed by human hands. According to the interview results, users indicated that they were likely to utilize the MH as an alternative to traditional massage. Therefore, integrated TTM with an MH may help healthcare providers deliver standardized, programmable massage therapy to patients as opposed to variable, inconsistent human massage.

Assessing palliative care needs: views of patients, informal carers and healthcare professionals.

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McIlfatrick, Sonja

2007-01-01

This paper reports a study to assess the palliative care needs of the adult population served by a healthcare provider organization in Northern Ireland from the perspectives of patients, informal carers and healthcare providers. Assessing palliative care need is a key factor for health service planning. Traditionally, palliative care has been associated with end-of-life care and cancer. More recently, the concept has been extended to include care for both cancer and non-cancer populations. Various approaches have been advocated for assessing need, including the exploration of professional provider and user perspectives of need. Semi-structured qualitative interviews were undertaken with a purposive sample of patients and lay carers receiving palliative care services (n = 24). Focus groups were also conducted with multi-professional palliative care providers (n = 52 participants) and face to face interviews were undertaken with key managerial stakeholders in the area (n = 7). The focus groups and interviews concentrated on assessment of palliative care need. All the interviews were transcribed verbatim and analysed using Burnard's framework. Professional providers experienced difficulty in defining the term palliative care. Difficulties in communication and information exchange, and fragmented co-ordination between services were identified. The main areas of need identified by all participants were social and psychological support; financial concerns; and the need for choice and information. All participants considered that there was inequity between palliative care service provision for patients with cancer and non-cancer diseases. All patients, regardless of diagnosis, should be able to access palliative care appropriate to their individual needs. For this to happen in practice, an integrated approach to palliative care is essential. The study methodology confirms the value of developing a comprehensive approach to assessing palliative care need.

Safe medication management in specialized home healthcare - an observational study.

Science.gov (United States)

Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

2017-08-24

Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

What role does performance information play in securing improvement in healthcare? a conceptual framework for levers of change.

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Levesque, Jean-Frederic; Sutherland, Kim

2017-08-28

Across healthcare systems, there is consensus on the need for independent and impartial assessment of performance. There is less agreement about how measurement and reporting performance improves healthcare. This paper draws on academic theories to develop a conceptual framework-one that classifies in an integrated manner the ways in which change can be leveraged by healthcare performance information. A synthesis of published frameworks. The framework identifies eight levers for change enabled by performance information, spanning internal and external drivers, and emergent and planned processes: (1) cognitive levers provide awareness and understanding; (2) mimetic levers inform about the performance of others to encourage emulation; (3) supportive levers provide facilitation, implementation tools or models of care to actively support change; (4) formative levers develop capabilities and skills through teaching, mentoring and feedback; (5) normative levers set performance against guidelines, standards, certification and accreditation processes; (6) coercive levers use policies, regulations incentives and disincentives to force change; (7) structural levers modify the physical environment or professional cultures and routines; (8) competitive levers attract patients or funders. This framework highlights how performance measurement and reporting can contribute to eight different levers for change. It provides guidance into how to align performance measurement and reporting into quality improvement programme. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Internet as a source of health information: experiences of cancer survivors and caregivers with healthcare providers.

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Dolce, Maria C

2011-05-01

To describe the experiences of cancer survivors and caregivers with healthcare providers in the context of the Internet as a source of health information. Qualitative description. Online cancer communities hosted by the Association of Cancer Online Resources. Purposive sample of 488 cancer survivors, with varying cancer types and survivorship stages, and caregivers. Secondary data analysis using Krippendorff's thematic clustering technique of qualitative content analysis. Survivorship, healthcare relationships, and the Internet. Disenchantment with healthcare relationships was associated with failed expectations related to evidence-based practice, clinical expertise, informational support, and therapeutic interpersonal communication. Survivors and caregivers exercised power in healthcare relationships through collaboration, direct confrontation, becoming expert, and endorsement to influence and control care decisions. Disenchantment propelled cancer survivors and caregivers to search the Internet for health information and resources. Conversely, Internet information-seeking precipitated the experience of disenchantment. Through online health information and resources, concealed failures in healthcare relationships were revealed and cancer survivors and caregivers were empowered to influence and control care decisions. The findings highlight failures in cancer survivorship care and underscore the importance of novel interdisciplinary programs and models of care that support evidence-informed decision making, self-management, and improved quality of life. Healthcare professionals need to receive education on survivors' use of the Internet as a source of health information and its impact on healthcare relationships. Future research should include studies examining the relationship between disenchantment and survivorship outcomes.

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

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Singer, Judy; Adams, Jon

2014-05-22

Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person

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

Integration of smart wearable mobile devices and cloud computing in South African healthcare

CSIR Research Space (South Africa)

Mvelase, PS

2015-11-01

Full Text Available Integration of Smart Wearable Mobile Devices and Cloud Computing in South African Healthcare Promise MVELASE, Zama DLAMINI, Angeline DLUDLA, Happy SITHOLE Abstract: The acceptance of cloud computing is increasing in a fast pace in distributed...

Integrating herbal medicine into mainstream healthcare in Ghana: clients' acceptability, perceptions and disclosure of use.

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Agyei-Baffour, Peter; Kudolo, Agnes; Quansah, Dan Yedu; Boateng, Daniel

2017-12-01

Although there are current efforts to integrate herbal medicine (HM) into mainstream healthcare in Ghana, there is paucity of empirical evidence on the acceptability and concurrent use of HM, in the formal health facilities in Ghana. This study sought to determine client perception, disclosure and acceptability of integrating herbal medicine in mainstream healthcare in Kumasi, Ghana. A cross-sectional study was conducted from May to August, 2015. Five hundred patients presenting at the outpatient departments of Kumasi South, Suntreso and Tafo Government Hospitals in Kumasi were randomly selected. Interviews were conducted with the use of structured questionnaires. A logistic regression analysis, using backward selection, was conducted to determine the influence of socio-demographic and facility related factors on the odds of using HM at the facility. All statistical tests were two-sided and considered significant at a p-value of herbal medicines. Respondents who rated themselves wealthy had increased odds of using herbal medicines at the health facility as compared to those who rated themselves poor (OR = 4.9; 95%CI = 1.6-15.3). This study shows that integration of herbal medicine is feasible and herbal medicines may be generally accepted as a formal source of healthcare in Ghana. The results of this study might serve as a basis for improvement and upscale of the herbal medicine integration programme in Ghana.

Case Study: Employee Use of Information and Communication Technologies in a Healthcare Organization

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Aponte, Jorge I.

2011-01-01

This qualitative case study explored the employee use of information and communication technologies (ICT) in a southern Puerto Rico healthcare organization. Thirty-two employees of a southern Puerto Rico healthcare organization provided their perspectives regarding their use of ICT in the workplace. The findings distinguished how employees use ICT…

Stakeholder engagement: a key component of integrating genomic information into electronic health records.

Science.gov (United States)

Hartzler, Andrea; McCarty, Catherine A; Rasmussen, Luke V; Williams, Marc S; Brilliant, Murray; Bowton, Erica A; Clayton, Ellen Wright; Faucett, William A; Ferryman, Kadija; Field, Julie R; Fullerton, Stephanie M; Horowitz, Carol R; Koenig, Barbara A; McCormick, Jennifer B; Ralston, James D; Sanderson, Saskia C; Smith, Maureen E; Trinidad, Susan Brown

2013-10-01

Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine.

Healthcare managers' decision making: findings of a small scale exploratory study.

Science.gov (United States)

Macdonald, Jackie; Bath, Peter A; Booth, Andrew

2008-12-01

Managers who work in publicly funded healthcare organizations are an understudied group. Some of the influences on their decisions may be unique to healthcare. This study considers how to integrate research knowledge effectively into healthcare managers' decision making, and how to manage and integrate information that will include community data. This first phase in a two-phase mixed methods research study used a qualitative, multiple case studies design. Nineteen semi-structured interviews were undertaken using the critical incident technique. Interview transcripts were analysed using the NatCen Framework. One theme represented ;information and decisions'. Cases were determined to involve complex multi-level, multi-situational decisions with participants in practical rather than ceremonial work roles. Most considered organizational knowledge in the first two decision phases and external knowledge, including research, in the third phase. All participants engaged in satisficing to some degree.

A Hash Based Remote User Authentication and Authenticated Key Agreement Scheme for the Integrated EPR Information System.

Science.gov (United States)

Li, Chun-Ta; Weng, Chi-Yao; Lee, Cheng-Chi; Wang, Chun-Cheng

2015-11-01

To protect patient privacy and ensure authorized access to remote medical services, many remote user authentication schemes for the integrated electronic patient record (EPR) information system have been proposed in the literature. In a recent paper, Das proposed a hash based remote user authentication scheme using passwords and smart cards for the integrated EPR information system, and claimed that the proposed scheme could resist various passive and active attacks. However, in this paper, we found that Das's authentication scheme is still vulnerable to modification and user duplication attacks. Thereafter we propose a secure and efficient authentication scheme for the integrated EPR information system based on lightweight hash function and bitwise exclusive-or (XOR) operations. The security proof and performance analysis show our new scheme is well-suited to adoption in remote medical healthcare services.

Investments in information systems and technology in the healthcare: Project management mediation

Directory of Open Access Journals (Sweden)

Jorge Gomes

2017-03-01

Full Text Available Healthcare organisations must improve their business practices and internal procedures in order to answer the increasing demand of health professionals and the general public for more and better information. Hospitals invest massively in information systems and technology (IS/IT in the hope that these investments will improve healthcare and meet patients’ demands. The main objective of our research is to study how organisational maturity, enhanced by investments in IS/IT, project management and best practices, leads to successful projects in public healthcare organisations. The rational of our model is that organisational maturity has a positive effect on IS/IT project success, and that this success is also positively enhanced by the use of project management practices. We emphasise that this combination of approaches can increase the effectiveness of projects. Furthermore, it can also improve the confidence that the results of investments will meet stakeholders’ expectations.

An integrative framework for sensor-based measurement of teamwork in healthcare.

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Rosen, Michael A; Dietz, Aaron S; Yang, Ting; Priebe, Carey E; Pronovost, Peter J

2015-01-01

There is a strong link between teamwork and patient safety. Emerging evidence supports the efficacy of teamwork improvement interventions. However, the availability of reliable, valid, and practical measurement tools and strategies is commonly cited as a barrier to long-term sustainment and spread of these teamwork interventions. This article describes the potential value of sensor-based technology as a methodology to measure and evaluate teamwork in healthcare. The article summarizes the teamwork literature within healthcare, including team improvement interventions and measurement. Current applications of sensor-based measurement of teamwork are reviewed to assess the feasibility of employing this approach in healthcare. The article concludes with a discussion highlighting current application needs and gaps and relevant analytical techniques to overcome the challenges to implementation. Compelling studies exist documenting the feasibility of capturing a broad array of team input, process, and output variables with sensor-based methods. Implications of this research are summarized in a framework for development of multi-method team performance measurement systems. Sensor-based measurement within healthcare can unobtrusively capture information related to social networks, conversational patterns, physical activity, and an array of other meaningful information without having to directly observe or periodically survey clinicians. However, trust and privacy concerns present challenges that need to be overcome through engagement of end users in healthcare. Initial evidence exists to support the feasibility of sensor-based measurement to drive feedback and learning across individual, team, unit, and organizational levels. Future research is needed to refine methods, technologies, theory, and analytical strategies. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions

78 FR 4983 - Proposed Information Collection; Women Veterans Healthcare Barriers Survey Activity: Comment Request

Science.gov (United States)

2013-01-23

... Veterans Healthcare Barriers Survey Activity: Comment Request AGENCY: Veterans Health Administration... Healthcare Barriers Survey'' in any correspondence. During the comment period, comments may be viewed online... of automated collection techniques or the use of other forms of information technology. Title: Women...

IoT Contextual Factors on Healthcare.

Science.gov (United States)

Michalakis, Konstantinos; Caridakis, George

2017-01-01

With the emergence of the Internet of Things, new services in healthcare will be available and existing systems will be integrated in the IoT framework, providing automated medical supervision and efficient medical treatment. Context awareness plays a critical role in realizing the vision of the IoT, providing rich contextual information that can help the system act more efficiently. Since context in healthcare has its unique characteristics, it is necessary to define an appropriate context aware framework for healthcare IoT applications. We identify this context as perceived in healthcare applications and describe the context aware procedures. We also present an architecture that connects the sensors that measure biometric data with the sensory networks of the environment and the various IoT middleware that reside in the geographical area. Finally, we discuss the challenges for the realization of this vision.

Role of HIS/RIS DICOM interfaces in the integration of imaging into the Department of Veterans Affairs healthcare enterprise

Science.gov (United States)

Kuzmak, Peter M.; Dayhoff, Ruth E.

1998-07-01

The U.S. Department of Veterans Affairs is integrating imaging into the healthcare enterprise using the Digital Imaging and Communication in Medicine (DICOM) standard protocols. Image management is directly integrated into the VistA Hospital Information System (HIS) software and clinical database. Radiology images are acquired via DICOM, and are stored directly in the HIS database. Images can be displayed on low- cost clinician's workstations throughout the medical center. High-resolution diagnostic quality multi-monitor VistA workstations with specialized viewing software can be used for reading radiology images. DICOM has played critical roles in the ability to integrate imaging functionality into the Healthcare Enterprise. Because of its openness, it allows the integration of system components from commercial and non- commercial sources to work together to provide functional cost-effective solutions (see Figure 1). Two approaches are used to acquire and handle images within the radiology department. At some VA Medical Centers, DICOM is used to interface a commercial Picture Archiving and Communications System (PACS) to the VistA HIS. At other medical centers, DICOM is used to interface the image producing modalities directly to the image acquisition and display capabilities of VistA itself. Both of these approaches use a small set of DICOM services that has been implemented by VistA to allow patient and study text data to be transmitted to image producing modalities and the commercial PACS, and to enable images and study data to be transferred back.

Audit trails in OpenSLEX : paving the road for process mining in healthcare

NARCIS (Netherlands)

González López De Murillas, E.; Helm, E.; Reijers, H.A.; Küng, J.; Bursa, M.; Holzinger, A.; Elena Renda, M.; Khuri, S.

2017-01-01

The analysis of organizational and medical treatment pro-cesses is crucial for the future development of the healthcare domain. Recent approaches to enable process mining on healthcare data make use of the hospital information systems' Audit Trails. In this work, methods are proposed to integrate

Medical information, communication, and archiving system (MICAS): Phase II integration and acceptance testing

Science.gov (United States)

Smith, Edward M.; Wandtke, John; Robinson, Arvin E.

1999-07-01

The Medical Information, Communication and Archive System (MICAS) is a multi-modality integrated image management system that is seamlessly integrated with the Radiology Information System (RIS). This project was initiated in the summer of 1995 with the first phase being installed during the first half of 1997 and the second phase installed during the summer of 1998. Phase II enhancements include a permanent archive, automated workflow including modality worklist, study caches, NT diagnostic workstations with all components adhering to Digital Imaging and Communications in Medicine (DICOM) standards. This multi-vendor phased approach to PACS implementation is designed as an enterprise-wide PACS to provide images and reports throughout our healthcare network. MICAS demonstrates that aa multi-vendor open system phased approach to PACS is feasible, cost-effective, and has significant advantages over a single vendor implementation.

Telemedicine and EHR Integrated Approach for An Effective E-Governance Healthcare Framework

Directory of Open Access Journals (Sweden)

Alpana Kakkar

2017-05-01

Full Text Available In the recent years, people have been more inclined towards the use of technology to reduce human effort. Telemedicine is one such concept which has gained popularity among the people, providing them easy access to health care. Telemedicine refers to the concept of providing health care from a distance through an integrated approach using information and communication technology (ICT. India, being a geographically wide country has its difficulties when it comes to providing health care facilities to people belonging to the different regions. This is one of the few reasons why India is the best stage to introduce a concept like telemedicine. The use of this technology to counter the various challenges has been highly regarded and termed as something which can revolutionize the medical field. Integrating telemedicine with electronic health record (EHR, which is a digital document of a person’s medical history is said to be a perfect combination which can help improve clinical efficiency. The country has seen initiatives taken up by various organizations, with the main motive of connecting the rural to the urban. Through this paper, we have discussed the potential we have with this technology, and also propose an EHR integrated telemedicine model to make the best use of it in an emergency healthcare situation to help save lives. We have also touched a few factors which can help the government better the current health scenario.

Managing healthcare information using short message service (SMS) in wireless broadband networks

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Documet, Jorge; Tsao, Sinchai; Documet, Luis; Liu, Brent J.; Zhou, Zheng; Joseph, Anika O.

2007-03-01

Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and Communications System) data. SMS is a flexible and mobile method for real-time access and control of Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or any other localized signal. It provides a simple, reliable yet flexible method to communicate with an information system. In addition, SMS services are widely available for low costs from cellular phone service providers and allows for more mobility than other services such as wireless internet. This paper aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.

Impact of Internet on Cytology Information Management.

Science.gov (United States)

Luić, Ljerka; Molnar, Livia

2016-01-01

Internet technologies and services impose global information standards in the sphere of healthcare as a whole, which are then implied and applied in the domain of cytology laboratories. Web-based operations form a significant operating segment of any contemporary cytology laboratory as they enable operations by the use of technology, which is usually free of the restrictions imposed by the traditional way of business (geographic area and narrow localisation of activities). In their operations, almost all healthcare organisations currently create and use electronic data anddocuments, which can originate both inside and outside the organisation. An enormous amount of information thus used and exchanged may be processed timely and in a high-quality way only by integrated information systems, given three basic safety requirements: data confidentiality, integrity and availability. In the Republic of Croatia, integration of private and public healthcare information systems has been ongoing for several years but the private healthcare does not yet operate as an integrated system. Instead, each office operates using its own separate information system, i.e. This paper elaborates the argument that the sample private cytology laboratory possesses an IT system that meets current market and stakeholder needs of the healthcare sector in Croatia, given that private doctors' offices/polyclinics use IT technologies in their operations but make only partial use of Internet capacities in the segment of communication with their business associates and patients, implying the need to continue the research on a statistically relevant sample of EU countries.

The Challenges and Issues Regarding E-Health and Health Information Technology Trends in the Healthcare Sector

Science.gov (United States)

Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

Like other industries, the utilization of the internet and Information Technology (IT) has increased in the health sector. Different applications attributed to the internet and IT in healthcare practice. It includes a range of services that intersect the edge of medicine, computer and information science. The presence of the internet helps healthcare practice with the use of electronic processes and communication. Also, health IT (HIT) deals with the devices, clinical guidelines and methods required to improve the management of information in healthcare. Although the internet and HIT has been considered as an influential means to enhance health care delivery, it is completely naive to imagine all new tools and mechanisms supported by the internet and HIT systems are simply adopted and used by all organizational members. As healthcare professionals play an important role in the healthcare sector, there is no doubt that mechanism of newly introduced HIT and new application of the internet in medical practice should be coupled with healthcare professionals' acceptance. Therefore, with great resistance by healthcare professionals new mechanism and tools supported by IT and the internet cannot be used properly and subsequently may not improve the quality of medical care services. However, factors affecting the healthcare professionals' adoption behavior concerning new e-health and HIT mechanism are still not conclusively identified. This research (as a theoretical study) tries to propose the source of resistance in order to handle the challenges over new e-technology in the health industry. This study uses the involved concepts and develops a conceptual framework to improve overall acceptance of e-health and HIT by healthcare professionals.

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.

Healthcare in Disasters and the Role of RFID.

Science.gov (United States)

Madanian, Samaneh; Parry, David; Norris, Tony

2015-01-01

Disasters either natural or man-made are inevitable, and therefore disaster management has always been an important function of government. Since during a disaster healthcare is often adversely affected, a lot of effort has been made in terms of researching effective responses and ways of improving the quality of delivered care to direct casualties and the rest of the community. In this regard, information technology plays an important role to help healthcare systems achieve this goal. One of these technologies that has become popular recently is Radio-Frequency Identification (RFID). This paper explores the relationship between emergency management and disaster healthcare and examines the role of RFID. It is suggested that RFID will become an integral part of disaster healthcare and a means of improving response performance.

Recognizing nurse stakeholder dissonance as a critical determinant of patient safety in new healthcare information technologies.

Science.gov (United States)

Samaras, Elizabeth A; Real, Sara D; Curtis, Amber M; Meunier, Tessa S

2012-01-01

Proper identification of all stakeholders and the comprehensive assessment of their evolving and often conflicting Needs, Wants, and Desires (NWDs) is a fundamental principle of human factors science and human-centered systems engineering; it is not yet a consistent element in development and deployment of new health information technologies (HIT). As the single largest group of healthcare professionals, nurses are critical stakeholders for these new technologies. Careful analysis can reveal nurse stakeholder dissonance (NSD) when integrating new technologies into the healthcare environment. Stakeholder dissonance is a term that describes the conflict between the NWDs of different stakeholders which, if left unresolved, can result in dissatisfaction, workarounds, errors, and threats to patient safety. Three case studies drawn from the authors' experience in a variety of acute-care settings where new HITs have been recently deployed are examined to illustrate the concept of NSD. Conflicting NWDs, other stakeholders, and possible root causes of the NSD are analyzed and mapped to threats to patient safety. Lessons learned, practical guidance for anticipating, identifying, and mitigating NSD, future research and implications for HFE and nursing practice are discussed.

A Method of Signal Scrambling to Secure Data Storage for Healthcare Applications.

Science.gov (United States)

Bao, Shu-Di; Chen, Meng; Yang, Guang-Zhong

2017-11-01

A body sensor network that consists of wearable and/or implantable biosensors has been an important front-end for collecting personal health records. It is expected that the full integration of outside-hospital personal health information and hospital electronic health records will further promote preventative health services as well as global health. However, the integration and sharing of health information is bound to bring with it security and privacy issues. With extensive development of healthcare applications, security and privacy issues are becoming increasingly important. This paper addresses the potential security risks of healthcare data in Internet-based applications and proposes a method of signal scrambling as an add-on security mechanism in the application layer for a variety of healthcare information, where a piece of tiny data is used to scramble healthcare records. The former is kept locally and the latter, along with security protection, is sent for cloud storage. The tiny data can be derived from a random number generator or even a piece of healthcare data, which makes the method more flexible. The computational complexity and security performance in terms of theoretical and experimental analysis has been investigated to demonstrate the efficiency and effectiveness of the proposed method. The proposed method is applicable to all kinds of data that require extra security protection within complex networks.

Social Influence on Information Technology Adoption and Sustained Use in Healthcare: A Hierarchical Bayesian Learning Method Analysis

Science.gov (United States)

Hao, Haijing

2013-01-01

Information technology adoption and diffusion is currently a significant challenge in the healthcare delivery setting. This thesis includes three papers that explore social influence on information technology adoption and sustained use in the healthcare delivery environment using conventional regression models and novel hierarchical Bayesian…

Perfect match? Generation Y as change agents for information communication technology implementation in healthcare.

Science.gov (United States)

Yee, Kwang Chien; Miils, Erin; Airey, Caroline

2008-01-01

The current healthcare delivery model will not meet future healthcare demands. The only sustainable healthcare future is one that best leverages advances in technology to improve productivity and efficiency. Information communication technology (ICT) has, therefore, been touted as the panacea of future healthcare challenges. Many ICT projects in healthcare, however, fail to deliver on their promises to transform the healthcare system. From a technologist's perspective, this is often due to the lack of socio-technical consideration. From a socio-cultural perspective, however, there is often strong inertia to change. While the utilisation of user-centred design principles will generate a new wave of enthusiasm among technologists, this has to be matched with socio-cultural changes within the healthcare system. Generation Y healthcare workers might be the socio-cultural factor required, in combination with new technology, to transform the healthcare system. Generation Y has generated significant technology-driven changes in many other industries. The socio-cultural understanding of generation Y healthcare workers is essential to guide the design and implementation of ICT solutions for a sustainable healthcare future. This paper presents the initial analysis of our qualitative study which aims to generate in-depth conceptual insights of generation Y healthcare workers and their view of ICT in healthcare. Our results show that generation Y healthcare workers might assist future ICT implementation in healthcare. This paper, however, argues that significant changes to the current healthcare organisation will be required in order to unleash the full potential of generation Y workers and ICT implementation. Finally, this paper presents some strategies to empower generation Y workers as change agents for a sustainable future healthcare system.

Missed opportunities in child healthcare

Directory of Open Access Journals (Sweden)

Linda Jonker

2014-01-01

Full Text Available Background: Various policies in health, such as Integrated Management of Childhood Illnesses, were introduced to enhance integrated service delivery in child healthcare. During clinical practice the researcher observed that integrated services may not be rendered.Objectives: This article describes the experiences of mothers that utilised comprehensive child health services in the Cape Metropolitan area of South Africa. Services included treatment for diseases; preventative interventions such as immunisation; and promotive interventions, such as improvement in nutrition and promotion of breastfeeding.Method: A qualitative, descriptive phenomenological approach was applied to explore the experiences and perceptions of mothers and/or carers utilising child healthcare services. Thirty percent of the clinics were selected purposively from the total population. A convenience purposive non-probability sampling method was applied to select 17 mothers who met the criteria and gave written consent. Interviews were conducted and recorded digitally using an interview guide. The data analysis was done using Tesch’s eight step model.Results: Findings of the study indicated varied experiences. Not all mothers received information about the Road to Health book or card. According to the mothers, integrated child healthcare services were not practised. The consequences were missed opportunities in immunisation, provision of vitamin A, absence of growth monitoring, feeding assessment and provision of nutritional advice.Conclusion: There is a need for simple interventions such as oral rehydration, early recognition and treatment of diseases, immunisation, growth monitoring and appropriate nutrition advice. These services were not offered diligently. Such interventions could contribute to reducing the incidence of child morbidity and mortality.

Religious values and healthcare accommodations: voices from the American Muslim community.

Science.gov (United States)

Padela, Aasim I; Gunter, Katie; Killawi, Amal; Heisler, Michele

2012-06-01

Minority populations receive a lower quality healthcare in part due to the inadequate assessment of, and cultural adaptations to meet, their culturally informed healthcare needs. The seven million American Muslims, while ethnically and racially diverse, share religiously informed healthcare values that influence their expectations of healthcare. There is limited empirical research on this community's preferences for cultural modifications in healthcare delivery. Identify healthcare accommodations requested by American Muslims. Using community-based participatory research (CBPR) methods, we partnered with four community organizations in the Greater Detroit area to design and conduct thirteen focus groups at area mosques serving African American, Arab American, and South Asian American Muslims. Qualitative content analysis utilized a framework team-based approach. Participants reported stigmatization within the healthcare system and voiced the need for culturally competent healthcare providers. In addition, they identified three key healthcare accommodations to address Muslim sensitivities: the provision of (1) gender-concordant care, (2) halal food and (3) a neutral prayer space. Gender concordance was requested based on Islamic conceptions of modesty and privacy. Halal food was deemed to be health-promoting and therefore integral to the healing process. Lastly, a neutral prayer space was requested to ensure security and privacy during worship. This study informs efforts to deliver high-quality healthcare to American Muslims in several ways. We note three specific healthcare accommodations requested by this community and the religious values underlying these requests. Healthcare systems can further cultural sensitivity, engender trust, and improve the healthcare experiences of American Muslims by understanding and then attempting to accommodate these values as much as possible.

Inter-organisational communication networks in healthcare: centralised versus decentralised approaches

OpenAIRE

Pirnejad, Habibollah; Bal, Roland; Stoop, Arjen P.; Berg, Marc

2007-01-01

Background: To afford efficient and high quality care, healthcare providers increasingly need to exchange patient data. The existence of a communication network amongst care providers will help them to exchange patient data more efficiently. Information and communication technology (ICT) has much potential to facilitate the development of such a communication network. Moreover, in order to offer integrated care interoperability of healthcare organizations based upon the exchanged data is of c...

Uncovering Hospitalists' Information Needs from Outside Healthcare Facilities in the Context of Health Information Exchange Using Association Rule Learning.

Science.gov (United States)

Martinez, D A; Mora, E; Gemmani, M; Zayas-Castro, J

2015-01-01

Important barriers to health information exchange (HIE) adoption are clinical workflow disruptions and troubles with the system interface. Prior research suggests that HIE interfaces providing faster access to useful information may stimulate use and reduce barriers for adoption; however, little is known about informational needs of hospitalists. To study the association between patient health problems and the type of information requested from outside healthcare providers by hospitalists of a tertiary care hospital. We searched operational data associated with fax-based exchange of patient information (previous HIE implementation) between hospitalists of an internal medicine department in a large urban tertiary care hospital in Florida, and any other affiliated and unaffiliated healthcare provider. All hospitalizations from October 2011 to March 2014 were included in the search. Strong association rules between health problems and types of information requested during each hospitalization were discovered using Apriori algorithm, which were then validated by a team of hospitalists of the same department. Only 13.7% (2 089 out of 15 230) of the hospitalizations generated at least one request of patient information to other providers. The transactional data showed 20 strong association rules between specific health problems and types of information exist. Among the 20 rules, for example, abdominal pain, chest pain, and anaemia patients are highly likely to have medical records and outside imaging results requested. Other health conditions, prone to have records requested, were lower urinary tract infection and back pain patients. The presented list of strong co-occurrence of health problems and types of information requested by hospitalists from outside healthcare providers not only informs the implementation and design of HIE, but also helps to target future research on the impact of having access to outside information for specific patient cohorts. Our data

An open, component-based information infrastructure for integrated health information networks.

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Tsiknakis, Manolis; Katehakis, Dimitrios G; Orphanoudakis, Stelios C

2002-12-18

A fundamental requirement for achieving continuity of care is the seamless sharing of multimedia clinical information. Different technological approaches can be adopted for enabling the communication and sharing of health record segments. In the context of the emerging global information society, the creation of and access to the integrated electronic health record (I-EHR) of a citizen has been assigned high priority in many countries. This requirement is complementary to an overall requirement for the creation of a health information infrastructure (HII) to support the provision of a variety of health telematics and e-health services. In developing a regional or national HII, the components or building blocks that make up the overall information system ought to be defined and an appropriate component architecture specified. This paper discusses current international priorities and trends in developing the HII. It presents technological challenges and alternative approaches towards the creation of an I-EHR, being the aggregation of health data created during all interactions of an individual with the healthcare system. It also presents results from an ongoing Research and Development (R&D) effort towards the implementation of the HII in HYGEIAnet, the regional health information network of Crete, Greece, using a component-based software engineering approach. Critical design decisions and related trade-offs, involved in the process of component specification and development, are also discussed and the current state of development of an I-EHR service is presented. Finally, Human Computer Interaction (HCI) and security issues, which are important for the deployment and use of any I-EHR service, are considered.

Issues in healthcare services in Malaysia as experienced by Japanese retirees.

Science.gov (United States)

Kohno, Ayako; Musa, Ghazali; Nik Farid, Nik Daliana; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-05-05

Worldwide, international retirement migration is growing in its popularity and Japanese retirees choose Malaysia as their most preferred destination. This study examines the pertinent issues related to healthcare services as experienced by Japanese retirees in this country. From January to March 2015, we conducted focus group discussions with 30 Japanese retirees who live in Kuala Lumpur and Ipoh. Guided by the social-ecological model, we discovered seven pertinent themes: 'language barriers','healthcare decisions', 'medical check-ups','healthcare insurance', 'nursing and palliative care', 'trust and distrust of healthcare services', and 'word-of-mouth information'. We identified seven pertinent issues related to healthcare services among Japanese retirees in Malaysia, of which four are especially important. These issues are explained as integrated themes within the social-ecological model. Language barriers prohibit them from having difficulty accessing to healthcare in Malaysia, but lack of will to improve their language skills exist among them. For that reason, they rely heavily on word-of-mouth information when seeking for healthcare. As a consequence, some develop feelings of trust and distrust of healthcare services. In addition, we have identified the needs for provide nursing and palliative care among Japanese retirees in Malaysia. Based on the magnitude of the discussion, we concluded that there are four crucial healthcare issues among Japanese retirees; 'language barriers', 'trust and distrust of healthcare services', 'word-of-mouth information' and 'nursing and palliative care'. We propose that further dialogue by healthcare stakeholders should be carried out to improve further the healthcare service provisions for Japanese retirees in Malaysia.

Factors influencing early stage healthcare-academia partnerships.

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Uvhagen, Håkan; von Knorring, Mia; Hasson, Henna; Øvretveit, John; Hansson, Johan

2018-02-12

Purpose The purpose of this paper is to explore factors influencing early implementation and intermediate outcomes of a healthcare-academia partnership in a primary healthcare setting. Design/methodology/approach The Academic Primary Healthcare Network (APHN) initiative was launched in 2011 in Stockholm County, Sweden and included 201 primary healthcare centres. Semi-structured interviews were conducted in 2013-2014 with all coordinating managers ( n=8) and coordinators ( n=4). A strategic change model framework was used to collect and analyse data. Findings Several factors were identified to aid early implementation: assignment and guidelines that allowed flexibility; supportive management; dedicated staff; facilities that enabled APHN actions to be integrated into healthcare practice; and positive experiences from research and educational activities. Implementation was hindered by: discrepancies between objectives and resources; underspecified guidelines that trigger passivity; limited research and educational activities; a conflicting non-supportive reimbursement system; limited planning; and organisational fragmentation. Intermediate outcomes revealed that various actions, informed by the APHN assignment, were launched in all APHNs. Practical implications The findings can be rendered applicable by preparing stakeholders in healthcare services to optimise early implementation of healthcare-academia partnerships. Originality/value This study increases understanding of interactions between factors that influence early stage partnerships between healthcare services and academia in primary healthcare settings.

Rule-based Information Integration

NARCIS (Netherlands)

de Keijzer, Ander; van Keulen, Maurice

2005-01-01

In this report, we show the process of information integration. We specifically discuss the language used for integration. We show that integration consists of two phases, the schema mapping phase and the data integration phase. We formally define transformation rules, conversion, evolution and

Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

Science.gov (United States)

Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

2004-12-01

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

Integrating socially assistive robotics into mental healthcare interventions: applications and recommendations for expanded use.

Science.gov (United States)

Rabbitt, Sarah M; Kazdin, Alan E; Scassellati, Brian

2015-02-01

As a field, mental healthcare is faced with major challenges as it attempts to close the huge gap between those who need services and those who receive services. In recent decades, technological advances have provided exciting new resources in this battle. Socially assistive robotics (SAR) is a particularly promising area that has expanded into several exciting mental healthcare applications. Indeed, a growing literature highlights the variety of clinically relevant functions that these robots can serve, from companion to therapeutic play partner. This paper reviews the ways that SAR have already been used in mental health service and research and discusses ways that these applications can be expanded. We also outline the challenges and limitations associated with further integrating SAR into mental healthcare. SAR is not proposed as a replacement for specially trained and knowledgeable professionals nor is it seen as a panacea for all mental healthcare needs. Instead, robots can serve as clinical tools and assistants in a wide range of settings. Given the dramatic growth in this area, now is a critical moment for individuals in the mental healthcare community to become engaged in this research and steer it toward our field's most pressing clinical needs. Copyright © 2014. Published by Elsevier Ltd.

Improving the delivery of care and reducing healthcare costs with the digitization of information.

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Noffsinger, R; Chin, S

2000-01-01

In the coming years, the digitization of information and the Internet will be extremely powerful in reducing healthcare costs while assisting providers in the delivery of care. One example of healthcare inefficiency that can be managed through information digitization is the process of prescription writing. Due to the handwritten and verbal communication surrounding prescription writing, as well as the multiple tiers of authorizations, the prescription drug process causes extensive financial waste as well as medical errors, lost time, and even fatal accidents. Electronic prescription management systems are being designed to address these inefficiencies. By utilizing new electronic prescription systems, physicians not only prescribe more accurately, but also improve formulary compliance thereby reducing pharmacy utilization. These systems expand patient care by presenting proactive alternatives at the point of prescription while reducing costs and providing additional benefits for consumers and healthcare providers.

An integrated conceptual framework for evaluating and improving 'understanding' in informed consent.

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Bossert, Sabine; Strech, Daniel

2017-10-17

The development of understandable informed consent (IC) documents has proven to be one of the most important challenges in research with humans as well as in healthcare settings. Therefore, evaluating and improving understanding has been of increasing interest for empirical research on IC. However, several conceptual and practical challenges for the development of understandable IC documents remain unresolved. In this paper, we will outline and systematize some of these challenges. On the basis of our own experiences in empirical user testing of IC documents as well as the relevant literature on understanding in IC, we propose an integrated conceptual model for the development of understandable IC documents. The proposed conceptual model integrates different methods for the participatory improvement of written information, including IC, as well as quantitative methods for measuring understanding in IC. In most IC processes, understandable written information is an important prerequisite for valid IC. To improve the quality of IC documents, a conceptual model for participatory procedures of testing, revising, and retesting can be applied. However, the model presented in this paper needs further theoretical and empirical elaboration and clarification of several conceptual and practical challenges.

Primary healthcare-based integrated care with opioid agonist treatment: First experience from Ukraine.

Science.gov (United States)

Morozova, Olga; Dvoriak, Sergey; Pykalo, Iryna; Altice, Frederick L

2017-04-01

Ukraine's HIV epidemic is concentrated among people who inject drugs (PWID), however, coverage with opioid agonist therapies (OATs) available mostly at specialty addiction clinics is extremely low. OAT integrated into primary healthcare clinics (PHCs) provides an opportunity for integrating comprehensive healthcare services and scaling up OAT. A pilot study of PHC-based integrated care for drug users conducted in two Ukrainian cities between 2014 and 2016 included three sub-studies: 1) cross-sectional treatment site preference assessment among current OAT patients (N=755); 2) observational cohort of 107 PWID who continued the standard of care versus transition of stabilized and newly enrolled PWID into PHC-based integrated care; and 3) pre/post analysis of attitudes toward PWID and HIV patients by PHC staff (N=26). Among 755 OAT patients, 53.5% preferred receiving OAT at PHCs, which was independently correlated with convenience, trust in physician, and treatment with methadone (vs. buprenorphine). In 107 PWID observed over 6 months, retention in treatment was high: 89% in PWID continuing OAT in specialty addiction treatment settings (standard of care) vs 94% in PWID transitioning to PHCs; and 80% among PWID newly initiating OAT in PHCs. Overall, satisfaction with treatment, subjective self-perception of well-being, and trust in physician significantly increased in patients prescribed OAT in PHCs. Among PHC staff, attitudes towards PWID and HIV patients significantly improved over time. OAT can be successfully integrated into primary care in low and middle-income countries and improves outcomes in both patients and clinicians while potentially scaling-up OAT for PWID. Copyright © 2017 Elsevier B.V. All rights reserved.

Is the Kaiser Permanente model superior in terms of clinical integration?: a comparative study of Kaiser Permanente, Northern California and the Danish healthcare system.

Science.gov (United States)

Strandberg-Larsen, Martin; Schiøtz, Michaela L; Silver, Jeremy D; Frølich, Anne; Andersen, John S; Graetz, Ilana; Reed, Mary; Bellows, Jim; Krasnik, Allan; Rundall, Thomas; Hsu, John

2010-04-08

Integration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in practice. Our objective was to compare primary care clinicians' perceptions of clinical integration and three sub-aspects in two healthcare systems: Kaiser Permanente, Northern California (KPNC) and the Danish healthcare system (DHS). Further, we examined the associations between specific organizational factors and clinical integration within each system. Comparable questionnaires were sent to a random sample of primary care clinicians in KPNC (n = 1103) and general practitioners in DHS (n = 700). Data were analysed using multiple logistic regression models. More clinicians in KPNC perceived to be part of a clinical integrated environment than did general practitioners in the DHS (OR = 3.06, 95% CI: 2.28, 4.12). Further, more KPNC clinicians reported timeliness of information transfer (OR = 2.25, 95% CI: 1.62, 3.13), agreement on roles and responsibilities (OR = 1.79, 95% CI: 1.30, 2.47) and established coordination mechanisms in place to ensure effective handoffs (OR = 6.80, 95% CI: 4.60, 10.06). None of the considered organizational factors in the sub-country analysis explained a substantial proportion of the variation in clinical integration. More primary care clinicians in KPNC reported clinical integration than did general practitioners in the DHS. Focused measures of clinical integration are needed to develop the field of clinical integration and to create the scientific foundation to guide managers searching for evidence based approaches.

Managing and mitigating conflict in healthcare teams: an integrative review.

Science.gov (United States)

Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine

2016-07-01

To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Integrative literature review. CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. © 2016 John Wiley & Sons Ltd.

Health equity monitoring for healthcare quality assurance.

Science.gov (United States)

Cookson, R; Asaria, M; Ali, S; Shaw, R; Doran, T; Goldblatt, P

2018-02-01

Population-wide health equity monitoring remains isolated from mainstream healthcare quality assurance. As a result, healthcare organizations remain ill-informed about the health equity impacts of their decisions - despite becoming increasingly well-informed about quality of care for the average patient. We present a new and improved analytical approach to integrating health equity into mainstream healthcare quality assurance, illustrate how this approach has been applied in the English National Health Service, and discuss how it could be applied in other countries. We illustrate the approach using a key quality indicator that is widely used to assess how well healthcare is co-ordinated between primary, community and acute settings: emergency inpatient hospital admissions for ambulatory care sensitive chronic conditions ("potentially avoidable emergency admissions", for short). Whole-population data for 2015 on potentially avoidable emergency admissions in England were linked with neighborhood deprivation indices. Inequality within the populations served by 209 clinical commissioning groups (CCGs: care purchasing organizations with mean population 272,000) was compared against two benchmarks - national inequality and inequality within ten similar populations - using neighborhood-level models to simulate the gap in indirectly standardized admissions between most and least deprived neighborhoods. The modelled inequality gap for England was 927 potentially avoidable emergency admissions per 100,000 people, implying 263,894 excess hospitalizations associated with inequality. Against this national benchmark, 17% of CCGs had significantly worse-than-benchmark equity, and 23% significantly better. The corresponding figures were 11% and 12% respectively against the similar populations benchmark. Deprivation-related inequality in potentially avoidable emergency admissions varies substantially between English CCGs serving similar populations, beyond expected statistical

Exploring Healthcare Consumer Acceptance of Personal Health Information Management Technology through Personal Health Record Systems

Science.gov (United States)

Wu, Huijuan

2013-01-01

Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…

Legacy system integration using web technology

Science.gov (United States)

Kennedy, Richard L.; Seibert, James A.; Hughes, Chris J.

2000-05-01

As healthcare moves towards a completely digital, multimedia environment there is an opportunity to provide for cost- effective, highly distributed physician access to clinical information including radiology-based imaging. In order to address this opportunity a Universal Clinical Desktop (UCD) system was developed. A UCD provides a single point of entry into an integrated view of all types of clinical data available within a network of disparate healthcare information systems. In order to explore the application of a UCD in a hospital environment, a pilot study was established with the University of California Davis Medical Center using technology from Trilix Information Systems. Within this pilot environment the information systems integrated under the UCD include a radiology information system (RIS), a picture archive and communication system (PACS) and a laboratory information system (LIS).

Emergency healthcare process automation using mobile computing and cloud services.

Science.gov (United States)

Poulymenopoulou, M; Malamateniou, F; Vassilacopoulos, G

2012-10-01

Emergency care is basically concerned with the provision of pre-hospital and in-hospital medical and/or paramedical services and it typically involves a wide variety of interdependent and distributed activities that can be interconnected to form emergency care processes within and between Emergency Medical Service (EMS) agencies and hospitals. Hence, in developing an information system for emergency care processes, it is essential to support individual process activities and to satisfy collaboration and coordination needs by providing readily access to patient and operational information regardless of location and time. Filling this information gap by enabling the provision of the right information, to the right people, at the right time fosters new challenges, including the specification of a common information format, the interoperability among heterogeneous institutional information systems or the development of new, ubiquitous trans-institutional systems. This paper is concerned with the development of an integrated computer support to emergency care processes by evolving and cross-linking institutional healthcare systems. To this end, an integrated EMS cloud-based architecture has been developed that allows authorized users to access emergency case information in standardized document form, as proposed by the Integrating the Healthcare Enterprise (IHE) profile, uses the Organization for the Advancement of Structured Information Standards (OASIS) standard Emergency Data Exchange Language (EDXL) Hospital Availability Exchange (HAVE) for exchanging operational data with hospitals and incorporates an intelligent module that supports triaging and selecting the most appropriate ambulances and hospitals for each case.

Measuring integrated care.

Science.gov (United States)

Strandberg-Larsen, Martin

2011-02-01

The positive outcomes of coordination of healthcare services are to an increasing extent becoming clear. However the complexity of the field is an inhibiting factor for vigorously designed trial studies. Conceptual clarity and a consistent theoretical frame-work are thus needed. While researchers respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser Permanente has been put forward as an example for European healthcare systems to follow, although the evidence base is far from conclusive. The thesis has five objectives: 1) To contribute to the understanding of the concept of integration in healthcare systems and to identify measurement methods to capture the multi-dimensional aspects of integrated healthcare delivery. 2) To assess the level of integration of the Danish healthcare system. 3) To assess the use of joint health plans as a tool for coordination between the regional and local level in the Danish healthcare system. 4) To compare the inputs and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine the associations between specific organizational factors and clinical integration within each system. The literature was systematically searched to identify methods for measurement of integrated healthcare delivery. A national cross-sectional survey was conducted among major professional stake-holders at five different levels of the Danish healthcare system. The survey data were used to allow for analysis of the level of integration achieved. Data from the survey were

The Economics of Healthcare Shape the Practice of Neuropsychology in the Era of Integrated Healthcare.

Science.gov (United States)

Pliskin, Neil H

2018-05-01

The healthcare system in the United States is in the midst of a major transformation that has affected all healthcare specialties, including clinical psychology/neuropsychology. If this shift in the economics of healthcare reimbursement continues, it promises to impact clinical practice patterns for neuropsychologists far into the next decade.

[Online information supplied by Italian Hospitals and Local Healthcare Units: a descriptive research on their compliance with the guidelines issued by the Italian Ministry of Health].

Science.gov (United States)

Vanzetta, M; Vellone, E; De Marinis, M G; Cavicchi, I; Alvaro, R

2012-01-01

In most countries where Internet is widely used the number of people surfing the web for healthcare information equals (and in some countries is more than) the number of people looking for healthcare assistance. More and more often, all over the world, Internet is integrated by advanced healthcare systems as a cornerstone of their e-health infrastructure, to meet citizens' needs for health information. Therefore, information plays a key role in the relationship between healthcare providers and citizenship. In 2010 the Italian Ministry of Health has worked out a set of guidelines to improve online communication, within the framework of health promotion. To analyze if the web sites of the Italian public hospitals (PH) and the local healthcare units (LHU) comply with the guidelines of the Italian Ministry of Health (IMH) on the improvement of online communication within the framework of healthcare promotion. All Italian PH and LHU web sites have been analyzed using the self evaluation tool of the IMH. The total number of web sites analyzed was 245. Their compliance with the IMH guidelines was low. Web sites linking to other professional sites, such as the College of Physicians, the College of Pharmacists, or the College of Nurses, were 32 (13%). One hundred and forty-two (58%) were the sites that did not offer any kind of health information, such as pathophysiology of diseases, the most relevant pathologic conditions, risky behaviors, primary and secondary prevention's interventions. A web navigation menu organized according to the most relevant life events or according to categories of users (I am ... /dedicated to...) was available only in 53 web sites (22%). The IMH's guidelines on online communication -- with reference to the aspects here analyzed -- have been in some ways disregarded and the criteria suggested by them have not been fully adopted by PHs and LHUs. Overall, communication is globally meant (and directed) "towards" citizenship and not "together with

The Quality of Clinical Information in Adverse Drug Reaction Reports by Patients and Healthcare Professionals: A Retrospective Comparative Analysis.

Science.gov (United States)

Rolfes, Leàn; van Hunsel, Florence; van der Linden, Laura; Taxis, Katja; van Puijenbroek, Eugène

2017-07-01

Clinical information is needed to assess the causal relationship between a drug and an adverse drug reaction (ADR) in a reliable way. Little is known about the level of relevant clinical information about the ADRs reported by patients. The aim was to determine to what extent patients report relevant clinical information about an ADR compared with their healthcare professional. A retrospective analysis of all ADR reports on the same case, i.e., cases with a report from both the patient and the patient's healthcare professional, selected from the database of the Dutch Pharmacovigilance Center Lareb, was conducted. The extent to which relevant clinical information was reported was assessed by trained pharmacovigilance assessors, using a structured tool. The following four domains were assessed: ADR, chronology, suspected drug, and patient characteristics. For each domain, the proportion of reported information in relation to information deemed relevant was calculated. An average score of all relevant domains was determined and categorized as poorly (≤45%), moderately (from 46 to 74%) or well (≥75%) reported. Data were analyzed using a paired sample t test and Wilcoxon signed rank test. A total of 197 cases were included. In 107 cases (54.3%), patients and healthcare professionals reported a similar level of clinical information. Statistical analysis demonstrated no overall differences between the groups (p = 0.126). In a unique study of cases of ADRs reported by patients and healthcare professionals, we found that patients report clinical information at a similar level as their healthcare professional. For an optimal pharmacovigilance, both healthcare professionals and patient should be encouraged to report.

Cybersecurity and privacy issues for socially integrated mobile healthcare applications operating in a multi-cloud environment.

Science.gov (United States)

Al-Muhtadi, Jalal; Shahzad, Basit; Saleem, Kashif; Jameel, Wasif; Orgun, Mehmet A

2017-05-01

Social media has enabled information-sharing across massively large networks of people without spending much financial resources and time that are otherwise required in the print and electronic media. Mobile-based social media applications have overwhelmingly changed the information-sharing perspective. However, with the advent of such applications at an unprecedented scale, the privacy of the information is compromised to a larger extent if breach mitigation is not adequate. Since healthcare applications are also being developed for mobile devices so that they also benefit from the power of social media, cybersecurity privacy concerns for such sensitive applications have become critical. This article discusses the architecture of a typical mobile healthcare application, in which customized privacy levels are defined for the individuals participating in the system. It then elaborates on how the communication across a social network in a multi-cloud environment can be made more secure and private, especially for healthcare applications.

The invisible hands made visible: recognizing the value of informal care in healthcare decision-making.

Science.gov (United States)

van Exel, Job; Bobinac, Ana; Koopmanschap, Marc; Brouwer, Werner

2008-12-01

The healthcare sector depends heavily on the informal care provided by families and friends of those who are ill. Informal caregivers may experience significant burden as well as health and well-being effects. Resource allocation decisions, in particular from a societal perspective, should account explicitly for these effects in the social environment of patients. This is not only important to make a complete welfare economic assessment of treatments, but also to ensure the lasting involvement of informal caregivers in the care-giving process. Measurement and valuation techniques for the costs and effects of informal care have been developed and their use is becoming more common. Decision-makers in healthcare - and eventually families and patients - would be helped by more uniformity in methods.

Data Entities and Information System Matrix for Integrated Agriculture Information System (IAIS)

Science.gov (United States)

Budi Santoso, Halim; Delima, Rosa

2018-03-01

Integrated Agriculture Information System is a system that is developed to process data, information, and knowledge in Agriculture sector. Integrated Agriculture Information System brings valuable information for farmers: (1) Fertilizer price; (2) Agriculture technique and practise; (3) Pest management; (4) Cultivation; (5) Irrigation; (6) Post harvest processing; (7) Innovation in agriculture processing. Integrated Agriculture Information System contains 9 subsystems. To bring an integrated information to the user and stakeholder, it needs an integrated database approach. Thus, researchers describes data entity and its matrix relate to subsystem in Integrated Agriculture Information System (IAIS). As a result, there are 47 data entities as entities in single and integrated database.

An Ethnographically Informed Participatory Design of Primary Healthcare Information Technology in a Developing Country Setting.

Science.gov (United States)

Shidende, Nima Herman; Igira, Faraja Teddy; Mörtberg, Christina Margaret

2017-01-01

Ethnography, with its emphasis on understanding activities where they occur, and its use of qualitative data gathering techniques rich in description, has a long tradition in Participatory Design (PD). Yet there are limited methodological insights in its application in developing countries. This paper proposes an ethnographically informed PD approach, which can be applied when designing Primary Healthcare Information Technology (PHIT). We use findings from a larger multidisciplinary project, Health Information Systems Project (HISP) to elaborate how ethnography can be used to facilitate participation of health practitioners in developing countries settings as well as indicating the importance of ethnographic approach to participatory Health Information Technology (HIT) designers. Furthermore, the paper discusses the pros and cons of using an ethnographic approach in designing HIT.

Integrated care information technology.

Science.gov (United States)

Rowe, Ian; Brimacombe, Phil

2003-02-21

Counties Manukau District Health Board (CMDHB) uses information technology (IT) to drive its Integrated Care strategy. IT enables the sharing of relevant health information between care providers. This information sharing is critical to closing the gaps between fragmented areas of the health system. The tragic case of James Whakaruru demonstrates how people have been falling through those gaps. The starting point of the Integrated Care strategic initiative was the transmission of electronic discharges and referral status messages from CMDHB's secondary provider, South Auckland Health (SAH), to GPs in the district. Successful pilots of a Well Child system and a diabetes disease management system embracing primary and secondary providers followed this. The improved information flowing from hospital to GPs now enables GPs to provide better management for their patients. The Well Child system pilot helped improve reported immunization rates in a high health need area from 40% to 90%. The diabetes system pilot helped reduce the proportion of patients with HbA1c rang:9 from 47% to 16%. IT has been implemented as an integral component of an overall Integrated Care strategic initiative. Within this context, Integrated Care IT has helped to achieve significant improvements in care outcomes, broken down barriers between health system silos, and contributed to the establishment of a system of care continuum that is better for patients.

Educating patients about warfarin therapy using information technology: A survey on healthcare professionals’ perspectives

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Mullan J

2012-06-01

Full Text Available Objective: To explore healthcare professionals’ views about the benefits and challenges of using information technology (IT resources for educating patients about their warfarin therapy.Methods: A cross-sectional survey of both community and hospital-based healthcare professionals (e.g., doctors, pharmacists and nurses involved using a purpose-designed questionnaire. The questionnaires were distributed using a multi-modal approach to maximise response rates.Results: Of the total 300 questionnaires distributed, 109 completed surveys were received (43.3% response rate. Over half (53.2% of the healthcare participants were aged between 40-59 years, the majority (59.5% of whom were female. Fifty nine (54.1% participants reported having had no access to warfarin-specific IT-based patient education resources, and a further 19 (38.0% of the participants who had IT-access reported that they never used such resources. According to the healthcare participants, the main challenges associated with educating their patients about warfarin therapy included: patient-related factors, such as older age, language barriers, cognitive impairments and/or ethnic backgrounds or healthcare professional factors, such as time constraints. The healthcare professionals reported that there were several aspects about warfarin therapy which they found difficult to educate their patients about which is why they identified computers and interactive touch screen kiosks as preferred IT devices to deliver warfarin education resources in general practices, hospital-based clinics and community pharmacies. At the same time, the healthcare professionals also identified a number of facilitators (e.g., to reinforce warfarin education, to offer reliable and easily comprehensible information and barriers (e.g., time and costs of using IT resources, difficulty in operating the resources that could impact on the effective implementation of these devices in educating patients about their

Informal care, employment and quality of life: Barriers and facilitators to combining informal care and work participation for healthcare professionals.

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Heitink, Eveline; Heerkens, Yvonne; Engels, Josephine

2017-01-01

In The Netherlands, one out of six Dutch employees has informal care tasks; in the hospital and healthcare sector, this ratio is one out of four workers. Informal carers experience problems with the combination of work and informal care. In particular, they have problems with the burden of responsibility, a lack of independence and their health. These problems can reveal themselves in a variety of mental and physical symptoms that can result in absenteeism, reduction or loss of (work) participation, reduction of income, and even social isolation. The aim of the study was to describe the factors that informal carers who are employed in healthcare organizations identify as affecting their quality of life, labour participation and health. We conducted an exploratory study in 2013-2014 that included desk research and a qualitative study. Sixteen semi-structured interviews were conducted with healthcare employees who combine work and informal care. Data were analyzed with Atlas-TI. We identified five themes: 1. Fear and responsibility; 2. Sense that one's own needs are not being met; 3. Work as an escape from home; 4. Health: a lack of balance; and 5. The role of colleagues and managers: giving support and understanding. Respondents combine work and informal care because they have no other solution. The top three reasons for working are: income, escape from home and satisfaction. The biggest problems informal carers experience are a lack of time and energy. They are all tired and are often or always exhausted at the end of the day. They give up activities for themselves, their social networks become smaller and they have less interest in social activities. Their managers are usually aware of the situation, but informal care is not a topic of informal conversation or in performance appraisals. Respondents solve their problems with colleagues and expect little from the organization.

Improving healthcare practice behaviors: an exploratory study identifying effective and ineffective behaviors in healthcare.

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Van Fleet, David D; Peterson, Tim O

2016-01-01

The purpose of this paper is to present the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients. The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups. The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities. The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners' instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1997). With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers. The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider. Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as

Smart Items, Fog and Cloud Computing as Enablers of Servitization in Healthcare

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Vladimir STANTCHEV

2015-02-01

Full Text Available In this article we argue that smart items and cloud computing can be powerful enablers of servitization as business trend. This is exemplified by an application scenario in healthcare that was developed in the context of the OpSIT-Project in Germany. We present a three-level architecture for a smart healthcare infrastructure. The approach is based on a service-oriented architecture and extends established architectural approaches developed previously at our group. More specifically, it integrates a role model, a layered cloud computing architecture, as well as a fog- computing-informed paradigm in order to provide a viable architecture for healthcare and elderly-care applications. The integration of established paradigms is beneficial with respect to providing adequate quality of service and governance (e.g., data privacy and compliance. It has been verified by expert interviews with healthcare specialists and IT professionals. To further demonstrate the validity of this architectural model, we provide an example use-case as a template for any kind of smart sensor-based healthcare infrastructure.

Equipping providers with principles, knowledge and skills to successfully integrate behaviour change counselling into practice: a primary healthcare framework.

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Vallis, M; Lee-Baggley, D; Sampalli, T; Ryer, A; Ryan-Carson, S; Kumanan, K; Edwards, L

2018-01-01

There is an urgent need for healthcare providers and healthcare systems to support productive interactions with patients that promote sustained health behaviour change in order to improve patient and population health outcomes. Behaviour change theories and interventions have been developed and evaluated in experimental contexts; however, most healthcare providers have little training, and therefore low confidence in, behaviour change counselling. Particularly important is how to integrate theory and method to support healthcare providers to engage in behaviour change counselling competently. In this article, we describe a general training model developed from theory, evidence, experience and stakeholder engagement. This model will set the stage for future evaluation research on training needed to achieve competency, sustainability of competency, as well as effectiveness/cost-effectiveness of training in supporting behaviour change. A framework to support competency based training in behaviour change counselling is described in this article. This framework is designed to be integrative, sustainable, scalable and capable of being evaluated in follow-up studies. Effective training in behaviour change counselling is critical to meet the current and future healthcare needs of patients living with, or at risk of, chronic diseases. Increasing competency in establishing change-based relationships, assessing and promoting readiness to change, implementing behaviour modification and addressing psychosocial issues will be value added to the healthcare system. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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

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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.

Healthcare professionals' organisational barriers to health information technologies-a literature review.

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Lluch, Maria

2011-12-01

This literature review identifies and categorises, from an organisational management perspective, barriers to the use of HIT or ICT for health. Based on the review, it offers policy interventions. This systematic literature review was carried out during December 2009 and January 2010. Additional on-going reviews of updates through automated system alerts took place up until this paper was submitted. A total of thirty-one sources were searched including nine software platforms/databases, fifteen specialised websites/targeted databases, Google Scholar, ISI Science Citation Index and five journals hand-searched. The study covers seventy-nine articles on organisational barriers to ICT adoption by healthcare professionals. These are categorised under five main headings - (I) Structure of healthcare organisations; (II) Tasks; (III) People policies; (IV) Incentives; and (V) Information and decision processes. A total of ten subcategories are also identified. By adopting an organisational management approach, some recommendations to remove organisational management barriers are made. Despite their apparent promise, health information technologies (HIT) have proved difficult to implement. This systematic review reveals the implementation barriers associated to organisational management and their interrelations. Several important future directions in the field are also suggested: (1) there is a need for further research providing evidence of HIT cost-effectiveness as well as the development of optimal HIT applications; (2) more information is needed regarding organisational change, incentives, liability issues, end-users HIT competences and skills, structure and work process issues involved in realising the benefits from HIT. Future policy interventions should consider the five dimensions identified when addressing the impact of HIT in healthcare organisational systems, and how the impact of an intervention aimed at a particular dimension would interrelate with others. 2011

The Effects of Public Concern for Information Privacy on the Adoption of Health Information Exchanges (HIEs) by Healthcare Entities.

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Esmaeilzadeh, Pouyan

2018-05-08

The implementation of Health Information Exchanges (HIEs) by healthcare organizations may not achieve the desired outcomes as consumers may request that their health information remains unshared because of information privacy concerns. Drawing on the insights of concern for information privacy (CFIP) literature, this work extends the application of CFIP to the HIE domain. This study attempts to develop and test a model centered on the four dimensions of CFIP construct (collection, errors, unauthorized access, and secondary use) and their antecedents to predict consumers' opt-in behavioral intention toward HIE in the presence of the perceived health status' effects. We conducted an online survey in the United States using 826 samples. The results demonstrate that the perceived health information sensitivity and computer anxiety meaningfully contribute to information privacy concerns and CFIP construct significantly impedes consumers' opt-in decision to HIEs. Interestingly, contrary to our expectation, perceived poor health status considerably attenuates the negative effects exerted by CFIP on opt-in intention. The model proposed by this study can be used as a useful conceptual tool by both further studies and practitioners to examine the complex nature of patients' reactions to information privacy threats associated with the use of HIE technology in the healthcare industry.

Video Analysis and Remote Digital Ethnography: Approaches to understanding user perspectives and processes involving healthcare information technology.

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Kushniruk, Andre W; Borycki, Elizabeth M

2015-01-01

Innovations in healthcare information systems promise to revolutionize and streamline healthcare processes worldwide. However, the complexity of these systems and the need to better understand issues related to human-computer interaction have slowed progress in this area. In this chapter the authors describe their work in using methods adapted from usability engineering, video ethnography and analysis of digital log files for improving our understanding of complex real-world healthcare interactions between humans and technology. The approaches taken are cost-effective and practical and can provide detailed ethnographic data on issues health professionals and consumers encounter while using systems as well as potential safety problems. The work is important in that it can be used in techno-anthropology to characterize complex user interactions with technologies and also to provide feedback into redesign and optimization of improved healthcare information systems.

El Sistema Nacional Integrado de Salud en Uruguay y los desafíos para la Atención Primaria The Integrated National Healthcare System in Uruguay and the challenges for Primary Healthcare

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Ana Sollazzo

2011-06-01

Full Text Available El artículo aborda resultados del análisis panorámico de la Atención Primaria en Salud (APS en Uruguay en Uruguay en 2009, en el marco de un estudio multicéntrico con objetivo de identificar posibilidades para reorientar la Atención Primaria en Salud (APS como estrategia para alcanzar sistemas de salud universales, considerando la segmentación del sistema y la fragmentación en la provisión. La metodología incluyó análisis documental, entrevistas con informantes clave y triangulación de fuentes de información. Los resultados se presentan en base al modelo analítico construido en cinco dimensiones: conducción, financiamiento, recursos, integralidad e intersectorialidad de la APS. A nivel macro se observa la reciente reforma sectorial con creación de un Sistema Nacional Integrado de Salud (SNIS que favorece el desarrollo de la APS desde una concepción integradora. Se han definido acciones que apuntan a superar la segmentación del sistema y la fragmentación de los cuidados. Sin embargo a nivel operativo la segmentación presente antes del SNIS, así como el bajo nivel de coordinación de los cuidados no se han modificado aún. Esto se relaciona con la capacidad de gestión y factores organizacionales. La falta de recursos humanos adecuados para la implementación de la estrategia de APS, se identifica como factor relevante.The article examines the results of the overview of PHC (Primary Healthcare in Uruguay in 2009, within the context of the multicentric study of PHC with a view to identifying possibilities of redefining PHC as a strategy to achieve universal healthcare systems, taking into account the healthcare system's segmentation and fragmentation. The methodology included document analysis, key informant interviews and triangulation of information sources. The results presented are based on the analytical model structured in five dimensions: delivery, financing, resources, and integrated and intersectoral PHC. At the macro

Enhancing research capacity across healthcare and higher education sectors: development and evaluation of an integrated model

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Whitworth Anne

2012-08-01

Full Text Available Abstract Background With current policy in healthcare research, in the United Kingdom and internationally, focused on development of research excellence in individuals and teams, building capacity for implementation and translation of research is paramount among the professionals who use that research in daily practice. The judicious use of research outcomes and evaluation of best evidence and practice in healthcare is integrally linked to the research capacity and capabilities of the workforce. In addition to promoting high quality research, mechanisms for actively enhancing research capacity more generally must be in place to address the complexities that both undermine and facilitate this activity. Methods A comprehensive collaborative model for building research capacity in one health professional group, speech and language therapy, was developed in a region within the UK and is presented here. The North East of England and the strong research ethos of this profession in addressing complex interventions offered a fertile context for developing and implementing a model which integrated the healthcare and university sectors. Two key frameworks underpin this model. The first addresses the individual participants’ potential trajectory from research consciousness to research participative to research active. The second embeds a model developed for general practitioners into a broader framework of practice-academic partnership and knowledge and skills exchange, and considers external drivers and impacts on practice and patient outcomes as key elements. Results and discussion The integration of practice and academia has been successful in building a culture of research activity within one healthcare profession in a region in the UK and has resulted, to date, in a series of research related outcomes. Understanding the key components of this partnership and the explicit strategies used has driven the implementation of the model and are discussed

Probabilistic XML in Information Integration

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de Keijzer, Ander; Shim, J.; Casati, F.

2006-01-01

Information integration is a difficult research problem. In an ambient environment, where devices can connect and disconnect arbitrarily, the problem only increases, because data sources may become available at any time, but can also disappear. In such an environment, information integration needs

Convergent Innovation in Emerging Healthcare Technology Ecosystems: Addressing Complexity and Integration

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Mark A. Phillips

2017-09-01

Full Text Available Precision Medicine and Digital Health are emerging areas in healthcare, and they are underpinned by convergent or cross-industry innovation. However, convergence results in greater uncertainty and complexity in terms of technologies, value networks, and organization. There has been limited empirical research on emerging and convergent ecosystems, especially in addressing the issue of integration. This research identifies how organizations innovate in emerging and convergent ecosystems, specifically, how they address the challenge of integration. We base our research on empirical analyses using a series of longitudinal case studies employing a combination of case interviews, field observations, and documents. Our findings identify a need to embrace the complexity by adopting a variety of approaches that balance “credibility-seeking” and “advantage-seeking” behaviours, to navigate, negotiate, and nurture both the innovation and ecosystem, in addition to a combination of “analysis” and “synthesis” actions to manage aspects of integration. We contribute to the convergent innovation agenda and provide practical approaches for innovators in this domain.

Perioperative and ICU Healthcare Analytics within a Veterans Integrated System Network: a Qualitative Gap Analysis.

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Mudumbai, Seshadri; Ayer, Ferenc; Stefanko, Jerry

2017-08-01

Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development. Methods consisted of semi-structured interviews in 2 phases with a diverse set (n = 9) of support personnel and end users from five facilities across a Veterans Integrated Service Network. Phase 1 identified underlying needs and previous experiences with the analytics platform across various roles and operational responsibilities. Phase 2 validated preliminary feedback, lessons learned, and recommendations for improvement. Emerging themes suggested that the existing system met a small pool of national reporting requirements. However, pain points were identified with accessing data in several information system silos and performing multiple manual validation steps of data content. Notable recommendations included enhancing systems integration to create "one-stop shopping" for data, and developing a capability to perform trends analysis. Our gap analysis suggests that analytics platforms designed for surgical and ICU patients should employ approaches similar to those being used for primary care patients.

Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

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Rentz, Michael F; Ruffner, Andrew H; Ancona, Rachel M; Hart, Kimberly W; Kues, John R; Barczak, Christopher M; Lindsell, Christopher J; Fichtenbaum, Carl J; Lyons, Michael S

2017-11-23

Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT. The study aimed to evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting. Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became the next-generation index cases in a snowball recruitment strategy. The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported that they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years. TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Analyzing the concept of disruptive behavior in healthcare work: an integrative review*

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Roberta Meneses Oliveira

Full Text Available Abstract OBJECTIVE To analyze the concept of disruptive behavior in healthcare work. METHOD An integrative review carried out in the theoretical phase of a qualitative research substantiated by the theoretical framework of the Hybrid Model of Concept Development. The search for articles was conducted in the CINAHL, LILACS, PsycINFO, PubMed and SciVerse Scopus databases in 2013. RESULTS 70 scientific articles answered the guiding question and lead to attributes of disruptive behavior, being: incivility, psychological violence and physical/sexual violence; with their main antecedents (intrapersonal, interpersonal and organizational being: personality characteristics, stress and work overload; and consequences of: workers' moral/mental distress, compromised patient safety, labor loss, and disruption of communication, collaboration and teamwork. CONCLUSION Analysis of the disruptive behavior concept in healthcare work showed a construct in its theoretical stage that encompasses different disrespectful conduct adopted by health workers in the hospital context, which deserve the attention of leadership for better recognition and proper handling of cases and their consequences.

A Service-Oriented Healthcare Message Alerting Architecture in an Asia Medical Center: A Case Study

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Jin-Shin Lai

2009-06-01

Full Text Available This paper illustrates how our development team has used some information technologies to let physicians obtain an instant abnormal laboratory result report for critical patient care services. We have implementeda healthcare message alerting system (HMAS on a healthcare short message service (HSMS engine and the distributed healthcare-oriented service environment (DiHOSE in the National Taiwan University Hospital (NTUH. The HSMS engine has a general interface for all applications which could easily send any kind of alerting messages. Fundamentally, the DiHOSE uses HL7 standard formats to process the information exchange behaviors and can be flexibly extended for reasonable user requirements. The disease surveillance subsystem is an integral part of NTUH new hospital information system which is based on DiHOSE and the disease surveillance subsystem would send alerting messages through the HSMS engine. The latest cell phone message alerting subsystem, a case study, in NTUH proved that the DiHOSE could integrate the user required functions without much work. We concluded that both HSMS and DiHOSE can generalize and extend application demands efficiently.

Service Robotics in Healthcare: A Perspective for Information Systems Researchers?

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Garmann-Johnsen, Niels Frederik; Mettler, Tobias; Sprenger, Michaela

2014-01-01

Recent advances in electronics and telecommunication have paved the way for service robots to enter the clinical world. While service robotics has long been a core research theme in computer science and other engineering-related fields, it has attracted little interest of Information Systems (IS) researchers so far. We argue that service robotics represents an interesting area of investigation, especially for healthcare, since current research lacks a thorough examination of socio-technical p...

Integration of IEEE 1451 and HL7 exchanging information for patients' sensor data.

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Kim, Wooshik; Lim, Suyoung; Ahn, Jinsoo; Nah, Jiyoung; Kim, Namhyun

2010-12-01

HL7 (Health Level 7) is a standard developed for exchanging incompatible healthcare information generated from programs or devices among heterogenous medical information systems. At present, HL7 is growing as a global standard. However, the HL7 standard does not support effective methods for treating data from various medical sensors, especially from mobile sensors. As ubiquitous systems are growing, HL7 must communicate with various medical transducers. In the area of sensor fields, IEEE 1451 is a group of standards for controlling transducers and for communicating data from/to various transducers. In this paper, we present the possibility of interoperability between the two standards, i.e., HL7 and IEEE 1451. After we present a method to integrate them and show the preliminary results of this approach.

What might a health information system look like?

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Mikko Nenonen

2002-09-01

Full Text Available A health information system is more than just an electronic patient database. It is also more than a reporting system for healthcare data. It is a precondition for a modern healthcare system driven by information rather than by resources or norms. However, we have not yet seen such a system operating anywhere. In this paper we try to draft a general framework for a health information system, link it to evidence-based support mechanisms for both clinical and administrative decision making and present it as an integral part of our healthcare systems.

Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

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Vandebroek, Ina

2013-07-30

The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy). Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested. To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities. The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare. Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of

A path analysis study of retention of healthcare professionals in urban India using health information technology.

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Bhattacharya, Indrajit; Ramachandran, Anandhi

2015-07-31

Healthcare information technology (HIT) applications are being ubiquitously adopted globally and have been indicated to have effects on certain dimensions of recruitment and retention of healthcare professionals. Retention of healthcare professionals is affected by their job satisfaction (JS), commitment to the organization and intention to stay (ITS) that are interlinked with each other and influenced by many factors related to job, personal, organization, etc. The objectives of the current study were to determine if HIT was one among the factors and, if so, propose a probable retention model that incorporates implementation and use of HIT as a strategy. This was a cross-sectional survey study covering 20 hospitals from urban areas of India. The sample (n = 586) consisted of doctors, nurses, paramedics and hospital administrators. Data was collected through a structured questionnaire. Factors affecting job satisfaction were determined. Technology acceptance by the healthcare professionals was also determined. Interactions between the factors were predicted using a path analysis model. The overall satisfaction rate of the respondents was 51 %. Based on factor analysis method, 10 factors were identified for JS and 9 factors for ITS. Availability and use of information technology was one factor that affected JS. The need for implementing technology influenced ITS through work environment and career growth. Also, the study indicated that nearly 70 % of the respondents had awareness of HIT, but only 40 % used them. The importance of providing training for HIT applications was stressed by many respondents. The results are in agreement with literature studies exploring job satisfaction and retention among healthcare professionals. Our study documented a relatively medium level of job satisfaction among the healthcare professionals in the urban area. Information technology was found to be one among the factors that can plausibly influence their job satisfaction and

The Influence of Organizational Subculture on Information Technology Project Success in the Healthcare Sector: A Qualitative, Multi-Case Study

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Mallet, Richard Kofi

2014-01-01

Healthcare providers face high demands for technology based healthcare services due to global population increases and adapting information technology (IT) to achieve quality patient care. IT has become center stage in the operations and management of healthcare organizations. IT requirements emerge from the visions, values, and beliefs of…

Orchestrating a unified approach to information management.

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Friedman, B A

1997-01-01

Articles in both business and healthcare literature make frequent reference to the need for integration in healthcare organizations. In healthcare, the term horizontal integration can refer to the purchase of one hospital by another in the same geographical area, particularly where the hospitals' services overlap. Services might be consolidated in this example or one hospital may totally shut down the acquired one. Vertical integration refers to a hospital exercising control of its inputs or outputs. In one sense, patients referred to a hospital can be considered inputs. A hospital that purchases physician practices or integrated delivery systems is an example. Purchasing a nursing facility by an integrated delivery system (IDS) is another. This article focuses on organizational or holographic integration, where an organization is understood and embedded--like a hologram--in each of its smaller components, and each operating unit has knowledge about the whole system in which it is embedded. Conceptually, a hospital can achieve organizational integration relatively easily. One way is to assign administrative responsibility for two departments, radiology and pathology, for example, to one person who will handle billing, budgeting and human resources issues. Organizational integration breaks down turf barriers between distinct functional areas (often known as stovepipes or the silo mentality) because the result is less energy expended to solve problems. Organizational integration must include the merging of information technology (IT) into a single computer system that can report results across several departments, for example, in order entry, result reporting, resource scheduling or billing. At the University of Michigan Health System, technical and organizational integration are taking place across the information systems of the radiology and pathology departments. Deployment of an intranet-based architecture for ancillary information systems will provide the means

[Economic aspects of integrated care].

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Lange, A; Braun, S; Greiner, W

2012-05-01

For more than 10 years integrated care has been an inherent part of the German healthcare system. The aims of selective contracts are to minimize interface problems between outpatient and inpatient sectors, generalist und specialist care as well as to intensify competition. Despite repeated efforts by the legislator, comprehensive integrated healthcare is still limited to a few flagship projects. This is mainly due to low incentives on the part of both suppliers and customers. Therefore, this article focuses on the economic aspects of integrated care. From a theoretical perspective, integrated care improves efficiency in the healthcare sector by reducing interface problems and asymmetric information as well as by intensifying competition. In practice, however, there are a number of obstacles to implementation. Particularly noteworthy are the financial difficulties in addition to problems regarding sectoral budgeting and the long-term nature of investments. However, the political environment and thus the financial arrangements within the statutory health insurance seem to be more important for further development of integrated care in Germany than the financing issues.

Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers.

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Agaku, Israel T; Adisa, Akinyele O; Ayo-Yusuf, Olalekan A; Connolly, Gregory N

2014-01-01

This study assessed the perceptions and behaviors of US adults about the security of their protected health information (PHI). The first cycle of the fourth wave of the Health Information National Trends Survey was analyzed to assess respondents' concerns about PHI breaches. Multivariate logistic regression was used to assess the effect of such concerns on disclosure of sensitive medical information to a healthcare professional (pdata breach when their PHI was being transferred between healthcare professionals by fax (67.0%; 95% CI 64.2% to 69.8%) or electronically (64.5%; 95% CI 61.7% to 67.3%). About 12.3% (95% CI 10.8% to 13.8%) of respondents had ever withheld information from a healthcare provider because of security concerns. The likelihood of information withholding was higher among respondents who perceived they had very little say about how their medical records were used (adjusted OR=1.42; 95% CI 1.03 to 1.96). This study underscores the need for enhanced measures to secure patients' PHI to avoid undermining their trust.

Healthcare System Information at Language Schools for Newly Arrived Immigrants: A Pertinent Setting in Times of Austerity

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

2017-01-01

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. Methods: Immigrants attending a language school in Copenhagen in 2012 received…

Integrated inventory information system

Digital Repository Service at National Institute of Oceanography (India)

Sarupria, J.S.; Kunte, P.D.

The nature of oceanographic data and the management of inventory level information are described in Integrated Inventory Information System (IIIS). It is shown how a ROSCOPO (report on observations/samples collected during oceanographic programme...

Depiction of Trends in Administrative Healthcare Data from Hospital Information System.

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Kalankesh, Leila R; Pourasghar, Faramarz; Jafarabadi, Mohammad Asghari; Khanehdan, Negar

2015-06-01

administrative healthcare data are among main components of hospital information system. Such data can be analyzed and deployed for a variety of purposes. The principal aim of this research was to depict trends of administrative healthcare data from HIS in a general hospital from March 2011 to March 2014. data set used for this research was extracted from the SQL database of the hospital information system in Razi general hospital located in Marand. The data were saved as CSV (Comma Separated Values) in order to facilitate data cleaning and analysis. The variables of data set included patient's age, gender, final diagnosis, final diagnosis code based on ICD-10 classification system, date of hospitalization, date of discharge, LOS(Length of Stay), ward, and survival status of the patient. Data were analyzed and visualized after applying appropriate cleansing and preparing techniques. morbidity showed a constant trend over three years. Pregnancy, childbirth and the puerperium were the leading category of final diagnosis (about 32.8 %). The diseases of the circulatory system were the second class accounting for 13 percent of the hospitalization cases. The diseases of the digestive system had the third rank (10%). Patients aged between 14 and 44 constituted a higher proportion of total cases. Diseases of the circulatory system was the most common class of diseases among elderly patients (age≥65). The highest rate of mortality was observed among patients with final diagnosis of the circulatory system diseases followed by those with diseases of the respiratory system, and neoplasms. Mortality rate for the ICU and the CCU patients were 62% and 33% respectively. The longest average of LOS (7.3 days) was observed among patients hospitalized in the ICU while patients in the Obstetrics and Gynecology ward had the shortest average of LOS (2.4 days). Multiple regression analysis revealed that LOS was correlated with variables of surgery, gender, and type of payment, ward, the

Enabling IoT: Integration of wireless sensor network for healthcare application using Waspmote

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Azmi, Noraini; Kamarudin, Latifah Munirah

2017-03-01

The number of patients that require medical assistance is increasing each day while staff-patient ratio is not balanced causing issues such as treatment delay and often leads to patient dissatisfaction. Besides that, healthcare devices are getting complex and challenging for it to be handled and interpreted personally by patient. Lack of staff and challenges in operating the medical devices not only affect patient in hospital but also caused problem to home care patients that require full attention and constant monitoring. This urges for a development of new method or technology. At present, Wireless Sensor Network (WSN) is gaining interest as one of the major components in enabling Internet of Things (IoT) since it offers low cost, low power monitoring besides reducing devices dependency on wires or cable. Although, WSN is initially developed for military application, nowadays, it is being integrated into various applications such as environmental monitoring, smart monitoring and agricultural monitoring. The idea of wireless monitoring with low power consumption motivates researchers to discover the possibility of deploying wireless sensor network for mission critical application such as in healthcare applications. This paper presents the details on the design and development of wireless sensor network using Waspmote from Libelium Inc. for mission critical applications such as healthcare applications.

Leveraging the Experiences of Informal Caregivers to Create Future Healthcare Workforce Options.

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Phillips, Sara S; Ragas, Daiva M; Hajjar, Nadia; Tom, Laura S; Dong, XinQi; Simon, Melissa A

2016-01-01

The objective of this study was gather pilot data from informal caregivers regarding the potential for a training program to assist current or past caregivers in reentering the job market, and thus offering a pathway to economic resilience. In an effort that could foster a sustainable and competent caregiving market to help meet the needs of an aging America, whether training informal caregivers might help them transition into a paid caregiving or other health service role was explored. Caregivers (N=55) of a chronically or terminally ill family member or friend in a suburban county near Chicago were interviewed. The interview guide addressed household economic effect of illness, emotional burden, and training program interest. Fifty-six percent of caregivers were interested in training to work outside the home, caring for people in other households, 84% indicated a desire to learn more about health care, and 68% reported a desire to explore job possibilities in health care. Eighty-two percent were experienced in working with an individual aged 50 and older. Informal caregivers' interest in a training program to bolster their qualifications for a role in the healthcare workforce, including the option of a formal caregiver position, supports the demand for such a program. Considering the need for healthcare workers to serve the growing elderly population and the desire of informal caregivers to find gainful employment, these informal caregivers could provide the impetus to invest in informal caregiver training. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

[Interdisciplinary healthcare centres--a way of organising healthcare in the future from a health insurer's perspective].

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Hecke, Torsten L; Hoyer, Jens Martin

2009-01-01

The German healthcare system modernization act enables healthcare providers to fund interdisciplinary healthcare centres. The Techniker Krankenkasse (TK) is a statutory health sickness fund that has contracted with some of the interdisciplinary healthcare centres named ATRIO-MED to achieve high-quality medical care and healthcare management. A range of patient-centred services is described in the cooperation agreement; in addition to central medical patient records one of the core competencies includes integrated pathways for defined diagnosis. The concept of the interdisciplinary healthcare centre is highly accepted among patients. It will serve as a platform for future TK healthcare policies.

Redefining Health: Implication for Value-Based Healthcare Reform.

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Putera, Ikhwanuliman

2017-03-02

Health definition consists of three domains namely, physical, mental, and social health that should be prioritized in delivering healthcare. The emergence of chronic diseases in aging populations has been a barrier to the realization of a healthier society. The value-based healthcare concept seems in line with the true health objective: increasing value. Value is created from health outcomes which matter to patients relative to the cost of achieving those outcomes. The health outcomes should include all domains of health in a full cycle of care. To implement value-based healthcare, transformations need to be done by both health providers and patients: establishing true health outcomes, strengthening primary care, building integrated health systems, implementing appropriate health payment schemes that promote value and reduce moral hazards, enabling health information technology, and creating a policy that fits well with a community.

Promoting healthcare innovation on the demand side

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Eisenberg, Rebecca S.

2017-01-01

Abstract Innovation policy often focuses on fortifying the incentives of firms that develop and sell new products by offering them lucrative rights to exclude competitors from the market. Regulators also rely on these same firms—and on similar incentives—to develop information about the effects of their products in patients, despite their obvious conflict of interest. The result may be a distorted understanding that leads to overuse of expensive new medical technologies. Recent technological advances have put healthcare payers in an excellent position to play a larger role in future innovation to improve healthcare and reduce its costs. Insurance companies and integrated healthcare providers have custody of treasure troves of data about healthcare provision and outcomes that can yield valuable insights about the effects of medical treatment without the need to conduct costly clinical trials. Some integrated healthcare systems have seized upon this advantage to make notable discoveries about the effects of particular products that have changed the standard of care. Moreover, to the extent that healthcare payers can profit from reducing costs, they will seek to avoid inappropriate use of costly technologies. Greater involvement of payers in healthcare innovation thus offers a potential counterweight to the incentives of product sellers to promote excessive use of costly new products. In recent years, the federal government has sought to promote innovation through analysis of healthcare records in a series of initiatives; some picture insurers as passive data repositories, while others provide opportunities for insurers to take a more active role in innovation. In this paper, we examine the role of health insurers in developing new knowledge about the provision and effects of healthcare—what we call ‘demand-side innovation’. We address the contours of this underexplored area of innovation and describe the behavior of participating firms. We examine the

Why bother about health? A study on the factors that influence health information seeking behaviour among Malaysian healthcare consumers.

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Jaafar, Noor Ismawati; Ainin, Sulaiman; Yeong, Mun Wai

2017-08-01

The general improvement of socio-economic conditions has resulted in people becoming more educated to make better-informed decisions in health related matters. Individual's perspective on health increases with better understanding of ways to improve lifestyle for better health and living. With the increase in lifestyle related diseases that lead to health problems, there is an increase in the availability of healthcare information. Thus, it is important to identify the factors that influence information seeking behaviour in the area of healthcare and lifestyle. This exploratory study examines the relationship between the factors that affect online health information-seeking behaviour among healthcare product in the capital city of Malaysia. Survey questionnaire was used to collect empirical data. A survey was conducted among 300 healthcare consumers in three main cities in Malaysia where questionnaires were personally distributed through snowball sampling. A total of 271 questionnaire forms were used in the analysis. Health Behaviour of the consumers influences Health Information Seeking Behaviour. And this relationship is strongly affected by Gender whereby the affect is strongly among females compared to males. The findings indicate that Health Behaviour influences Health Information Seeking Behaviour. Marketers can find out which target segment of population to target when devising information channels for consumers, especially through the Internet. However, message that promotes positive health behaviour to a target audience who already has positive Health Behaviour increase the motivation to Health Information Seeking Behaviour. Copyright © 2017 Elsevier B.V. All rights reserved.

The Swedish strategy and method for development of a national healthcare information architecture.

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Rosenälv, Jessica; Lundell, Karl-Henrik

2012-01-01

"We need a precise framework of regulations in order to maintain appropriate and structured health care documentation that ensures that the information maintains a sufficient level of quality to be used in treatment, in research and by the actual patient. The users shall be aided by clearly and uniformly defined terms and concepts, and there should be an information structure that clarifies what to document and how to make the information more useful. Most of all, we need to standardize the information, not just the technical systems." (eHälsa - nytta och näring, Riksdag report 2011/12:RFR5, p. 37). In 2010, the Swedish Government adopted the National e-Health - the national strategy for accessible and secure information in healthcare. The strategy is a revision and extension of the previous strategy from 2006, which was used as input for the most recent efforts to develop a national information structure utilizing business-oriented generic models. A national decision on healthcare informatics standards was made by the Swedish County Councils, which decided to follow and use EN/ISO 13606 as a standard for the development of a universally applicable information structure, including archetypes and templates. The overall aim of the Swedish strategy for development of National Healthcare Information Architecture is to achieve high level semantic interoperability for clinical content and clinical contexts. High level semantic interoperability requires consistently structured clinical data and other types of data with coherent traceability to be mapped to reference clinical models. Archetypes that are formal definitions of the clinical and demographic concepts and some administrative data were developed. Each archetype describes the information structure and content of overarching core clinical concepts. Information that is defined in archetypes should be used for different purposes. Generic clinical process model was made concrete and analyzed. For each decision

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.

The Role of Healthcare Technology Management in Facilitating Medical Device Cybersecurity.

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Busdicker, Mike; Upendra, Priyanka

2017-09-02

This article discusses the role of healthcare technology management (HTM) in medical device cybersecurity and outlines concepts that are applicable to HTM professionals at a healthcare delivery organization or at an integrated delivery network, regardless of size. It provides direction for HTM professionals who are unfamiliar with the security aspects of managing healthcare technologies but are familiar with standards from The Joint Commission (TJC). It provides a useful set of recommendations, including relevant references for incorporating good security practices into HTM practice. Recommendations for policies, procedures, and processes referencing TJC standards are easily applicable to HTM departments with limited resources and to those with no resource concerns. The authors outline processes from their organization as well as best practices learned through information sharing at AAMI, National Health Information Sharing and Analysis Center (NH-ISAC), and Medical Device Innovation, Safety, and Security Consortium (MDISS) conferences and workshops.

Beyond xMOOCs in healthcare education: study of the feasibility in integrating virtual patient systems and MOOC platforms.

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Stathakarou, Natalia; Zary, Nabil; Kononowicz, Andrzej A

2014-01-01

Background. Massive Open Online Courses (MOOCs) are an emerging trend in online learning. However, their technology is not yet completely adjusted to the needs of healthcare education. Integration of Virtual Patients within MOOCs to increase interactivity and foster clinical reasoning skills training, has been discussed in the past, but not verified by a practical implementation. Objective. To investigate the technical feasibility of integrating MOOCs with Virtual Patients for the purpose of enabling further research into the potential pedagogical benefits of this approach. Methods. We selected OpenEdx and Open Labyrinth as representative constituents of a MOOC platform and Virtual Patient system integration. Based upon our prior experience we selected the most fundamental technical requirement to address. Grounded in the available literature we identified an e-learning standard to guide the integration. We attempted to demonstrate the feasibility of the integration by designing a "proof-of-concept" prototype. The resulting pilot implementation was subject of verification by two test cases. Results. A Single Sign-On mechanism connecting Open Labyrinth with OpenEdx and based on the IMS LTI standard was successfully implemented and verified. Conclusion. We investigated the technical perspective of integrating Virtual Patients with MOOCs. By addressing this crucial technical requirement we set a base for future research on the educational benefits of using virtual patients in MOOCs. This provides new opportunities for integrating specialized software in healthcare education at massive scale.

Beyond xMOOCs in healthcare education: study of the feasibility in integrating virtual patient systems and MOOC platforms

Directory of Open Access Journals (Sweden)

Natalia Stathakarou

2014-11-01

Full Text Available Background. Massive Open Online Courses (MOOCs are an emerging trend in online learning. However, their technology is not yet completely adjusted to the needs of healthcare education. Integration of Virtual Patients within MOOCs to increase interactivity and foster clinical reasoning skills training, has been discussed in the past, but not verified by a practical implementation.Objective. To investigate the technical feasibility of integrating MOOCs with Virtual Patients for the purpose of enabling further research into the potential pedagogical benefits of this approach.Methods. We selected OpenEdx and Open Labyrinth as representative constituents of a MOOC platform and Virtual Patient system integration. Based upon our prior experience we selected the most fundamental technical requirement to address. Grounded in the available literature we identified an e-learning standard to guide the integration. We attempted to demonstrate the feasibility of the integration by designing a “proof-of-concept” prototype. The resulting pilot implementation was subject of verification by two test cases.Results. A Single Sign-On mechanism connecting Open Labyrinth with OpenEdx and based on the IMS LTI standard was successfully implemented and verified.Conclusion. We investigated the technical perspective of integrating Virtual Patients with MOOCs. By addressing this crucial technical requirement we set a base for future research on the educational benefits of using virtual patients in MOOCs. This provides new opportunities for integrating specialized software in healthcare education at massive scale.

The reliability and validity of the informant AD8 by comparison with a series of cognitive assessment tools in primary healthcare.

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Shaik, Muhammad Amin; Xu, Xin; Chan, Qun Lin; Hui, Richard Jor Yeong; Chong, Steven Shih Tsze; Chen, Christopher Li-Hsian; Dong, YanHong

2016-03-01

The validity and reliability of the informant AD8 in primary healthcare has not been established. Therefore, the present study examined the validity and reliability of the informant AD8 in government subsidized primary healthcare centers in Singapore. Eligible patients (≥60 years old) were recruited from primary healthcare centers and their informants received the AD8. Patient-informant dyads who agreed for further cognitive assessments received the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and a locally validated formal neuropsychological battery at a research center in a tertiary hospital. 1,082 informants completed AD8 assessment at two primary healthcare centers. Of these, 309 patients-informant dyads were further assessed, of whom 243 (78.6%) were CDR = 0; 22 (7.1%) were CDR = 0.5; and 44 (14.2%) were CDR≥1. The mean administration time of the informant AD8 was 2.3 ± 1.0 minutes. The informant AD8 demonstrated good internal consistency (Cronbach's α = 0.85); inter-rater reliability (Intraclass Correlation Coefficient (ICC) = 0.85); and test-retest reliability (weighted κ = 0.80). Concurrent validity, as measured by the correlation between total AD8 scores and CDR global (R = 0.65, p validity, as measured by convergent validity (R ≥ 0.4) between individual items of AD8 with CDR and neuropsychological domains was acceptable. The informant AD8 demonstrated good concurrent and construct validity and is a reliable measure to detect cognitive dysfunction in primary healthcare.

A COMPARISON OF PATIENT AND HEALTHCARE PROFESSIONAL VIEWS WHEN ASSESSING QUALITY OF INFORMATION ON PITUITARY ADENOMA AVAILABLE ON THE INTERNET.

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Druce, Irena; Williams, Chantal; Baggoo, Carolyn; Keely, Erin; Malcolm, Janine

2017-10-01

Patients are increasingly turning to the internet to seek reliable sources of health information and desire guidance in assessing the quality of information as healthcare becomes progressively more complex. Pituitary adenomas are a rare, diverse group of tumors associated with increased mortality and morbidity whose management requires a multidisciplinary approach. As such, patients with this disorder are often searching for additional sources of healthcare information. We undertook a study to assess the quality of information available on the internet for patients with pituitary adenoma. After exclusion, 42 websites were identified based on a search engine query with various search terms. Each website was assessed in triplicate: once by a health professional, once by a simulated patient, and once by a patient who had a pituitary adenoma and underwent medical and surgical treatment. The assessment tools included a content-specific questionnaire, the DISCERN tool, and the Ensuring Quality Information for Patients tool. The readability of the information was assessed with the Flesch-Kincaid grade level. We found that the overall quality of information on pituitary adenoma on the internet was variable and written at a high grade level. Correlation between the different assessors was poor, indicating that there may be differences in how healthcare professionals and patients view healthcare information. Our findings highlight the importance of assessment of the health information by groups of the intended user to ensure the needs of that population are met. Abbreviation: EQIP = Ensuring Quality Information 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 Healthcare Improvement Scotland evidence note rapid review process: providing timely, reliable evidence to inform imperative decisions on healthcare.

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McIntosh, Heather M; Calvert, Julie; Macpherson, Karen J; Thompson, Lorna

2016-06-01

Rapid review has become widely adopted by health technology assessment agencies in response to demand for evidence-based information to support imperative decisions. Concern about the credibility of rapid reviews and the reliability of their findings has prompted a call for wider publication of their methods. In publishing this overview of the accredited rapid review process developed by Healthcare Improvement Scotland, we aim to raise awareness of our methods and advance the discourse on best practice. Healthcare Improvement Scotland produces rapid reviews called evidence notes using a process that has achieved external accreditation through the National Institute for Health and Care Excellence. Key components include a structured approach to topic selection, initial scoping, considered stakeholder involvement, streamlined systematic review, internal quality assurance, external peer review and updating. The process was introduced in 2010 and continues to be refined over time in response to user feedback and operational experience. Decision-makers value the responsiveness of the process and perceive it as being a credible source of unbiased evidence-based information supporting advice for NHSScotland. Many agencies undertaking rapid reviews are striving to balance efficiency with methodological rigour. We agree that there is a need for methodological guidance and that it should be informed by better understanding of current approaches and the consequences of different approaches to streamlining systematic review methods. Greater transparency in the reporting of rapid review methods is essential to enable that to happen.

Human Microbiome and Learning Healthcare Systems: Integrating Research and Precision Medicine for Inflammatory Bowel Disease

Science.gov (United States)

Chuong, Kim H.; Mack, David R.; Stintzi, Alain

2018-01-01

Abstract Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care. To date, much discussion in this context has focused on the potential of human genomic data, and not yet on human microbiome data. Rapid advances in human microbiome research suggest that profiling of, and interventions on, the human microbiome can provide substantial opportunity for improved diagnosis, therapeutics, risk management, and risk stratification. In this study, we discuss a potential role for microbiome science in LHSs. We first review the key elements of LHSs, and discuss possibilities of Big Data and patient engagement. We then consider potentials and challenges of integrating human microbiome research into clinical practice as part of an LHS. With rapid growth in human microbiome research, patient-specific microbial data will begin to contribute in important ways to precision medicine. Hence, we discuss how patient-specific microbial data can help guide therapeutic decisions and identify novel effective approaches for precision care of inflammatory bowel disease. To the best of our knowledge, this expert analysis makes an original contribution with new insights poised at the emerging intersection of LHSs, microbiome science, and postgenomics medicine. PMID:28282257

Human Microbiome and Learning Healthcare Systems: Integrating Research and Precision Medicine for Inflammatory Bowel Disease.

Science.gov (United States)

Chuong, Kim H; Mack, David R; Stintzi, Alain; O'Doherty, Kieran C

2018-02-01

Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care. To date, much discussion in this context has focused on the potential of human genomic data, and not yet on human microbiome data. Rapid advances in human microbiome research suggest that profiling of, and interventions on, the human microbiome can provide substantial opportunity for improved diagnosis, therapeutics, risk management, and risk stratification. In this study, we discuss a potential role for microbiome science in LHSs. We first review the key elements of LHSs, and discuss possibilities of Big Data and patient engagement. We then consider potentials and challenges of integrating human microbiome research into clinical practice as part of an LHS. With rapid growth in human microbiome research, patient-specific microbial data will begin to contribute in important ways to precision medicine. Hence, we discuss how patient-specific microbial data can help guide therapeutic decisions and identify novel effective approaches for precision care of inflammatory bowel disease. To the best of our knowledge, this expert analysis makes an original contribution with new insights poised at the emerging intersection of LHSs, microbiome science, and postgenomics medicine.

Increasing consumerism in healthcare through intelligent information technology.

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Cohen, Seth B; Grote, Kurt D; Pietraszek, Wayne E; Laflamme, Francois

2010-12-01

In healthcare, consumerism is not a product or program. Instead, it is an orientation to new care delivery models that encourage and enable greater patient responsibility through the intelligent use of information technology. Despite the promise of consumerism, current approaches have not fully realized the potential benefits of improved outcomes and lower cost. We recommend 4 guiding principles to ensure that next-generation innovation yields the returns that providers, patients, and other stakeholders expect: (1) keep the consumer at the center of innovation, (2) keep it simple, (3) link products and services to a broader "ecosystem" of care, and (4) encourage health in addition to treating illness. Now may be a particularly compelling time to invest in a consumerist approach.

Finnish perspectives of wireless in healthcare.

Science.gov (United States)

Alasaarela, Esko

2009-01-01

Wireless solutions are a good choice for healthcare development in Finland. A survey of 135 experts in Finland show that (1) the competences needed for developing wireless solutions exist (2) the Finnish healthcare system is integrated enough and (3) the technology industry in this area is too weak for global marketing. The following recommendations can be concluded: (1) Cooperate internationally (2) Develop integrated solutions and health managing concepts for the important health problems (such as diabetes), (3) Harness the healthcare system to act as a test bed for new solutions and (4) Help companies to grow and take global roles.

Preanalytical errors in primary healthcare: a questionnaire study of information search procedures, test request management and test tube labelling.

Science.gov (United States)

Söderberg, Johan; Brulin, Christine; Grankvist, Kjell; Wallin, Olof

2009-01-01

Most errors in laboratory medicine occur in the preanalytical phase and are the result of human mistakes. This study investigated information search procedures, test request management and test tube labelling in primary healthcare compared to the same procedures amongst clinical laboratory staff. A questionnaire was completed by 317 venous blood sampling staff in 70 primary healthcare centres and in two clinical laboratories (response rate = 94%). Correct procedures were not always followed. Only 60% of the primary healthcare staff reported that they always sought information in the updated, online laboratory manual. Only 12% reported that they always labelled the test tubes prior to drawing blood samples. No major differences between primary healthcare centres and clinical laboratories were found, except for test tube labelling, whereby the laboratory staff reported better practices. Re-education and access to documented routines were not clearly associated with better practices. The preanalytical procedure in the surveyed primary healthcare centres was associated with a risk of errors which could affect patient safety. To improve patient safety in laboratory testing, all healthcare providers should survey their preanalytical procedures and improve the total testing process with a systems perspective.

Integrated Compliance Information System (ICIS)

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U.S. Environmental Protection Agency — The purpose of ICIS is to meet evolving Enforcement and Compliance business needs for EPA and State users by integrating information into a single integrated data...

Integrating HIV care and treatment into primary healthcare: Are clinics equipped?

Directory of Open Access Journals (Sweden)

Talitha Crowley

2014-01-01

Full Text Available Background: The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting: The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal.Aim: The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics.Methods: A quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization’s guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities.Results: None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure.Conclusion: HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics.

Integrating HIV care and treatment into primary healthcare: Are clinics equipped?

Directory of Open Access Journals (Sweden)

Talitha Crowley

2014-08-01

Full Text Available Background: The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting: The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal. Aim: The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics. Methods: A quantitative, cross-sectional descriptive study was undertaken in 20 randomly-selected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization’s guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities. Results: None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure. Conclusion: HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics.

Transition from paediatric to adult healthcare for young people with cystic fibrosis: Parents' information needs.

Science.gov (United States)

Coyne, Imelda; Malone, Helen; Chubb, Emma; While, Alison E

2018-01-01

Parents of young people with cystic fibrosis (YPWCF) play an important role during the transition from paediatric to adult health services. There is limited evidence on parental information needs and the extent to which they are met. An online survey was conducted targeting a finite population of 190 parents of YPWCF in Ireland. Fifty-nine parents responded (31% response rate). Parents reported the need for more general preparation and timing of the transfer, more information regarding the differences between adult and child health services and how their child will self-manage his/her illness in the future. Most parents received information on the timing of transfer and new healthcare providers but reported being insufficiently informed about their legal status relating to medical confidentiality for their adult child and community resources available for their child after transition to adult health services. The findings highlight the importance of information and preparation for caregivers as well as young people to promote successful transition to adult healthcare. Providing parents with clear information and anticipatory guidance are simple changes in practice that may lead to improvements in transition experiences.

Reception of nutrition information by adult and older adult users of Primary Healthcare: Occurrence, associated factors, and sources of information

Directory of Open Access Journals (Sweden)

Ivana Loraine LINDEMANN

Full Text Available ABSTRACT Objective: To investigate reception of nutrition information (outcome, associated factors, and types of sources. Methods: This cross-sectional study, conducted in 2013, included 1,246 adult and older adult users of the Primary Healthcare network of Pelotas, Rio Grande do Sul, Brazil. The sample was characterized by reception of nutrition information, its sources, and demographic, socioeconomic, health, knowledge, and life habit variables. Prevalence ratios and their respective 95% confidence intervals investigated associations between reception of nutrition information and independent variables. Results: More than one-third of the sample (37.6% received nutrition information (95%CI=34.9-40.3. Older adults, individuals with positive self-perceived diet, those who received health information, and those who were physically active were more likely to receive nutrition information, and normal weight individuals were less likely. The outcome differed by income strata, being highest in the highest quintile. There was a linear trend for education level and for following the Ten Steps to Healthy Eating: the outcome was more likely in individuals with at least higher education and those who followed at least four steps. The most cited sources of nutrition information were television shows (56.2%, other (46.2%, physician (41.2%, Internet (25.1%, and family members (20.9%, which did not differ by sex. Conclusion: Primary healthcare users received little nutrition information, and television could be a useful tool for the institutions responsible for the sector to disseminate the official nutritional recommendations.

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

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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

Web-based Service Portal in Healthcare

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Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

Information delivery is one the most important task in healthcare. The growing sector of electronic healthcare has an important impact on the information delivery. There are two basic approaches towards information delivering. The first is web portal and second is touch-screen terminal. The aim of this paper is to investigate the web-based service portal. The most important advantage of web-based portal in the field of healthcare is an independent access for patients. This paper deals with the conditions and frameworks for healthcare portals

Current National Approach to Healthcare ICT Standardization: Focus on Progress in New Zealand.

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Park, Young-Taek; Atalag, Koray

2015-07-01

Many countries try to efficiently deliver high quality healthcare services at lower and manageable costs where healthcare information and communication technologies (ICT) standardisation may play an important role. New Zealand provides a good model of healthcare ICT standardisation. The purpose of this study was to review the current healthcare ICT standardisation and progress in New Zealand. This study reviewed the reports regarding the healthcare ICT standardisation in New Zealand. We also investigated relevant websites related with the healthcare ICT standards, most of which were run by the government. Then, we summarised the governance structure, standardisation processes, and their output regarding the current healthcare ICT standards status of New Zealand. New Zealand government bodies have established a set of healthcare ICT standards and clear guidelines and procedures for healthcare ICT standardisation. Government has actively participated in various enactments of healthcare ICT standards from the inception of ideas to their eventual retirement. Great achievements in eHealth have already been realized, and various standards are currently utilised at all levels of healthcare regionally and nationally. Standard clinical terminologies, such as International Classification of Diseases (ICD) and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) have been adopted and Health Level Seven (HL7) standards are actively used in health information exchanges. The government to New Zealand has well organised ICT institutions, guidelines, and regulations, as well as various programs, such as e-Medications and integrated care services. Local district health boards directly running hospitals have effectively adopted various new ICT standards. They might already be benefiting from improved efficiency resulting from healthcare ICT standardisation.

Information Integration; The process of integration, evolution and versioning

NARCIS (Netherlands)

de Keijzer, Ander; van Keulen, Maurice

2005-01-01

At present, many information sources are available wherever you are. Most of the time, the information needed is spread across several of those information sources. Gathering this information is a tedious and time consuming job. Automating this process would assist the user in its task. Integration

From buzzword to business strategy: the case for information and decision support systems in e-healthcare.

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Korukonda, Appa Rao; Korukonda, Saritha

2006-01-01

Although electronic healthcare can boast of a remarkable origin in modern-day e-commerce in the form of Electronic Data Interchange (EDI), its mission-critical nature in information-based strategising is yet to be realised. Restricting the scope of e-healthcare management to product advertisements and website management reflects an unfortunate trend of underutilisation of the scope of electronic decision support systems in pricing and other business strategies. This paper aims to illustrate how this trend can be corrected by transforming e-healthcare into a full-fledged business strategy for strategic positioning and corporate profitability. This argument is illustrated with the aid of a business example related to transfer pricing.

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

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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.

Integrated information theory of consciousness: an updated account.

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Tononi, G

2012-12-01

This article presents an updated account of integrated information theory of consciousness (liT) and some of its implications. /IT stems from thought experiments that lead to phenomenological axioms (existence, compositionality, information, integration, exclusion) and corresponding ontological postulates. The information axiom asserts that every experience is spec~fic - it is what it is by differing in its particular way from a large repertoire of alternatives. The integration axiom asserts that each experience is unified- it cannot be reduced to independent components. The exclusion axiom asserts that every experience is definite - it is limited to particular things and not others and flows at a particular speed and resolution. /IT formalizes these intuitions with postulates. The information postulate states that only "differences that make a difference" from the intrinsic perpective of a system matter: a mechanism generates cause-effect information if its present state has selective past causes and selective future effects within a system. The integration postulate states that only information that is irreducible matters: mechanisms generate integrated information only to the extent that the information they generate cannot be partitioned into that generated within independent components. The exclusion postulate states that only maxima of integrated information matter: a mechanism specifies only one maximally irreducible set of past causes and future effects - a concept. A complex is a set of elements specifying a maximally irreducible constellation of concepts, where the maximum is evaluated over elements and at the optimal spatiatemporal scale. Its concepts specify a maximally integrated conceptual information structure or quale, which is identical with an experience. Finally, changes in information integration upon exposure to the environment reflect a system's ability to match the causal structure of the world. After introducing an updated definition of

Regional Logistics Information Resources Integration Patterns and Countermeasures

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Wu, Hui; Shangguan, Xu-ming

Effective integration of regional logistics information resources can provide collaborative services in information flow, business flow and logistics for regional logistics enterprises, which also can reduce operating costs and improve market responsiveness. First, this paper analyzes the realistic significance on the integration of regional logistics information. Second, this paper brings forward three feasible patterns on the integration of regional logistics information resources, These three models have their own strengths and the scope of application and implementation, which model is selected will depend on the specific business and the regional distribution of enterprises. Last, this paper discusses the related countermeasures on the integration of regional logistics information resources, because the integration of regional logistics information is a systems engineering, when the integration is advancing, the countermeasures should pay close attention to the current needs and long-term development of regional enterprises.

External factors in hospital information system (HIS) adoption model: a case on Malaysia.

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Lee, Heng Wei; Ramayah, Thurasamy; Zakaria, Nasriah

2012-08-01

Studies related to healthcare ICT integration in Malaysia are relatively little, thus this paper provide a literature review of the integration of information and communication technologies (ICT) in the healthcare sector in Malaysia through the hospital information system (HIS). Our study emphasized on secondary data to investigate the factors related to ICT integration in healthcare through HIS. Therefore this paper aimed to gather an in depth understanding of issues related to HIS adoption, and contributing in fostering HIS adoption in Malaysia and other countries. This paper provides a direction for future research to study the correlation of factors affecting HIS adoption. Finally a research model is proposed using current adoption theories and external factors from human, technology, and organization perspectives.

Healthcare predictive analytics: An overview with a focus on Saudi Arabia.

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Alharthi, Hana

2018-03-08

Despite a newfound wealth of data and information, the healthcare sector is lacking in actionable knowledge. This is largely because healthcare data, though plentiful, tends to be inherently complex and fragmented. Health data analytics, with an emphasis on predictive analytics, is emerging as a transformative tool that can enable more proactive and preventative treatment options. This review considers the ways in which predictive analytics has been applied in the for-profit business sector to generate well-timed and accurate predictions of key outcomes, with a focus on key features that may be applicable to healthcare-specific applications. Published medical research presenting assessments of predictive analytics technology in medical applications are reviewed, with particular emphasis on how hospitals have integrated predictive analytics into their day-to-day healthcare services to improve quality of care. This review also highlights the numerous challenges of implementing predictive analytics in healthcare settings and concludes with a discussion of current efforts to implement healthcare data analytics in the developing country, Saudi Arabia. Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.

Health Literacy and Health-Care Engagement as Predictors of Shared Decision-Making Among Adult Information Seekers in the USA: a Secondary Data Analysis of the Health Information National Trends Survey.

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Wigfall, Lisa T; Tanner, Andrea H

2018-02-01

The objective of this study is to examine the relationship between health literacy, health-care engagement, and shared decision-making (SDM). We analyzed Health Information National Trends Survey 4 (cycle 3) data for 1604 information seekers who had one or more non-emergency room health-care visits in the previous year. SDM was more than two times higher among adults who "always" versus "usually/sometimes/never" take health information to doctor visits (OR = 2.54; 95 % CI 1.19-5.43). There was a twofold increase in SDM among adults who were "completely/very confident" versus "somewhat/a little/not confident" about finding health information (OR = 2.03; 95 % CI 1.37-3.02). Differences in SDM between adults who understood health information and those who had difficulty understanding health information were not statistically significant (OR = 1.39; 95 % CI 0.93-2.07). A Healthy People 2020 goal is to increase SDM. Previous research has suggested that SDM may improve health outcomes across the continuum of care. Only about half of adults report always being involved in health-care decisions. Even more alarming is the fact that SDM has not increased from 2003 to 2013. Our findings suggest that increasing health literacy has the potential to increase health-care engagement and subsequently increase SDM. Effective intervention strategies are needed to improve health literacy and promote health-care engagement.

Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study.

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Jiang, Shan; Powers, Matthew; Allison, David; Vincent, Ellen

2017-07-01

This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people's preference scores. The factor analysis indicated additional supportive features that may affect people's preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.

Contract Design: The problem of information asymmetry

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Axel C. Mühlbacher

2018-01-01

Full Text Available Introduction: Integrated care systems are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. Little is known about the contractual design and the main challenges of delegating “accountability” to these new kinds of organisations and/or contracts. The research question in this article focuses on how healthcare contracts can look like and which possible problems arise in designing such contracts. In this a special interest is placed on information asymmetries.  Methods: A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. This article is the first in a row of three that all contribute to a specific issue in designing healthcare contracts. Starting with the organisation of contracts and information asymmetries, part 2 focusses on financial options and risks and part 3 finally concludes with the question of risk management and evaluation.  Results: Healthcare contracting between providers and payers will have a major impact on the overall design of future healthcare systems. If Integrated care systems or any other similar concept of care delivery are to be contracted directly by payers to manage the continuum of care the costs of market utilisation play an essential role. Transaction costs also arise in the course of the negotiation and implementation of contracts. These costs are the reason why it is generally not possible to conclude perfect (complete contracts. Problems with asymmetric distribution of information can relate to the situation before a contract is concluded (adverse selection and after conclusion of a contract (moral hazard.  Discussion and Conclusions: Information asymmetries are seen as a major obstacle to the efficient operation of integrated care programmes. Coordination and motivation problems cannot be solved

Contract Design: The problem of information asymmetry.

Science.gov (United States)

Mühlbacher, Axel C; Amelung, Volker E; Juhnke, Christin

2018-01-12

Integrated care systems are advocated as an effective method of improving the performance of healthcare systems. These systems outline a payment and care delivery model that intends to tie provider reimbursements to predefined quality metrics. Little is known about the contractual design and the main challenges of delegating "accountability" to these new kinds of organisations and/or contracts. The research question in this article focuses on how healthcare contracts can look like and which possible problems arise in designing such contracts. In this a special interest is placed on information asymmetries. A comprehensive literature review on methods of designing contracts in Integrated Care was conducted. This article is the first in a row of three that all contribute to a specific issue in designing healthcare contracts. Starting with the organisation of contracts and information asymmetries, part 2 focusses on financial options and risks and part 3 finally concludes with the question of risk management and evaluation. Healthcare contracting between providers and payers will have a major impact on the overall design of future healthcare systems. If Integrated care systems or any other similar concept of care delivery are to be contracted directly by payers to manage the continuum of care the costs of market utilisation play an essential role. Transaction costs also arise in the course of the negotiation and implementation of contracts. These costs are the reason why it is generally not possible to conclude perfect (complete) contracts. Problems with asymmetric distribution of information can relate to the situation before a contract is concluded (adverse selection) and after conclusion of a contract (moral hazard). Information asymmetries are seen as a major obstacle to the efficient operation of integrated care programmes. Coordination and motivation problems cannot be solved at no-costs. The presented problems in the design of selective individual contracts

MOBILE CLOUD COMPUTING APPLIED TO HEALTHCARE APPROACH

OpenAIRE

Omar AlSheikSalem

2016-01-01

In the past few years it was clear that mobile cloud computing was established via integrating both mobile computing and cloud computing to be add in both storage space and processing speed. Integrating healthcare applications and services is one of the vast data approaches that can be adapted to mobile cloud computing. This work proposes a framework of a global healthcare computing based combining both mobile computing and cloud computing. This approach leads to integrate all of ...

Bottom-up and middle-out approaches to electronic patient information systems: a focus on healthcare pathways

Directory of Open Access Journals (Sweden)

Ken Eason

2013-12-01

Full Text Available Background A study is reported that examines the use of electronic health record (EHR systems in two UK local health communities.Objective These systems were developed locally and the aim of the study was to explore how well they were supporting the coordination of care along healthcare pathways that cross the organisational boundaries between the agencies delivering health care.Results The paper presents the findings for two healthcare pathways; the Stroke Pathway and a pathway for the care of the frail elderly in their own homes. All the pathways examined involved multiple agencies and many locally tailored EHR systems are in use to aid the coordination of care. However, the ability to share electronic patient information along the pathways was patchy. The development of systems that enabled effective sharing of information was characterised by sociotechnical system development, i.e. associating the technical development with process changes and organisational changes, with local development teams that drew on all the relevant agencies in the local health community and on evolutionary development, as experience grew of the benefits that EHR systems could deliver.Conclusions The study concludes that whilst there may be a role for a national IT strategy, for example, to set standards for systems procurement that facilitate data interchange, most systems development work needs to be done at a ‘middle-out’ level in the local health community, where joint planning between healthcare agencies can occur, and at the local healthcare pathway level where systems can be matched to specific needs for information sharing.

Healthcare technology innovation adoption electronic health records and other emerging health information technology innovations

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Daim, Tugrul U; Basoglu, Nuri; Kök, Orhun M; Hogaboam, Liliya

2016-01-01

This book aims to study the factors affecting the adoption and diffusion of Health Information Technology (HIT) innovation. It analyzes the adoption processes of various tools and applications, particularly Electronic Health Records (EHR), highlighting the impact on various sectors of the healthcare system, such as physicians, administration,  and patient care, while also identifying the various pitfalls and gaps in the literature. With the various challenges currently facing the United States healthcare system, the study, adoption and diffusion of healthcare technology innovation, particularly HIT, is imperative to achieving national goals. This book is organized into three sections. Section one reviews theories and applications for the diffusion of Health Care Technologies. Section two evaluates EHR technology, including the barriers and enables in adoption and alternative technologies. Finally, section three examines the factors impacting the adoption of EHR systems. This book will be a key source for stu...

Migrants' access to healthcare

DEFF Research Database (Denmark)

Norredam, Marie

2011-01-01

There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare...... according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why...... are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were...

Recommended Vaccines for Healthcare Workers

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... Vaccination Resources for Healthcare Professionals Recommended Vaccines for Healthcare Workers Recommend on Facebook Tweet Share Compartir On ... for More Information Resources for Those Vaccinating HCWs Healthcare workers (HCWs) are at risk for exposure to ...

Management-By-Objectives in Healthcare

DEFF Research Database (Denmark)

Traberg, Andreas

that managers are able to incorporate those indicators they find useful in their department, and thus secure sufficient informational support for the department's decision-making processes. The Performance Account thereby eases the identification of areas suited for corrective actions, and provides the decision......; collectively, however, they pose a significant drawback. The vast selection of self-contained initiatives limits the overview for decision makers and imposes an escalating administrative burden on operational staff members. Contrary to the initial objective, the expanding informational burden limits...... the overview and transparency for healthcare decision makers; as a result, well-documented initiatives fail to become integrated support in operational decision-making processes. This research work has thus striven to design a holistic Management-By-Objectives framework that can enable managers and operational...

Leveraging health information technology to achieve the "triple aim" of healthcare reform.

Science.gov (United States)

Sheikh, Aziz; Sood, Harpreet S; Bates, David W

2015-07-01

To investigate experiences with leveraging health information technology (HIT) to improve patient care and population health, and reduce healthcare expenditures. In-depth qualitative interviews with federal government employees, health policy, HIT and medico-legal experts, health providers, physicians, purchasers, payers, patient advocates, and vendors from across the United States. The authors undertook 47 interviews. There was a widely shared belief that Health Information Technology for Economic and Clinical Health (HITECH) had catalyzed the creation of a digital infrastructure, which was being used in innovative ways to improve quality of care and curtail costs. There were however major concerns about the poor usability of electronic health records (EHRs), their limited ability to support multi-disciplinary care, and major difficulties with health information exchange, which undermined efforts to deliver integrated patient-centered care. Proposed strategies for enhancing the benefits of HIT included federal stimulation of competition by mandating vendors to open-up their application program interfaces, incenting development of low-cost consumer informatics tools, and promoting Congressional review of the The Health Insurance Portability and Accountability Act (HIPPA) to optimize the balance between data privacy and reuse. Many underscored the need to "kick the legs from underneath the fee-for-service model" and replace it with a data-driven reimbursement system that rewards high quality care. The HITECH Act has stimulated unprecedented, multi-stakeholder interest in HIT. Early experiences indicate that the resulting digital infrastructure is being used to improve quality of care and curtail costs. Reform efforts are however severely limited by problems with usability, limited interoperability and the persistence of the fee-for-service paradigm-addressing these issues therefore needs to be the federal government's main policy target. © The Author 2015

Integrated Information Management (IIM)

National Research Council Canada - National Science Library

McIlvain, Jason

2007-01-01

Information Technology is the core capability required to align our resources and increase our effectiveness on the battlefield by integrating and coordinating our preventative measures and responses...

Health Digital Divide in the Era of Precision Healthcare: Taking Yunnan Province as an Example.

Science.gov (United States)

Peng, Yan; Yan, Li; Kuanghua, Liuwang; Tang, Guozheng

2017-01-01

With healthcare coming into the era of Precision Healthcare, it will facilitate the development of health informatics from information processing, integration, analysis, application and other uses. If we ignore the e-health development of developing areas, it will bring a health digital divide. This study takes Yunnan province as an example, and analyzes the problems of e-health development in a developing area, hoping to get more attention from researchers and regulators.

Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

Science.gov (United States)

Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

2017-04-21

Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

Integrated Reporting Information System -

Data.gov (United States)

Department of Transportation — The Integrated Reporting Information System (IRIS) is a flexible and scalable web-based system that supports post operational analysis and evaluation of the National...

Cognitive overload and communication in two healthcare settings.

Science.gov (United States)

Cicourel, Aaron V

2004-01-01

The confluence of organizational social interaction and cognitive information processing constraints create 'noisy' conditions in institutionalized settings. Attentional and memory limitations always influence the ability of participants to comprehend each other's communication. Two organizational settings (a medical specialty clinic and periodontal office) will be used to explore a few features of healthcare delivery that are often ignored in studies of such systems. Scheduling appointments, for example, creates stress for both patients and healthcare personnel but is often an unexamined aspect of healthcare delivery that has become both challenging and often irritating for all concerned. For example, when patients call, someone at a general scheduling center or the particular clinic or office of an individual physician or dentist or a group practice will answer the call with a menu of options, or the caller may be asked to leave message. When a patient leaves a clinic or surgery office after a visit, they may be allowed to make a new appointment. The term 'cognitive overload' is a ubiquitous element of all healthcare systems and refers to organizationally induced and constrained limited capacity processing inherent in the way improvised discourse practices, and annotative devices or artifacts (such as written notes or some related strategy) become an integral part of everyday healthcare delivery.

Improvement and renewal of healthcare processes : results of an empirical research project

NARCIS (Netherlands)

Bij, van der J.D.; Dijkstra, L.; Vries, de G.; Walburg, J.A.

1999-01-01

Professionals in healthcare organizations, who generally produce high-quality work, commonly operate in isolation or locally. However, due to developments in society and legislation, healthcare organizations are forced to integrate healthcare activities, and achieve integral quality management,

Accounting System in Croatian Public Healthcare Organizations: an Empirical Analysis

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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.

Undergraduate nurses' preferred use of mobile devices in healthcare settings.

Science.gov (United States)

Mather, Carey; Cummings, Elizabeth; Allen, Penny

2015-01-01

The growth of digital technology has created challenges for appropriate and safe use of mobile or portable devices in healthcare environments. There is perceived risk that the use of mobile technology for learning may distract from provision of patient care if used by undergraduate students during work-integrated learning. This paper reports on a study that aimed to identify differences in preferred behavior of student nurses in their use of mobile technology during and away from the clinical practice environment. A previously validated online survey was administered to students during a period of work integrated learning in a range of healthcare settings in two Australian states. Respondents agreed that mobile devices could be beneficial to patient care. Overall, students proposed they would use mobile devices for accessing information, during work integrated learning, less than when away from the workplace. The development of policy to guide the use of mobile devices, in situ, is important to the provision of safe and competent care and improved health outcomes for patients.

Integration of Health Services Improves Multiple Healthcare Outcomes Among HIV-infected People Who Inject Drugs in Ukraine

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Bachireddy, Chethan; Soule, Michael C.; Izenberg, Jacob M.; Dvoryak, Sergey; Dumchev, Konstantin; Altice, Frederick L.

2013-01-01

Background People who inject drugs (PWID) experience poor outcomes and fuel HIV epidemics in middle-income countries in Eastern Europe and Central Asia. We assess integrated/co-located (ICL) healthcare for HIV-infected PWID, which despite international recommendations, is neither widely available nor empirically examined. Methods A 2010 cross-sectional study randomly sampled 296 HIV-infected opioid-dependent PWID from two representative HIV-endemic regions in Ukraine where ICL, non-co-located (NCL) and harm reduction/outreach (HRO) settings are available. ICL settings provide onsite HIV, addiction, and tuberculosis services, NCLs only treat addiction, and HROs provide counseling, needles/syringes, and referrals, but no opioid substitution therapy (OST). The primary outcome was receipt of quality healthcare, measured using a quality healthcare indicator (QHI) composite score representing percentage of eight guidelines-based recommended indicators met for HIV, addiction and tuberculosis treatment. The secondary outcomes were individual QHIs and health-related quality-of-life (HRQoL). Results On average, ICL-participants had significantly higher QHI composite scores compared to NCL- and HRO-participants (71.9% versus 54.8% versus 37.0%, p<0.001) even after controlling for potential confounders. Compared to NCL-participants, ICL-participants were significantly more likely to receive antiretroviral therapy (49.5% versus 19.2%, p<0.001), especially if CD4≤200 (93.8% versus 62.5% p<0.05); guideline-recommended OST dosage (57.3% versus 41.4%, p<0.05); and isoniazid preventive therapy (42.3% versus 11.2%, p<0.001). Subjects receiving OST had significantly higher HRQoL than those not receiving it (p<0.001); however, HRQoL did not differ significantly between ICL- and NCL-participants. Conclusions These findings suggest that OST alone improves quality-of-life, while receiving care in integrated settings collectively and individually improves healthcare quality for PWID

Responsible healthcare innovation: anticipatory governance of nanodiagnostics for theranostics medicine.

Science.gov (United States)

Fisher, Erik; Boenink, Marianne; van der Burg, Simone; Woodbury, Neal

2012-11-01

Theranostics signals the integrated application of molecular diagnostics, therapeutic treatment and patient response monitoring. Such integration has hitherto neglected another crucial dimension: coproduction of theranostic scientific knowledge, novel technological development and broader sociopolitical systems whose boundaries are highly porous. Nanodiagnostics applications to theranostics are one of the most contested and potentially volatile postgenomics innovation trajectories as they build on past and current tensions and promises surrounding both nanotechnology and personalized medicine. Recent science policy research suggests that beneficial outcomes of innovations do not simply flow from the generation of scientific knowledge and technological capability in a linear or automatic fashion. Thus, attempts to offset public concerns about controversial emerging technologies by expert risk assurances can be unproductive. Anticipation provides a more robust basis for governance that supports genuine healthcare progress. This article presents a synthesis of novel policy approaches that directly inform theranostics medicine and the future(s) of postgenomics healthcare.

Mobile healthcare information management utilizing Cloud Computing and Android OS.

Science.gov (United States)

Doukas, Charalampos; Pliakas, Thomas; Maglogiannis, Ilias

2010-01-01

Cloud Computing provides functionality for managing information data in a distributed, ubiquitous and pervasive manner supporting several platforms, systems and applications. This work presents the implementation of a mobile system that enables electronic healthcare data storage, update and retrieval using Cloud Computing. The mobile application is developed using Google's Android operating system and provides management of patient health records and medical images (supporting DICOM format and JPEG2000 coding). The developed system has been evaluated using the Amazon's S3 cloud service. This article summarizes the implementation details and presents initial results of the system in practice.

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.

How do supply-side factors influence informal payments for healthcare? The case of HIV patients in Cameroon.

Science.gov (United States)

Kankeu, Hyacinthe Tchewonpi; Boyer, Sylvie; Fodjo Toukam, Raoul; Abu-Zaineh, Mohammad

2016-01-01

Direct out-of-pocket payments for healthcare continue to be a major source of health financing in low-income and middle-income countries. Some of these direct payments take the form of informal charges paid by patients to access the needed healthcare services. Remarkably, however, little is known about the extent to which these payments are exercised and their determinants in the context of Sub-Saharan Africa. This study attempts therefore to shed light on the role of supply-side factors in the occurrence of informal payments while accounting for the demand-side factors. The study relies on data taken from a nationally representative survey conducted among people living with HIV/AIDS in Cameroon. A multilevel mixed-effect logistic model is employed to identify the factors associated with the incidence of informal payments. Results reveal that circa 3.05% of the surveyed patients incurred informal payments for the consultations made on the day of the survey. The amount paid informally represents up to four times the official tariff. Factors related to the following: (i) human resource management of the health facilities (e.g., task shifting); (ii) health professionals' perceptions vis-à-vis the remunerations of HIV care provision; and (iii) reception of patients (e.g., waiting time) significantly influence the probability of incurring informal payments. Also of note, the type of healthcare facilities is found to play a role: informal payments appear to be significantly lower in private non-profit facilities compared with those belonging to public sector. Our findings allude to some policy recommendations that can help reduce the incidence of informal payments. Copyright © 2014 John Wiley & Sons, Ltd.

Creating value-focused healthcare delivery systems: Part three--Core competencies.

Science.gov (United States)

Beveridge, R N

1997-01-01

Value is created through the delivery of high-quality, cost--effective healthcare services. The ability to create value from the providers' perspective is facilitated through the development and implementation of essential, customer-focused core competencies. These core competencies include customer relationship management, payer/provider relationship management, disease management, outcomes management, financial/cost management, and information management. Customer relationship management is the foundation upon which all core competencies must be built. All of the core competencies must focus on the needs of the customers, both internal and external. Structuring all processes involved in the core competencies from the perspective of the customer will ensure that value is created throughout the system. Payer/provider relationship management will become a crucial pillar for healthcare providers in the future. As more vertical integration among providers occurs, the management of the relationships among providers and with payers will become more important. Many of the integration strategies being implemented across the country involve the integration of hospitals, physicians, and payers to form accountable health plans. The relationships must be organized to form "win/win" situations, where all parties are focused on a shared vision of creating value and none of the parties benefits at the expense of the others. Disease management in creating value requires that we begin examining the disease process along the entire continuum. Not only must providers be able to provide high-quality acute and chronic care, but they must also begin to focus more heavily on programs of prevention. Value is created throughout the system through reducing the prevalence and incidence of disease. Only through managing the full continuum of health will value be created throughout the healthcare delivery system. Outcomes management ensures that the outcomes are the highest quality at a cost

Identifying preferred format and source of exercise information in persons with multiple sclerosis that can be delivered by health-care providers.

Science.gov (United States)

Learmonth, Yvonne C; Adamson, Brynn C; Balto, Julia M; Chiu, Chung-Yi; Molina-Guzman, Isabel M; Finlayson, Marcia; Riskin, Barry J; Motl, Robert W

2017-10-01

There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health-care providers among persons with MS. We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health-care providers. Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States. Fifty semi-structured interviews were conducted and analysed using thematic analysis. Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in-person consultations with health-care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health-care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists). These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health-care providers including neurologists and physical therapists should be involved in exercise promotion. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

iMAGE cloud: medical image processing as a service for regional healthcare in a hybrid cloud environment.

Science.gov (United States)

Liu, Li; Chen, Weiping; Nie, Min; Zhang, Fengjuan; Wang, Yu; He, Ailing; Wang, Xiaonan; Yan, Gen

2016-11-01

To handle the emergence of the regional healthcare ecosystem, physicians and surgeons in various departments and healthcare institutions must process medical images securely, conveniently, and efficiently, and must integrate them with electronic medical records (EMRs). In this manuscript, we propose a software as a service (SaaS) cloud called the iMAGE cloud. A three-layer hybrid cloud was created to provide medical image processing services in the smart city of Wuxi, China, in April 2015. In the first step, medical images and EMR data were received and integrated via the hybrid regional healthcare network. Then, traditional and advanced image processing functions were proposed and computed in a unified manner in the high-performance cloud units. Finally, the image processing results were delivered to regional users using the virtual desktop infrastructure (VDI) technology. Security infrastructure was also taken into consideration. Integrated information query and many advanced medical image processing functions-such as coronary extraction, pulmonary reconstruction, vascular extraction, intelligent detection of pulmonary nodules, image fusion, and 3D printing-were available to local physicians and surgeons in various departments and healthcare institutions. Implementation results indicate that the iMAGE cloud can provide convenient, efficient, compatible, and secure medical image processing services in regional healthcare networks. The iMAGE cloud has been proven to be valuable in applications in the regional healthcare system, and it could have a promising future in the healthcare system worldwide.

Healthcare Practitioners' Personal and Professional Values

Science.gov (United States)

Moyo, Mpatisi; Goodyear-Smith, Felicity A.; Weller, Jennifer; Robb, Gillian; Shulruf, Boaz

2016-01-01

Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them…

Empowering Patients through Healthcare Technology and Information? The Challenge of becoming a Patient 2.0

DEFF Research Database (Denmark)

Brodersen, Søsser Grith Kragh; Lindegaard, Hanne

2015-01-01

of themselves appeared in newspapers, and self-management and telecare technologies were seen as ways to change elderly patients practices. Transformation of the traditional healthcare system remains on the agenda, and it continues to challenge the traditional view of the patient role (framed in this article...... on numerical representations of illness (i.e., metrics) than on direct observations of patients. Through ethnographic research in the Danish healthcare sector, we show how this new healthcare vision actually manifests in practice by presenting cases of elderly heart and diabetes patients. Technologies aimed......Abstract: In the mid-2000s, the term Patient 2.0 began to be used to denote a new patient role: empowered patients were expected to engage with various types of information and specific technologies in order to manage their own illnesses. Headlines such as Future patients will take care...

Integrated decision making in healthcare: an operations research and management science perspective

NARCIS (Netherlands)

Hulshof, P.J.H.

2013-01-01

The pressure on healthcare systems rises as both demand for healthcare and expenditures are increasing steadily. As a result, healthcare professionals face the challenging task to design and organize the healthcare delivery process more effectively and efficiently. Designing and organizing processes

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.

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions

International Nuclear Information System (INIS)

Kim, Chang Soo

2008-01-01

Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions

Energy Technology Data Exchange (ETDEWEB)

Kim, Chang Soo [Dept. of Radiological Science, College of Health Science, Catholic University of Pusan, Pusan (Korea, Republic of)

2008-03-15

Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

Integrity mechanism for eHealth tele-monitoring system in smart home environment.

Science.gov (United States)

Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

2009-01-01

During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described.

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

The importance of measuring unmet healthcare needs.

Science.gov (United States)

Gauld, Robin; Raymont, Antony; Bagshaw, Philip F; Nicholls, M Gary; Frampton, Christopher M

2014-10-17

Major restructuring of the health sector has been undertaken in many countries, including New Zealand and England, yet objective assessment of the outcomes has rarely been recorded. In the absence of comprehensive objective data, the success or otherwise of health reforms has been inferred from narrowly-focussed data or anecdotal accounts. A recent example relates to a buoyant King's Fund report on the quest for integrated health and social care in Canterbury, New Zealand which prompted an equally supportive editorial article in the British Medical Journal (BMJ) suggesting it may contain lessons for England's National Health Service. At the same time, a report published in the New Zealand Medical Journal expressed concerns at the level of unmet healthcare needs in Canterbury. Neither report provided objective information about changes over time in the level of unmet healthcare needs in Canterbury. We propose that the performance of healthcare systems should be measured regularly, objectively and comprehensively through documentation of unmet healthcare needs as perceived by representative segments of the population at formal interview. Thereby the success or otherwise of organisational changes to a health system and its adequacy as demographics of the population evolve, even in the absence of major restructuring of the health sector, can be better documented.

eHealth integration and interoperability issues: towards a solution through enterprise architecture.

Science.gov (United States)

Adenuga, Olugbenga A; Kekwaletswe, Ray M; Coleman, Alfred

2015-01-01

Investments in healthcare information and communication technology (ICT) and health information systems (HIS) continue to increase. This is creating immense pressure on healthcare ICT and HIS to deliver and show significance in such investments in technology. It is discovered in this study that integration and interoperability contribute largely to this failure in ICT and HIS investment in healthcare, thus resulting in the need towards healthcare architecture for eHealth. This study proposes an eHealth architectural model that accommodates requirement based on healthcare need, system, implementer, and hardware requirements. The model is adaptable and examines the developer's and user's views that systems hold high hopes for their potential to change traditional organizational design, intelligence, and decision-making.

Integrating Fingerprint Verification into the Smart Card-Based Healthcare Information System

OpenAIRE

Jin-Won Park; Sung Bum Pan; Yongwha Chung; Daesung Moon

2009-01-01

As VLSI technology has been improved, a smart card employing 32-bit processors has been released, and more personal information such as medical, financial data can be stored in the card. Thus, it becomes important to protect personal information stored in the card. Verification of the card holder's identity using a fingerprint has advantages over the present practices of Personal Identification Numbers (PINs) and passwords. However, the computational workload of fingerprint verification i...

Radiology information system: a workflow-based approach

International Nuclear Information System (INIS)

Zhang, Jinyan; Lu, Xudong; Nie, Hongchao; Huang, Zhengxing; Aalst, W.M.P. van der

2009-01-01

Introducing workflow management technology in healthcare seems to be prospective in dealing with the problem that the current healthcare Information Systems cannot provide sufficient support for the process management, although several challenges still exist. The purpose of this paper is to study the method of developing workflow-based information system in radiology department as a use case. First, a workflow model of typical radiology process was established. Second, based on the model, the system could be designed and implemented as a group of loosely coupled components. Each component corresponded to one task in the process and could be assembled by the workflow management system. The legacy systems could be taken as special components, which also corresponded to the tasks and were integrated through transferring non-work- flow-aware interfaces to the standard ones. Finally, a workflow dashboard was designed and implemented to provide an integral view of radiology processes. The workflow-based Radiology Information System was deployed in the radiology department of Zhejiang Chinese Medicine Hospital in China. The results showed that it could be adjusted flexibly in response to the needs of changing process, and enhance the process management in the department. It can also provide a more workflow-aware integration method, comparing with other methods such as IHE-based ones. The workflow-based approach is a new method of developing radiology information system with more flexibility, more functionalities of process management and more workflow-aware integration. The work of this paper is an initial endeavor for introducing workflow management technology in healthcare. (orig.)

Information technology for competitive advantage: the case of learning and innovation in behavioural healthcare service.

Science.gov (United States)

Hsieh, Chang-tseh; Lin, Binshan

2011-01-01

The utilisation of IS/IT could offer a substantial competitive advantage to healthcare service providers through the realisation of improved clinical, financial, and administrative outcomes. In this study, 42 journal articles were reviewed and summarised with respect to identified benefits and challenges of the development and implementation of electronic medical records, tele-health, and electronic appointment reminders. Results of this study help pave the knowledge foundation for management of the behavioural healthcare to learn how to apply state-of-the-art information technology to offer higher quality, clinically proven effective services at lower costs than those of their competitors.

GeoMedStat: an integrated spatial surveillance system to track air pollution and associated healthcare events

Directory of Open Access Journals (Sweden)

Fazlay S. Faruque

2014-12-01

Full Text Available Air pollutants, such as particulate matter with a diameter ≤2.5 microns (PM2.5 and ozone (O3, are known to exacerbate asthma and other respiratory diseases. An integrated surveillance system that tracks such air pollutants and associated disease incidence can assist in risk assessment, healthcare preparedness and public awareness. However, the implementation of such an integrated environmental health surveillance system is a challenge due to the disparate sources of many types of data and the implementation becomes even more complicated for a spatial and real-time system due to lack of standardised technological components and data incompatibility. In addition, accessing and utilising health data that are considered as Protected Health Information (PHI require maintaining stringent protocols, which have to be supported by the system. This paper aims to illustrate the development of a spatial surveillance system (GeoMedStat that is capable of tracking daily environmental pollutants along with both daily and historical patient encounter data. It utilises satellite data and the groundmonitor data from the US National Aeronautics and Space Administration (NASA and the US Environemental Protection Agenecy (EPA, rspectively as inputs estimating air pollutants and is linked to hospital information systems for accessing chief complaints and disease classification codes. The components, developmental methods, functionality of GeoMedStat and its use as a real-time environmental health surveillance system for asthma and other respiratory syndromes in connection with with PM2.5 and ozone are described. It is expected that the framework presented will serve as an example to others developing real-time spatial surveillance systems for pollutants and hospital visits.

Freeform electronics for advanced healthcare

KAUST Repository

Hussain, Muhammad Mustafa

2017-02-16

Freeform (physically flexible, stretchable and reconfigurable) electronics can be critical enabler for advanced personalized healthcare. With increased global population and extended average lifetime of mankind, it is more important than ever to integrate advanced electronics into our daily life for advanced personalized healthcare. In this paper, we discuss some critical criteria to design such electronics with enabling applications.

Freeform electronics for advanced healthcare

KAUST Repository

Hussain, Muhammad Mustafa; Hussain, Aftab M.; Nassar, Joanna M.; Kutbee, Arwa T.; Gumus, Abdurrahman; Hanna, Amir

2017-01-01

Freeform (physically flexible, stretchable and reconfigurable) electronics can be critical enabler for advanced personalized healthcare. With increased global population and extended average lifetime of mankind, it is more important than ever to integrate advanced electronics into our daily life for advanced personalized healthcare. In this paper, we discuss some critical criteria to design such electronics with enabling applications.

CALINX (California Information Exchange): a multi-stakeholder statewide initiative to improve healthcare information flows.

Science.gov (United States)

Hopkins, D S; Oswald, N; McCaffrey, K; Bressler, S; Davidson, N; Vela, L

2000-01-01

Given the diffusion of responsibilities for gathering and reporting healthcare information in a managed care environment, California stakeholders are taking concrete steps to break the deadlock on data and information flows that has characterized the industry for some time. The California Information Exchange (CALINX) was established to facilitate the implementation of the Health Insurance Portability and Accountability Act (HIPAA) standards in California and to create trust for data exchange between trading partners, without which data exchange still will not occur. Strategic directions are set by the chief executives of key associations and organizations representing purchasers, plans, providers, and consumers. Multi-stakeholder workgroups have produced detailed data guidelines for the HIPAA standards along with rules for exchange of key data sets between trading partners. These rules address frequency, timeliness, and accuracy of data submission. Both the data guidelines and the rules have been tested in live demonstration projects, and the results of these projects have been reported to substantiate the business case for implementation. Further incentives are being built into contracts between purchasers and plans, and between plans and providers. CALINX is currently promoting widespread adoption of the data guidelines and rules for exchange with all members of the industry.

Efficient Algorithms for Searching the Minimum Information Partition in Integrated Information Theory

Science.gov (United States)

Kitazono, Jun; Kanai, Ryota; Oizumi, Masafumi

2018-03-01

The ability to integrate information in the brain is considered to be an essential property for cognition and consciousness. Integrated Information Theory (IIT) hypothesizes that the amount of integrated information ($\\Phi$) in the brain is related to the level of consciousness. IIT proposes that to quantify information integration in a system as a whole, integrated information should be measured across the partition of the system at which information loss caused by partitioning is minimized, called the Minimum Information Partition (MIP). The computational cost for exhaustively searching for the MIP grows exponentially with system size, making it difficult to apply IIT to real neural data. It has been previously shown that if a measure of $\\Phi$ satisfies a mathematical property, submodularity, the MIP can be found in a polynomial order by an optimization algorithm. However, although the first version of $\\Phi$ is submodular, the later versions are not. In this study, we empirically explore to what extent the algorithm can be applied to the non-submodular measures of $\\Phi$ by evaluating the accuracy of the algorithm in simulated data and real neural data. We find that the algorithm identifies the MIP in a nearly perfect manner even for the non-submodular measures. Our results show that the algorithm allows us to measure $\\Phi$ in large systems within a practical amount of time.

An integrative review of the impact of mobile technologies used by healthcare professionals to support education and practice.

Science.gov (United States)

Guo, Ping; Watts, Kim; Wharrad, Heather

2016-04-01

The aim of this study was to provide evidence of the impact of mobile technologies among healthcare professionals in education and practice settings. Integrative literature review. Electronic databases including MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC and Web of Science were searched for papers published between 2002-2012. Quantitative studies were critically evaluated based on Thomas et al .'s framework, while the consolidated criteria for reporting qualitative research was used to appraise the rigour of the qualitative studies. Seventeen quantitative and three qualitative studies were included. The findings suggest a largely positive influence of mobile technologies on various clinical practice and educational outcomes. However, robust evidence was limited. Use of mobile technologies in health care are associated with improvements in access to information, accuracy and efficiency, evidence-based decision making at the point of care and enhancement in performance, confidence and engagement in different contexts.

[Nursing home placement of people with dementia: a secondary analysis of qualitative data and literature review on perspectives of informal caregivers and healthcare professionals].

Science.gov (United States)

Nguyen, Natalie; Renom-Guiteras, Anna; Meyer, Gabriele; Stephan, Astrid

2018-06-01

Background: Nursing home placement of people with dementia can become necessary when informal care is no longer sufficient. Informal carers experience the transition period as an additional burden. Aim: Experiences and views of informal carers and healthcare professionals regarding the transition from people with dementia to a nursing home are investigated to improve the support for informal carers. Method: This secondary analysis included data from all five focus groups with n = 30 informal carers and healthcare professionals conducted as part of the “RightTimePlaceCare” project. To supplement the material which resulted from a single interview question, a literature analysis with the same focus was conducted. Results: The merged results indicated that informal carers needed professional support early on at home until after the nursing home placement. Concerns regarding nursing homes, financial aspects and family related issues were important aspects in the decision making. Healthcare professionals recommended provision of early guidance regarding those matters and making own experiences with nursing homes. Healthcare professionals should serve as mediators during the transition process and improve the collaboration between service providers. Conclusions: Empowering families to make informed choices could be facilitated by offering advice at home about their options for formal support services, financial support, and housing solutions. Healthcare professionals should support caregivers to make a decision, coordinate the placement and to cope with the new situation.

Challenges of information security incident learning: An industrial case study in a Chinese healthcare organization.

Science.gov (United States)

He, Ying; Johnson, Chris

2017-12-01

Security incidents can have negative impacts on healthcare organizations, and the security of medical records has become a primary concern of the public. However, previous studies showed that organizations had not effectively learned lessons from security incidents. Incident learning as an essential activity in the "follow-up" phase of security incident response lifecycle has long been addressed but not given enough attention. This paper conducted a case study in a healthcare organization in China to explore their current obstacles in the practice of incident learning. We interviewed both IT professionals and healthcare professionals. The results showed that the organization did not have a structured way to gather and redistribute incident knowledge. Incident response was ineffective in cycling incident knowledge back to inform security management. Incident reporting to multiple stakeholders faced a great challenge. In response to this case study, we suggest the security assurance modeling framework to address those obstacles.

Health information systems: challenges for the 21st century.

Science.gov (United States)

Ball, M J; Lillis, J C

2000-08-01

No longer focused on mere automation of manual processes, healthcare technology is poised to transform practice. Healthcare information systems can extend and enhance the memory; streamline administrative processes; provide access to information where, when, and how it is needed; and manage the cost of care while protecting and improving clinical quality and customer satisfaction. To reap the benefits of information systems, healthcare professionals must take stock of the industry's current position on the road to transformation and determine how to manage the journey ahead. This article explores healthcare information technology trends, discusses emerging technologies such as the Internet and the computerized patient record, and offers future recommendations for achieving technology integration and acceptance. Key to this discussion is the belief that people-based skills such as cooperation, leadership, and creative thinking are just as important as--if not more important than--the actual technology.

Informal workers and access to healthcare: a qualitative study of facilitators and barriers to accessing healthcare for beer promoters in the Lao People's Democratic Republic.

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Sychareun, Vanphanom; Vongxay, Viengnakhone; Thammavongsa, Vassana; Thongmyxay, Souksamone; Phummavongsa, Phouthong; Durham, Jo

2016-04-18

Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. The purpose of this study was to examine the interplay between the experience of informal work and access to health, using as an example, female beer promoters employed in the informal economy, in the Lao People's Democratic Republic. In-depth interviews were undertaken with 24 female beer promoters working in beer shops, restaurants and entertainment venues in Vientiane City. The recruitment strategy of snowball sampling was used. Interviews explored the beer promoter's experience of the organization of work, perceived healthcare needs, access to healthcare and insurance, and health seeking practices. The data was analysed thematically and subsequently using Bourdieu's concepts of habitus, capital and field. Most of the beer promoters included in the study were 18 years of age, single, had worked as beer promoters for more than one year and just over half were working to support their higher education. The beer promoters demonstrated a holistic view of health, also viewing good health as contributing to being beautiful - an important attribute in their work. Many reported that their work conditions, including the noisy environment, exposure to second-hand tobacco smoke, long hours on their feet and sexual harassment negatively affected their physical and mental health. Only four participants had any form of health insurance with access to healthcare constrained by individual characteristics, health system factors and the conditions of their informal employment. Drawing on the work of Bourdieu, the study shows how both employment and illness are linked to habitus embodied in everyday practices, access to capital and the position the female beer promoters hold in the social hierarchy in the field of employment.

Migration of the Japanese healthcare enterprise from a financial to integrated management: strategy and architecture.

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Akiyama, M

2001-01-01

The Hospital Information System (HIS) has been positioned as the hub of the healthcare information management architecture. In Japan, the billing system assigns an "insurance disease names" to performed exams based on the diagnosis type. Departmental systems provide localized, departmental services, such as order receipt and diagnostic reporting, but do not provide patient demographic information. The system above has many problems. The departmental system's terminals and the HIS's terminals are not integrated. Duplicate data entry introduces errors and increases workloads. Order and exam data managed by the HIS can be sent to the billing system, but departmental data cannot usually be entered. Additionally, billing systems usually keep departmental data for only a short time before it is deleted. The billing system provides payment based on what is entered. The billing system is oriented towards diagnoses. Most importantly, the system is geared towards generating billing reports rather than at providing high-quality patient care. The role of the application server is that of a mediator between system components. Data and events generated by system components are sent to the application server that routes them to appropriate destinations. It also records all system events, including state changes to clinical data, access of clinical data and so on. Finally, the Resource Management System identifies all system resources available to the enterprise. The departmental systems are responsible for managing data and clinical processes at a departmental level. The client interacts with the system via the application server, which provides a general set of system-level functions. The system is implemented using current technologies CORBA and HTTP. System data is collected by the application server and assembled into XML documents for delivery to clients. Clients can access these URLs using standard HTTP clients, since each department provides an HTTP compliant web

Internationalization of healthcare applications: a generic approach for PACS workstations.

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Hussein, R; Engelmann, U; Schroeter, A; Meinzer, H P

2004-01-01

Along with the revolution of information technology and the increasing use of computers world-wide, software providers recognize the emerging need for internationalized, or global, software applications. The importance of internationalization comes from its benefits such as addressing a broader audience, making the software applications more accessible, easier to use, more flexible to support and providing users with more consistent information. In addition, some governmental agencies, e.g., in Spain, accept only fully localized software. Although the healthcare communication standards, namely, Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) support wide areas of internationalization, most of the implementers are still protective about supporting the complex languages. This paper describes a generic internationalization approach for Picture Archiving and Communication System (PACS) workstations. The Unicode standard is used to internationalize the application user interface. An encoding converter was developed to encode and decode the data between the rendering module (in Unicode encoding) and the DICOM data (in ISO 8859 encoding). An integration gateway was required to integrate the internationalized PACS components with the different PACS installations. To introduce a pragmatic example, the described approach was applied to the CHILI PACS workstation. The approach has enabled the application to handle the different internationalization aspects transparently, such as supporting complex languages, switching between different languages at runtime, and supporting multilingual clinical reports. In the healthcare enterprises, internationalized applications play an essential role in supporting a seamless flow of information between the heterogeneous multivendor information systems.

Insights from parents of a child with leukaemia and healthcare professionals about sharing illness and treatment information: A qualitative research study.

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Gibson, Faith; Kumpunen, Stephanie; Bryan, Gemma; Forbat, Liz

2018-04-13

Many parents report a strong desire to take on information-giving roles, and believe they are best positioned to discuss their child's illness with their child. Healthcare professionals have a supporting role to reduce the burden on parents who feel responsible for conveying information to their child and other family members. To examine parents' and healthcare professionals' perceptions of roles in receiving and communicating information when a child is diagnosed with and treated for acute lymphoblastic leukaemia. We used the principles of a grounded theory approach. This was a single site study, recruiting from a principal children's cancer treatment centre in the United Kingdom. The sample included parents of children receiving and completed treatment for acute lymphoblastic leukaemia (n = 28), and healthcare professionals (n = 34). Methods included individual interviews, face-to-face and telephone, focus groups, and an online forum. Communication 'touch points' are many over the course of a child's cancer journey. We describe often 'mismatched' communication encounters where those seeking information and those providing information have different goals. Healthcare professionals in the encounter have expertise at the outset while parents have less expertise, but this expertise grows over time and this can increase the perceptions of this 'mismatch' and create different challenges. Considered in the context of middle range transition theory, we might suggest that parental foreground (seeking information directly) and background (passive actors) roles are the result of differing levels of uncertainty, and depend on the situation and preferences and child and family needs that may present differently over time in different contexts. Our work contributes to the emerging consensus that communication is more than a core set of skills that healthcare professionals just need to learn: clear specifications of mutual roles, responsibilities and a shared

[Digitalization of radiological imaging information and consequences for patient care in the hospital ].

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den Heeten, G J; Barneveld Binkhuysen, F H

2001-08-25

Determining the rate at which radiology must be digitalised has been a controversial issue for many years. Much radiological information is still obtained from the film-screen combination (X-rays) with all of its known inherent restrictions. The importance of imaging information in the healthcare process continues to increase for both radiologists and referring physicians, and the ongoing developments in information technology means that it is possible to integrate imaging information and electronic patient files. The healthcare process can only become more effective and efficient when the appropriate information is in the right place at the right time, something that conventional methods, using photos that need to be physically moved, can scarcely satisfy. There is also a desire for integration with information obtained from nuclear medicine, pathology and endoscopy, and eventually of all stand-alone data systems with relevance for the individually oriented hospital healthcare. The transition from a conventional to a digital process is complex; it is accompanied by the transition from a data-oriented to a process-oriented system. Many years have already been invested in the integration of information systems and the development of digital systems within radiology, the current performance of which is such that many hospitals are considering the digitalisation process or are already implementing parts of it.

Effects of librarian-provided services in healthcare settings: a systematic review.

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Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

2014-01-01

To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review

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Sudhinaraset, May; Ingram, Matthew; Lofthouse, Heather Kinlaw; Montagu, Dominic

2013-01-01

Informal health care providers (IPs) comprise a significant component of health systems in developing nations. Yet little is known about the most basic characteristics of performance, cost, quality, utilization, and size of this sector. To address this gap we conducted a comprehensive literature review on the informal health care sector in developing countries. We searched for studies published since 2000 through electronic databases PubMed, Google Scholar, and relevant grey literature from The New York Academy of Medicine, The World Bank, The Center for Global Development, USAID, SHOPS (formerly PSP-One), The World Health Organization, DFID, Human Resources for Health Global Resource Center. In total, 334 articles were retrieved, and 122 met inclusion criteria and chosen for data abstraction. Results indicate that IPs make up a significant portion of the healthcare sector globally, with almost half of studies (48%) from Sub-Saharan Africa. Utilization estimates from 24 studies in the literature of IP for healthcare services ranged from 9% to 90% of all healthcare interactions, depending on the country, the disease in question, and methods of measurement. IPs operate in a variety of health areas, although baseline information on quality is notably incomplete and poor quality of care is generally assumed. There was a wide variation in how quality of care is measured. The review found that IPs reported inadequate drug provision, poor adherence to clinical national guidelines, and that there were gaps in knowledge and provider practice; however, studies also found that the formal sector also reported poor provider practices. Reasons for using IPs included convenience, affordability, and social and cultural effects. Recommendations from the literature amount to a call for more engagement with the IP sector. IPs are a large component of nearly all developing country health systems. Research and policies of engagement are needed. PMID:23405101

Review of behavioral health integration in primary care at Baylor Scott and White Healthcare, Central Region.

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Jolly, John B; Fluet, Norman R; Reis, Michael D; Stern, Charles H; Thompson, Alexander W; Jolly, Gillian A

2016-04-01