WorldWideScience

Sample records for net healthcare system

  1. Vaccine adverse events in a safety net healthcare system and a managed care organization.

    Science.gov (United States)

    Narwaney, Komal J; Breslin, Kristin; Ross, Colleen A; Shoup, Jo Ann; Wain, Kris F; Weintraub, Eric S; McNeil, Michael M; Hambidge, Simon J

    2017-03-01

    The Institute of Medicine, in a 2013 report, recommended that the Vaccine Safety Datalink (VSD) expand collaborations to include more diversity in the study population. Kaiser Permanente Colorado (KPCO), an established VSD site, partnered with Denver Health (DH), an integrated safety net healthcare system, to demonstrate the feasibility of integrating DH data within the VSD. Prior to incorporating the data, we examined the identification of specific vaccine associated adverse events (VAEs) in these two distinct healthcare systems. We conducted retrospective cohort analyses within KPCO and DH to compare select VAEs between the two populations. We examined the following associations between January 1, 2004 and December 31, 2013: Measles, Mumps, and Rubella (MMR) vaccine and febrile seizures in children 2years and younger, intussusception after rotavirus vaccine in infants 4-34weeks, syncope after adolescent vaccines (Tetanus, Diphtheria, acellular Pertussis; Meningococcal and Human Papillomavirus) in adolescents 13-17years and medically attended local reactions after pneumococcal polysaccharide (PPSV23) vaccine in adults 65years and older. Both sites used similar data procurement methods and chart review processes. For seizures after MMR vaccine (KPCO - 3.15vs. DH - 2.97/10,000 doses) and syncope after all adolescent vaccines (KPCO - 3.0vs. DH - 2.37/10,000 doses), the chart confirmed rates were comparable at the two sites. However, for medically attended local reactions after PPSV23, there were differences in chart confirmed rates between the sites (KPCO - 31.65vs. DH - 14.90/10,000 doses). For intussusception after rotavirus vaccine, the number of cases was too low to make a valid comparison (KPCO - 0vs. DH - 0.13/10,000 doses). We demonstrated that data on important targeted VAEs can be captured at DH and rates appear similar to those at KPCO. Work is ongoing on the optimal approach to assimilate DH data as a potential safety net healthcare system in the VSD

  2. Petri net methodology for solving healthcare management issues

    Directory of Open Access Journals (Sweden)

    Khushk Abdul Rauf

    2018-01-01

    Full Text Available Various approaches of Petri nets can be achieved as system security and information flow in the healthcare recording system inside any medical or health-related business. Petri net system formal modeling is essential as well as important to track down the records and secure information inside a preformed health organization. In this paper, we mainly focused on the formal model Petri net which security mechanism is controlled by public key encryption where PN based modeling is preferred. This Petri net is a mathematical modeling to solve graphical notation for step by step processes that include choice, repetition, and circumstantial execution. Petri nets offer widely mathematical applications of discrete and continuous event execution semiotics, with an efficient mathematical analysis processing theory. We sure that our formal model will lay a solid foundation to minimize the risks and overcome the security risks in the healthcare industry.

  3. Access and quality in Canada's parallel public healthcare systems: is the impact of workers' compensation boards a net positive?

    Science.gov (United States)

    Hughes Tuohy, Carolyn

    2008-01-01

    Jerry Hurley and his colleagues have done a major service in casting light on a dimension of public healthcare policy in Canada that normally flies under the radar of both public and academic debate. Workers' compensation represents less than 2% of public healthcare expenditures in Canada, and the care provided is concentrated in a few categories such as orthopedics. Nonetheless, the transformation of workers' compensation boards (WCBs) from "silent payers" to increasingly sophisticated and entrepreneurial purchasers of care may have important implications and lessons for the broader healthcare system.

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

    DEFF Research Database (Denmark)

    Bertolini, Cristiano; Liu, Zhiming; Srba, Jiri

    2013-01-01

    Workflows in modern healthcare systems are becoming increasingly complex and their execution involves concurrency and sharing of resources. The definition, analysis and management of collaborative healthcare workflows requires abstract model notations with a precisely defined semantics...... and a support for compositional reasoning. We use the formalism of component-based timed-arc Petri Nets (CTAPN) for modular modelling of collaborative healthcare workflows and demonstrate how the model checker TAPAAL supports the verification of their functional and non-functional requirements. To this end, we...

  5. PolicyNet Publication System

    Data.gov (United States)

    Social Security Administration — The PolicyNet Publication System project will merge the Oracle-based Policy Repository (POMS) and the SQL-Server CAMP system (MSOM) into a new system with an Oracle...

  6. The North Carolina Healthcare Safety Net, 2005: fragments of a lifeline serving the uninsured.

    Science.gov (United States)

    Silberman, Pam; Odom, Carmen Hooker; Smith, Sherwood; Dubay, Kristen L; Thompson, Kristie Weisner

    2005-01-01

    communities across our state. For those with healthcare insurance, these problems and their administrative complexities may seem of remote interest and concern. But, for the people who depend on the safety net services, these problems can mean the difference between health, work, and opportunity, or between disease, disability, or death. There is a genuine collective benefit to meeting the healthcare needs of the uninsured, for the health and wellbeing of a fifth of our state's population affects the health of all of us. Depending on a stop-gap, safety net to maintain the health of such a large segment of our population is a societal risk we all must confront. Failure of any part of the healthcare safety net could be detrimental to the stability of the larger healthcare system on which we all depend.

  7. The potential of net zero energy buildings (NZEBs) concept at design stage for healthcare buildings towards sustainable development

    Science.gov (United States)

    Hazli Abdellah, Roy; Asrul Nasid Masrom, Md; Chen, Goh Kai; Mohamed, Sulzakimin; Omar, Roshartini

    2017-11-01

    The focus on net-zero energy buildings (NZEBs) has been widely analysed and discussed particularly when European Union Parliament are progressively moving towards regulation that promotes the improvement of energy efficiency (EE). Additionally, it also to reduce energy consumption through the recast of the EU Directive on Energy Performance of Buildings (EPBD) in which all new buildings to be “nearly Zero-Energy” Buildings by 2020. Broadly, there is a growing trend to explore the feasibility of net zero energy in healthcare sector as the level energy consumption for healthcare sector is found significantly high. Besides that, healthcare buildings energy consumption also exceeds of many other nondomestic building types, and this shortcoming is still undetermined yet especially for developing countries. This paper aims to review the potential of NZEBs in healthcare buildings by considering its concept in design features. Data are gathered through a comprehensive energy management literature review from previous studies. The review is vital to encourage construction players to increase their awareness, practices, and implementation of NZEBs in healthcare buildings. It suggests that NZEBs concept has a potential to be adapted in healthcare buildings through emphasizing of passive approach as well as the utilization of energy efficiency systems and renewable energy systems in buildings. This paper will provide a basis knowledge for construction key players mainly architects to promote NZEBs concept at design stage for healthcare buildings development.

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

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

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

  9. 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...

  10. Analysis of Petri Nets and Transition Systems

    Directory of Open Access Journals (Sweden)

    Eike Best

    2015-08-01

    Full Text Available This paper describes a stand-alone, no-frills tool supporting the analysis of (labelled place/transition Petri nets and the synthesis of labelled transition systems into Petri nets. It is implemented as a collection of independent, dedicated algorithms which have been designed to operate modularly, portably, extensibly, and efficiently.

  11. Mobile Healthcare System using NFC Technology

    OpenAIRE

    A Devendran; T. Bhuvaneswari; Arun Kumar Krishnan

    2012-01-01

    Although primary care physicians are increasingly interested in adopting electronic medical record (EMR) systems, few use such systems in practice. Mobile devices offer new ways for users to access health care data and services in a secure and user-friendly environment. Mobile healthcare (m-healthcare) systems are regarded as a solution to healthcare costs without reducing the quality of patient care. We are developing a basic architecture for m-healthcare services using Near Field Communicat...

  12. Development of net cage acoustic alarm system

    Science.gov (United States)

    Hong, Shih-Wei; Wei, Ruey-Chang

    2004-05-01

    In recent years, the fishery production has been drastically decreased in Taiwan, mainly due to overfishing and coast pollution; therefore, fishermen and corporations are encouraged by government to invest in ocean net cage aquaculture. However, the high-price fishes in the net cage are often coveted, so incidences of fish stealing and net cage breaking were found occasionally, which cause great economical loss. Security guards or a visual monitoring system has limited effect, especially in the night when these intrusions occur. This study is based on acoustic measure to build a net cage alarm system, which includes the sonobuoy and monitor station on land. The sonobuoy is a passive sonar that collects the sounds near the net cage and transmits the suspected signal to the monitor station. The signals are analyzed by the control program on the personal computer in the monitor station, and the alarms at different stages could be activated by the sound levels and durations of the analyzed data. To insure long hours of surveillance, a solar panel is applied to charge the battery, and a photodetector is used to activate the system.

  13. Romanian healthcare system at a glance

    Directory of Open Access Journals (Sweden)

    Christiana Balan

    2013-04-01

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

  14. Healthcare Systems and Other Applications

    NARCIS (Netherlands)

    van Kasteren, T.L.M.; Kröse, B.J.A.

    2007-01-01

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

  15. Healthcare Firms and the ERP Systems

    Directory of Open Access Journals (Sweden)

    A. Garefalakis

    2016-04-01

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

  16. 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...

  17. Requirements for Interoperability in Healthcare Information Systems

    Directory of Open Access Journals (Sweden)

    Rita Noumeir

    2012-01-01

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

  18. UNIX and healthcare systems: a good marriage.

    Science.gov (United States)

    Wieners, W

    1992-08-01

    Powerful and versatile, UNIX makes open systems affordable in today's complex healthcare marketplace. As more emphasis is placed on combining the best systems for the least money, UNIX plays an important role. How many hospitals are using it already?

  19. Engineering the system of healthcare delivery

    National Research Council Canada - National Science Library

    Rouse, William B; Cortese, Denis A

    2010-01-01

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

  20. Executable Design Models for a Pervasive Healthcare Middleware System

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Christensen, Søren

    2002-01-01

     UML is applied in the design of a pervasive healthcare middleware system for the hospitals in Aarhus County, Denmark. It works well for the modelling of static aspects of the system, but with respect to describing the behaviour, UML is not sufficient. This paper explains why and, as a remedy......, suggests to supplement the UML models with behaviour descriptions in the modelling language Coloured Petri Nets, CPN. CPN models are executable and fine-grained, and a combined use of UML and CPN thus supports design-time investigation of the detailed behaviour of system components. In this way...

  1. Healthcare and healthcare systems: inspiring progress and future prospects.

    Science.gov (United States)

    Durrani, Hammad

    2016-01-01

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

  2. Healthcare information systems: the cognitive challenge.

    Science.gov (United States)

    Lintern, Gavan; Motavalli, Al

    2018-01-11

    Healthcare work is, to a considerable extent, cognitive. Subsequently, the analysis and the design of supporting technology must be sensitive to the cognitive and adaptive demands of the work and to the cognitive strategies employed by healthcare practitioners. Despite the vital role that cognition plays in healthcare work, current technocentric design approaches for healthcare technology do not account for it, failing to observe it during analysis and failing to develop support for it during design. By review and analysis of case studies, we show that healthcare systems developed without input from cognitive analysis and cognitive design fail to take account of important healthcare work processes and workflows. In contrast, systems developed with a cognitively-focused design strategy demonstrate how it is possible to introduce technology that supports and enhances the work strategies of those engaged in patient care. Significant problems emerge when technological support systems are developed without any serious and comprehensive attempt to understand the cognitive capabilities and skills deployed by those involved in patient care. In contrast, significant benefits accrue from taking full account of those cognitive capabilities and skills. Subsequently, the design and development of supporting technology must be sensitive to the cognitive demands of the work and the cognitive strategies employed by healthcare practitioners.

  3. Engineering healthcare as a service system.

    Science.gov (United States)

    Tien, James M; Goldschmidt-Clermont, Pascal J

    2010-01-01

    Engineering has and will continue to have a critical impact on healthcare; the application of technology-based techniques to biological problems can be defined to be technobiology applications. This paper is primarily focused on applying the technobiology approach of systems engineering to the development of a healthcare service system that is both integrated and adaptive. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components - people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.

  4. 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.

  5. Application of Coloured Petri Nets in System Development

    DEFF Research Database (Denmark)

    Kristensen, Lars Michael; Jørgensen, Jens Bæk; Jensen, Kurt

    2004-01-01

    Coloured Petri Nets (CP-nets or CPNs) and their supporting computer tools have been used in a wide range of application areas such as communication protocols, software designs, and embedded systems. The practical application of CP-nets has also covered many phases of system development ranging from...... requirements to design, validation, and implementation. This paper presents four case studies where CP-nets and their supporting computer tools have been used in system development projects with industrial partners. The case studies have been selected such that they illustrate different application areas of CP...

  6. Unix becoming healthcare's standard operating system.

    Science.gov (United States)

    Gardner, E

    1991-02-11

    An unfamiliar buzzword is making its way into healthcare executives' vocabulary, as well as their computer systems. Unix is being touted by many industry observers as the most likely candidate to be a standard operating system for minicomputers, mainframes and computer networks.

  7. A Fuzzy Petri Nets System for Heart Disease Diagnosis

    Directory of Open Access Journals (Sweden)

    Hussin Attya Lafta

    2017-02-01

    Full Text Available In this paper we have proposed a Fuzzy Petri Nets Expert System for heart disease diagnosis. The aim of the proposed system is simulating experience of experts in Diagnosis Heart Disease stage, based on Fuzzy Rule System and modeling reasoning operation by using Fuzzy Petri Nets. The database taken from Machine Learning Repository Center for machine learning and intelligent system. The system has 11 input fields and one output field. The accuracy of proposed system is 75%.

  8. Qualifications of Petri nets for modeling of logistical systems

    Directory of Open Access Journals (Sweden)

    Petr Jedlička

    2006-01-01

    Full Text Available Simulation and optimization is one of the most popular approaches to improve the use of simulation models as a tool to obtain the best system configuration. Petri nets have proved to be useful for examining the performance of different system configurations and/or alternative operating procedures for various systems. Based on their precise semantics and easy-to-understand graphical representation, Petri nets are appropriate to model logistic systems together with their quantitative and qualitative properties. In this paper, potential benefits of usage of object-oriented Petri nets for optimization of logistical systems are discussed.

  9. Personal healthcare system using cloud computing.

    Science.gov (United States)

    Takeuchi, Hiroshi; Mayuzumi, Yuuki; Kodama, Naoki; Sato, Keiichi

    2013-01-01

    A personal healthcare system used with cloud computing has been developed. It enables a daily time-series of personal health and lifestyle data to be stored in the cloud through mobile devices. The cloud automatically extracts personally useful information, such as rules and patterns concerning lifestyle and health conditions embedded in the personal big data, by using a data mining technology. The system provides three editions (Diet, Lite, and Pro) corresponding to users' needs.

  10. Public satisfaction with the healthcare system performance in South Korea: Universal healthcare system.

    Science.gov (United States)

    Park, Kisoo; Park, Jumin; Kwon, Young Dae; Kang, Yoonjeong; Noh, Jin-Won

    2016-06-01

    An awareness of the public's level of satisfaction with health professionals is becoming more important as steps are being taken to improve quality, reduce costs, and implement reform. The purpose of this study is to assess public satisfaction with the healthcare system and to examine the relationship between satisfaction and socio-demographic factors in the context of the health care environment in the Republic of Korea. The data were obtained from 1573 adults aged 20-69 in three major areas - Seoul, Gyeonggi, and Busan - by the Ministry of Health and Welfare during June and July 2011 in South Korea. Satisfaction with the healthcare system was evaluated by using 13 items in three sections: access to care, cost of care, and quality of care. A confirmatory factor analysis (CFA) was conducted to examine the validity of satisfaction with a healthcare system performance questionnaire. A structural equation model (SEM) was estimated to assess the relative impact of demographic and socio-economic variables on satisfaction. The study proposed a comprehensive three-factor model of healthcare system performance satisfaction. Among the three factors, the quality of care had the largest impact on satisfaction with the healthcare system, suggesting that is the most important determinant of consumers' satisfaction with their healthcare system. Regarding the relationships between public satisfaction and demographic and socio-economic variables, residence and marital status were significant predictors of the satisfaction level. It is important to be aware of the potential significance of background variables in determining satisfaction with the healthcare system. An understanding of the characteristics of the sample enables healthcare managers and/or policymakers to inform targeted follow-up actions. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. CifNet network multi-well data management system

    Science.gov (United States)

    Li, Ning; Wang, Mingchao; Cui, Jian; Wang, Jianqiang; Wang, Caizhi

    2004-10-01

    The CifNet network multi-well data management system is developed for 100MB or 1000MB local network environments which are used in Chinese oil industry. The kernel techniques of CifNet system include: 1, establishing a high efficient and low cost network multi-well data management architecture based on the General Logging Curve Theory and the Cif data format; 2, implementing efficient visit and transmission of multi-well data in C/S local network based on TCP/IP protocol; 3, ensuring the safety of multi-well data in store, visit and application based on Unix operating system security. By using CifNet system, the researcher in office or at home can visit curves of any borehole in any working area of any oilfield. The application foreground of CifNet system is also commented.

  12. RadNet (Environmental Radiation Ambient Monitoring System)

    Data.gov (United States)

    U.S. Environmental Protection Agency — RadNet, formerly Environmental Radiation Ambient Monitoring System (ERAMS), is a national network of monitoring stations that regularly collect air, precipitation,...

  13. Smart Cards Applications in the Healthcare System

    OpenAIRE

    Claudiu Oltean

    2011-01-01

    Current medical system based on medical records and health books is outdated and no longer meets the new requirements. Essential information security in terms of data privacy, integrity and authenticity, is not assured. Healthcare fraud with medical records is quite easy, because there is no security features to prevent this. Obtaining prescription drugs is slowly, the patient is forced in most cases, to go to the pharmacy staff to get their prescription. Another issue is data portability bec...

  14. Developing and measuring healthcare capacity and quality in Burundi: LifeNet International’s horizontal conversion franchise model

    Directory of Open Access Journals (Sweden)

    Michael F Brooks

    2016-01-01

    Full Text Available In a departure from traditional “vertical” healthcare interventions in low-resource settings that work to combat a single specific health issue, LifeNet International (LN uses a horizontal conversion franchise to develop and measure healthcare capacity and quality in primarily faith-based health centers in East Africa. Through a comprehensive franchise package of Medical Training, Management Training, Pharmaceutical Supply, and Growth Financing, LN is able to leverage existing resources and respond to a greater number of the obstacles preventing facilities from providing quality care. Through its Quality Score Card, LN measures improvements in quality of care within its network. This tool has measured consistent and significant improvements in quality of care following LN partnership. Together, these services improve quality of care at East African primary care facilities in ways that issue-specific, “vertical” interventions cannot.

  15. Human factors systems approach to healthcare quality and patient safety

    Science.gov (United States)

    Carayon, Pascale; Wetterneck, Tosha B.; Rivera-Rodriguez, A. Joy; Hundt, Ann Schoofs; Hoonakker, Peter; Holden, Richard; Gurses, Ayse P.

    2013-01-01

    Human factors systems approaches are critical for improving healthcare quality and patient safety. The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is a human factors systems approach that has been successfully applied in healthcare research and practice. Several research and practical applications of the SEIPS model are described. Important implications of the SEIPS model for healthcare system and process redesign are highlighted. Principles for redesigning healthcare systems using the SEIPS model are described. Balancing the work system and encouraging the active and adaptive role of workers are key principles for improving healthcare quality and patient safety. PMID:23845724

  16. Neural system modeling and simulation using Hybrid Functional Petri Net.

    Science.gov (United States)

    Tang, Yin; Wang, Fei

    2012-02-01

    The Petri net formalism has been proved to be powerful in biological modeling. It not only boasts of a most intuitive graphical presentation but also combines the methods of classical systems biology with the discrete modeling technique. Hybrid Functional Petri Net (HFPN) was proposed specially for biological system modeling. An array of well-constructed biological models using HFPN yielded very interesting results. In this paper, we propose a method to represent neural system behavior, where biochemistry and electrical chemistry are both included using the Petri net formalism. We built a model for the adrenergic system using HFPN and employed quantitative analysis. Our simulation results match the biological data well, showing that the model is very effective. Predictions made on our model further manifest the modeling power of HFPN and improve the understanding of the adrenergic system. The file of our model and more results with their analysis are available in our supplementary material.

  17. 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

    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...... 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...... healthcare information into an already existing language programme may be pertinent for providing immigrants with knowledge on the healthcare system....

  18. 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.

  19. 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.

  20. Fuzzy reasoning of accident provenance in pervasive healthcare monitoring systems.

    Science.gov (United States)

    Wang, Yongli; Hu, Xiaohua

    2013-11-01

    In pervasive healthcare monitoring environments, data provenance, as one metadata, can help people analyze the reasons for medical accidents that are generated by complex events. This reasoning processing often encounters inaccurate time and irreversible reasoning problems. How to solve the uncertain process and fuzzy transformation time presents many challenges to the study of data provenance. In this paper, we propose a backward derivation model with the provenance semantic, backward fuzzy time reasoning net (BFTRN), to solve these two problems. We design a backward reasoning algorithm motivated by time automation theory based on this model. With regard to given life-critical alarms and some constraints, it cannot only derive all evolution paths and the possibility distribution of paths from historical information, but also efficiently compute the value of fuzzy time function for each transition of lift-critical complex alarms in the healthcare monitoring system. We also analyze the properties of BFTRN model in this paper. Experiments on real dataset show that the proposed model is efficient.

  1. Coherence in the Danish Healthcare System

    DEFF Research Database (Denmark)

    Frederiksen, Jesper; Olivares Bøgeskov, Benjamin Miguel

    2017-01-01

    of this tradition are used to generate data from discourse as representations of institutional logics. The aim is to uncover how coherence in healthcare emerges as different strategies in healthcare governance in relation to different institutions seen as positions. Hence, our findings suggest that, although...... to the strategy of coherence, is a part of greater efforts to the endeavour of governing healthcare....

  2. The threat nets approach to information system security risk analysis

    NARCIS (Netherlands)

    Mirembe, Drake

    2015-01-01

    The growing demand for healthcare services is motivating hospitals to strengthen outpatient case management using information systems in order to serve more patients using the available resources. Though the use of information systems in outpatient case management raises patient data security

  3. Security threats categories in healthcare information systems.

    Science.gov (United States)

    Samy, Ganthan Narayana; Ahmad, Rabiah; Ismail, Zuraini

    2010-09-01

    This article attempts to investigate the various types of threats that exist in healthcare information systems (HIS). A study has been carried out in one of the government-supported hospitals in Malaysia.The hospital has been equipped with a Total Hospital Information System (THIS). The data collected were from three different departments, namely the Information Technology Department (ITD), the Medical Record Department (MRD), and the X-Ray Department, using in-depth structured interviews. The study identified 22 types of threats according to major threat categories based on ISO/IEC 27002 (ISO 27799:2008). The results show that the most critical threat for the THIS is power failure followed by acts of human error or failure and other technological factors. This research holds significant value in terms of providing a complete taxonomy of threat categories in HIS and also an important component in the risk analysis stage.

  4. Personalized biomedical devices & systems for healthcare applications

    Science.gov (United States)

    Chen, I.-Ming; Phee, Soo Jay; Luo, Zhiqiang; Lim, Chee Kian

    2011-03-01

    With the advancement in micro- and nanotechnology, electromechanical components and systems are getting smaller and smaller and gradually can be applied to the human as portable, mobile and even wearable devices. Healthcare industry have started to benefit from this technology trend by providing more and more miniature biomedical devices for personalized medical treatments in order to obtain better and more accurate outcome. This article introduces some recent development in non-intrusive and intrusive biomedical devices resulted from the advancement of niche miniature sensors and actuators, namely, wearable biomedical sensors, wearable haptic devices, and ingestible medical capsules. The development of these devices requires carful integration of knowledge and people from many different disciplines like medicine, electronics, mechanics, and design. Furthermore, designing affordable devices and systems to benefit all mankind is a great challenge ahead. The multi-disciplinary nature of the R&D effort in this area provides a new perspective for the future mechanical engineers.

  5. Net carbon flux in organic and conventional olive production systems

    Science.gov (United States)

    Saeid Mohamad, Ramez; Verrastro, Vincenzo; Bitar, Lina Al; Roma, Rocco; Moretti, Michele; Chami, Ziad Al

    2014-05-01

    Agricultural systems are considered as one of the most relevant sources of atmospheric carbon. However, agriculture has the potentiality to mitigate carbon dioxide mainly through soil carbon sequestration. Some agricultural practices, particularly fertilization and soil management, can play a dual role in the agricultural systems regarding the carbon cycle contributing to the emissions and to the sequestration process in the soil. Good soil and input managements affect positively Soil Organic Carbon (SOC) changes and consequently the carbon cycle. The present study aimed at comparing the carbon footprint of organic and conventional olive systems and to link it to the efficiency of both systems on carbon sequestration by calculating the net carbon flux. Data were collected at farm level through a specific and detailed questionnaire based on one hectare as a functional unit and a system boundary limited to olive production. Using LCA databases particularly ecoinvent one, IPCC GWP 100a impact assessment method was used to calculate carbon emissions from agricultural practices of both systems. Soil organic carbon has been measured, at 0-30 cm depth, based on soil analyses done at the IAMB laboratory and based on reference value of SOC, the annual change of SOC has been calculated. Substracting sequestrated carbon in the soil from the emitted on resulted in net carbon flux calculation. Results showed higher environmental impact of the organic system on Global Warming Potential (1.07 t CO2 eq. yr-1) comparing to 0.76 t CO2 eq. yr-1 in the conventional system due to the higher GHG emissions caused by manure fertilizers compared to the use of synthetic foliar fertilizers in the conventional system. However, manure was the main reason behind the higher SOC content and sequestration in the organic system. As a resultant, the organic system showed higher net carbon flux (-1.7 t C ha-1 yr-1 than -0.52 t C ha-1 yr-1 in the conventional system reflecting higher efficiency as a

  6. Accurate Complex Systems Design: Integrating Serious Games with Petri Nets

    Directory of Open Access Journals (Sweden)

    Kirsten Sinclair

    2016-03-01

    Full Text Available Difficulty understanding the large number of interactions involved in complex systems makes their successful engineering a problem. Petri Nets are one graphical modelling technique used to describe and check proposed designs of complex systems thoroughly. While automatic analysis capabilities of Petri Nets are useful, their visual form is less so, particularly for communicating the design they represent. In engineering projects, this can lead to a gap in communications between people with different areas of expertise, negatively impacting achieving accurate designs.In contrast, although capable of representing a variety of real and imaginary objects effectively, behaviour of serious games can only be analysed manually through interactive simulation. This paper examines combining the complementary strengths of Petri Nets and serious games. The novel contribution of this work is a serious game prototype of a complex system design that has been checked thoroughly. Underpinned by Petri Net analysis, the serious game can be used as a high-level interface to communicate and refine the design.Improvement of a complex system design is demonstrated by applying the integration to a proof-of-concept case study.   

  7. Implementation architecture and multithreaded runtime system of S-Net

    NARCIS (Netherlands)

    Grelck, C.; Penczek, F.; Scholz, S.-B.; Chitil, O.

    2011-01-01

    S-Net is a declarative coordination language and component technology aimed at modern multi-core/many-core architectures and systems-on-chip. It builds on the concept of stream processing to structure networks of communicating asynchronous components, which can be implemented using a conventional

  8. A Petri Net Definition of a System Description Language

    DEFF Research Database (Denmark)

    Jensen, Kurt; Kyng, Morten; Madsen, Ole Lehrmann

    1979-01-01

    This paper introduces a language for the description of systems with concurrency, and presents a formal definition of its semantics. The language is based on Delta and the semantic model is an extension of Petri nets with a data part and with expressions attached to transitions and to places....

  9. Improving healthcare empowerment through breast cancer patient navigation: a mixed methods evaluation in a safety-net setting.

    Science.gov (United States)

    Gabitova, Guzyal; Burke, Nancy J

    2014-09-19

    Breast cancer mortality rates in the U.S. remain relatively high, particularly among ethnic minorities and low-income populations. Unequal access to quality care, lower follow up rates, and poor treatment adherence contribute to rising disparities among these groups. Healthcare empowerment (HCE) is theorized to improve patient outcomes through collaboration with providers and improving understanding of and compliance with treatment. Patient navigation is a health care organizational intervention that essentially improves healthcare empowerment by providing informational, emotional, and psychosocial support. Patient navigators address barriers to care through multilingual coordination of treatment and incorporation of access to community services, support, and education into the continuum of cancer care. Utilizing survey and qualitative methods, we evaluated the patient navigation program in a Northern California safety-net hospital Breast Clinic by assessing its impact on patients' experiences with cancer care and providers' perspectives on the program. We conducted qualitative interviews with 16 patients and 4 service providers, conducted approximately 66 hours of clinic observations, and received feedback through the self-administered survey from 66 patients. The role of the patient navigator at the Breast Clinic included providing administrative assistance, psychosocial support, improved knowledge, better understanding of treatment process, and ensuring better communication between patients and providers. As such, patient navigators facilitated improved collaboration between patients and providers and understanding of interdisciplinary care processes. The survey results suggested that the majority of patients across all ethnic backgrounds and age groups were highly satisfied with the program and had a positive perception of their navigator. Interviews with patients and providers highlighted the roles of a navigator in ensuring continuity of care, improving

  10. Circular Orbit Target Capture Using Space Tether-Net System

    Directory of Open Access Journals (Sweden)

    Guang Zhai

    2013-01-01

    Full Text Available The space tether-net system for on-orbit capture is proposed in this paper. In order to research the dynamic behaviors during system deployment, both free and nonfree deployment dynamics in circular orbit are developed; the system motion with respect to Local Vertical and Local Horizontal frame is also researched with analysis and simulation. The results show that in the case of free deployment, the capture net follows curve trajectories due to the relative orbit dynamic perturbation, and the initial deployment velocities are planned by state transformation equations for static and floating target captures; in the case of non-free deployment, the system undergoes an altitude libration along the Local Vertical, and the analytical solutions that describe the attitude libration are obtained by using variable separation and integration. Finally, the dynamics of postdeployment system is also proved marginally stable if the critical initial conditions are satisfied.

  11. Pervasive mobile healthcare systems for chronic disease monitoring.

    Science.gov (United States)

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

    2017-05-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  13. Net ecosystem calcification and net primary production in two Hawaii back-reef systems

    Science.gov (United States)

    Kiili, S.; Colbert, S.; Hart, K.

    2016-02-01

    Back-reef systems have complex carbon cycling, driven by dominant benthic communities that change with environmental conditions and display characteristic patterns of net primary production (NP) and net ecosystem calcification (G). The G/NP ratio provides a fundamental community-level assessment to compare systems spatially and to evaluate temporal changes in carbon cycling. Carbon dynamics were examined at leeward Hōnaunau and windward Waíōpae, Hawaíi Island. Both locations discharge brackish groundwater, including geothermal water at Waíōpae. The change in total CO2 (TCO2) and total alkalinity (TA) between morning and afternoon was measured to calculate the G/NP ratio along a salinity gradient. At both sites, aragonite saturation (ΩAr) was lower than open ocean conditions, and increased with salinity. Between the morning and afternoon, ΩAr increased by at least 1 as photosynthesis consumed CO2. At Waíōpae, water was corrosive to aragonite due to the input of acidic groundwater, but not at Honaunau, demonstrating the importance of local watershed characteristics on ΩAr. Across the salinity gradient, TA and TCO2 decreased between morning and afternoon. At Hōnaunau, G/NP increased from 0.11 to 0.31 with salinity, consistent with an offshore increase in coral cover. But at Waíōpae, G/NP decreased from 0.49 to 0.0 with salinity, despite an increase in coral cover with salinity. Low G may be caused by benthic processes, including coral bleaching or high rates of carbonate dissolution in interstitial waters between tide pools. Broader environmental conditions than just salinity, including pH of fresh groundwater inputs, shape the carbon cycling in the back-reef system. Examining the G/NP ratio of a back-reef system allows for a simple method to establish community level activity, and possibly indicate changes in a dynamic system.

  14. Research and realization of info-net security controlling system

    Science.gov (United States)

    Xu, Tao; Zhang, Wei; Li, Xuhong; Wang, Xia; Pan, Wenwen

    2017-03-01

    The thesis introduces some relative concepts about Network Cybernetics, and we design and realize a new info-net security controlling system based on Network Cybernetics. The system can control the endpoints, safely save files, encrypt communication, supervise actions of users and show security conditions, in order to realize full-scale security management. At last, we simulate the functions of the system. The results show, the system can ensure the controllability of users and devices, and supervise them real-time. The system can maximize the security of the network and users.

  15. A microcomputer-based, net-lending interlibrary loan system.

    Science.gov (United States)

    Yau, L; Newman, M; Gascard, M

    1989-10-01

    A microcomputer-based, net-lending interlibrary loan system was developed at Lane Medical Library, Stanford University. The system, designed to generate the monthly billing invoices and all necessary statistical reports, has reduced the time required for logging-in procedures and compilation of monthly, quarterly, and annual statistics. User menus, help screens, and choice fields were developed explicitly for library staff who have little or no computer experience. The program was written using the DataEase database management software running on IBM PC, XT, AT, or compatible with a minimum of 512K RAM. Described are features of this automated interlibrary loan management system and its use in a net-lending interlibrary loan department. It focuses on data entry in the "Library Directory" and "ILL Log Sheet," details of billing invoices, and statistical reports, and flexibility in modifying tax rates, borrowing fees, and other parameters.

  16. System and method for determining the net output torque from a waste heat recovery system

    Science.gov (United States)

    Tricaud, Christophe; Ernst, Timothy C.; Zigan, James A.

    2016-12-13

    The disclosure provides a waste heat recovery system with a system and method for calculation of the net output torque from the waste heat recovery system. The calculation uses inputs from existing pressure and speed sensors to create a virtual pump torque sensor and a virtual expander torque sensor, and uses these sensors to provide an accurate net torque output from the WHR system.

  17. HEALTHCARE INFORMATION SYSTEM MANAGEMENT IN THE KYRGYZ REPUBLIC

    Directory of Open Access Journals (Sweden)

    R. Bokushev

    2016-01-01

    Full Text Available Despite the active reformation and informatization of healthcare, healthcare establishments of different levels feature a different degree of access to information resources. The situation is also characterized by parallel development of information collection flows, different level of development of different regions, poorly developed infrastructure. These aspects complicate operative information exchange for the purposes of managerial decision-making. We need to determine the degree of compliance of healthcare information systems and subsystems with user needs, as well as assess the capabilities of information systems to provide timely and quality healthcare information to all users of all levels for the purposes of managerial decision-making. The article presents results of a comprehensive assessment of the current state of healthcare informatization in the Kyrgyz Republic using HMN-developed (Health Metrics Network analytical tools. We demonstrate significant differences in healthcare information system management in the Kyrgyz Republic and note the heterogenous use thereof, especially in regions and districts.

  18. Healthcare

    Science.gov (United States)

    Carnevale, Anthony P.; Smith, Nicole; Gulish, Artem; Beach, Bennett H.

    2012-01-01

    This report, provides detailed analyses and projections of occupations in healthcare fields, and wages earned. In addition, the important skills and work values associated with workers in those fields of healthcare are discussed. Finally, the authors analyze the implications of research findings for the racial, ethnic, and class diversity of the…

  19. The Italian health-care system.

    Science.gov (United States)

    France, George; Taroni, Francesco; Donatini, Andrea

    2005-09-01

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for health care is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist. Copyright (c) 2005 John Wiley & Sons, Ltd.

  20. Unified Selenocentric Reference Coordinates Net in the Dynamic System

    Science.gov (United States)

    Nefedyev, Yuri; Petrova, Natalia; Varaksina, Natalia

    In this report the task of the making selenocentric inertial reference net is solved. The purpose is making summary reference net by expansion KSC-1162 selenodetic system using 12 cosmic and ground selenodesic catalogues. The prospective analysis of this net was performed. These selenocentric reference catalogue covers full visible and a part of far lunar sides. Modern cosmic technologies need the accurate coordinate - temporal support including reference frame realization, inertial and dynamic system orientation and studying dynamic and geometry celestial bodies. That refers to dynamic and geometric selenocentric lunar parameters. The catalogue based on mission “Apollo” and reference nets of the west lunar hemisphere made by missions “Zond 5”, ”Zond 8” cover small part of the Moon surface. Three ALSEP stations were used to transform “Apollo” topographic coordinates. Transformation mean-square errors are less than 80 meters and measurement’s errors are about 60 meters. On this account positions inaccuracy near and between ALSEP stations are less 150 meters. The offset from place of the location ALSEP enlarges the supposed mistake is more than 300 m and this is a major part of the lunar surface. In solving the problem of high-precision condensation and expansion of fundamental selenocentric net KSC-1162 on the visible side of the Moon and lunar far side were obtained following new results: a) the analysis and investigation of the accuracy of basic net contained in ULCN were carried out; b) the decryption of common objects for coordinate systems which are being explored was executed; c) the extension of the mathematical content package TSC was carried out; d) the development of TSC as an expert system of universal transformation planet's coordinates was carried out; e) the possibility of applying the ARM-approach to the problem TC on common objects, which allows to find optimal parameter estimation and model structure of TC was confirmed; f) the

  1. LIFE CYCLE ASSESSMENT IN HEALTHCARE SYSTEM OPTIMIZATION. INTRODUCTION

    Directory of Open Access Journals (Sweden)

    V. Sarancha

    2015-03-01

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

  2. 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

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

    African Journals Online (AJOL)

    Healthcare waste generation and its management system: the case of health centers in West Gojjam Zone, Amhara Region, Ethiopia. ... Operational guidelines were not found in all assessed health centers. Nine out 70 (13%) interviewed healthcare workers had needle injuries during the last 12 months prior this study.

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

    African Journals Online (AJOL)

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

  5. Automatic Prompt System in the Process of Mapping plWordNet on Princeton WordNet

    Directory of Open Access Journals (Sweden)

    Paweł Kędzia

    2015-06-01

    Full Text Available Automatic Prompt System in the Process of Mapping plWordNet on Princeton WordNet The paper offers a critical evaluation of the power and usefulness of an automatic prompt system based on the extended Relaxation Labelling algorithm in the process of (manual mapping plWordNet on Princeton WordNet. To this end the results of manual mapping – that is inter-lingual relations between plWN and PWN synsets – are juxtaposed with the automatic prompts that were generated for the source language synsets to be mapped. We check the number and type of inter-lingual relations introduced on the basis of automatic prompts and the distance of the respective prompt synsets from the actual target language synsets.

  6. Understanding how orthopaedic surgery practices generate value for healthcare systems.

    Science.gov (United States)

    Olson, Steven A; Mather, Richard C

    2013-06-01

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

  7. The influence of power in the Canadian healthcare system.

    Science.gov (United States)

    Seenandan-Sookdeo, Kendra-Ann I

    2012-01-01

    This article presents a review of the literature as it relates to the influence of the word power in the context of the Canadian healthcare system. The concept of power is used to explore issues of gender and the evolution of advanced nurse practice in the development of the Canadian healthcare system. Furthermore, issues related to the call for interprofessional collaboration are addressed. Healthcare workers, in particular nurses, are trusted in a society that seeks, promotes, and aspires for power and control. In addition, societal norms continue to shape our healthcare reform. As a consequence, the discussion centers on a call for true collaboration among our healthcare providers and concludes with implications for nursing.

  8. Role of teleconsultation in moving the healthcare system forward.

    Science.gov (United States)

    Yusof, Khairuddin; Neoh, Karen Hong Beng; bin Hashim, Muhammad Arif; Ibrahim, Ishak

    2002-01-01

    The equitable access to quality healthcare by Malaysians has consistently been the primary objective of the Ministry of Health (MOH). The epidemiological transition to chronic illnesses, advances in medical technology, escalating healthcare costs and rising patient expectations has necessitated the strategic use of information systems in healthcare delivery. Malaysia has broken new ground by implementing a nationwide network to address inadequate access to healthcare, as well as to lower costs and achieve better health outcomes. Teleconsultation refers to the electronic transmission of medical information and services from one site to another using telecommunication technologies. This technology transforms the healthcare system by rapidly matching patient needs with the appropriate level of care however geographically remote they may be. Our findings suggest that even in these early stages of implementation, teleconsultation has led to cost savings, a more efficient allocation of resources, enhanced diagnostic options and better health outcomes.

  9. Toward More Compassionate Healthcare Systems; Comment on “Enabling Compassionate Healthcare: Perils, Prospects and Perspectives”

    Directory of Open Access Journals (Sweden)

    Beth A. Lown

    2014-05-01

    Full Text Available Compassion is central to the purpose of medicine and the care of patients and their families. Compassionate healthcare begins with compassionate people, but cannot be consistently provided without systemic changes that enable clinicians and staff to collaborate and to care. We propose seven essential commitments to foster more compassionate healthcare organizations and systems: a commitment to compassionate leadership, to teach compassion, to value and reward compassionate care, to support clinical caregivers, to involve and partner with patients and families, to build compassion into the organization of healthcare delivery, and a commitment to deepen our understanding of compassion and its impact through research. Acting on these commitments will help us attend with care to the ill, injured, and vulnerable in every interaction.

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

    Science.gov (United States)

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

    2012-10-01

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

  11. The Intelligent Healthcare Data Management System Using Nanosensors

    Directory of Open Access Journals (Sweden)

    Ulzii-Orshikh Dorj

    2017-01-01

    Full Text Available We developed a design of Intelligent Healthcare Data Management System using nanosensors (IHDMS and composed an application for mobile device. The proposed IHDMS will coordinate the healthcare data of the patients from nanosensors and transforms it into a worldwide consumed standard HL7 (Health Level Seven for conversion of healthcare data. This converted data dispatches to a server of its system. The battery lifetime of the facility is feasible to increase, the memory usage is less than 100 KB, and it operates all data by employing few and far between resources. Moreover, the proposed system decreases the waiting time in the transposing data, and secured channel was used for the server of the healthcare center in the running HL7 format data.

  12. Engineering Value-Effective Healthcare Solutions: A Systems Design Perspective

    DEFF Research Database (Denmark)

    Patou, François; Maier, Anja

    2017-01-01

    models, i.e. decentralised, personalised, pervasive, connected, and stratified, promise to relieve some of this tension, they do not per se guarantee optimal value generation. We argue that systems thinking and engineering design can remedy this limitation. We support this claim by making the case...... the limitations of current engineering design practices and call for new theoretical and empirical research initiatives taking a systems perspective on healthcare product and service design.......Our modern healthcare systems commonly face an important dilemma. While they depend on innovation to provide continuously greater healthcare value, they also struggle financially with the burden of adopting a continuous flow of new products and services. Although several disruptive healthcare...

  13. Virtual Video Prototyping for Healthcare Systems

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bossen, Claus; Lykke-Olesen, Andreas

    2002-01-01

    Virtual studio technology enables the mixing of physical and digital 3D objects and thus expands the way of representing design ideas in terms of virtual video prototypes, which offers new possibilities for designers by combining elements of prototypes, mock-ups, scenarios, and conventional video....... In this article we report our initial experience in the domain of pervasive healthcare with producing virtual video prototypes and using them in a design workshop. Our experience has been predominantly favourable. The production of a virtual video prototype forces the designers to decide very concrete design...

  14. Virtual video prototyping of pervasive healthcare systems

    DEFF Research Database (Denmark)

    Bardram, Jakob; Bossen, Claus; Lykke-Olesen, Andreas

    2002-01-01

    Virtual studio technology enables the mixing of physical and digital 3D objects and thus expands the way of representing design ideas in terms of virtual video prototypes, which offers new possibilities for designers by combining elements of prototypes, mock-ups, scenarios, and conventional video....... In this article we report our initial experience in the domain of pervasive healthcare with producing virtual video prototypes and using them in a design workshop. Our experience has been predominantly favourable. The production of a virtual video prototype forces the designers to decide very concrete design...

  15. Mobile healthcare applications: system design review, critical issues and challenges.

    Science.gov (United States)

    Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

    2015-03-01

    Mobile phones are becoming increasingly important in monitoring and delivery of healthcare interventions. They are often considered as pocket computers, due to their advanced computing features, enhanced preferences and diverse capabilities. Their sophisticated sensors and complex software applications make the mobile healthcare (m-health) based applications more feasible and innovative. In a number of scenarios user-friendliness, convenience and effectiveness of these systems have been acknowledged by both patients as well as healthcare providers. M-health technology employs advanced concepts and techniques from multidisciplinary fields of electrical engineering, computer science, biomedical engineering and medicine which benefit the innovations of these fields towards healthcare systems. This paper deals with two important aspects of current mobile phone based sensor applications in healthcare. Firstly, critical review of advanced applications such as; vital sign monitoring, blood glucose monitoring and in-built camera based smartphone sensor applications. Secondly, investigating challenges and critical issues related to the use of smartphones in healthcare including; reliability, efficiency, mobile phone platform variability, cost effectiveness, energy usage, user interface, quality of medical data, and security and privacy. It was found that the mobile based applications have been widely developed in recent years with fast growing deployment by healthcare professionals and patients. However, despite the advantages of smartphones in patient monitoring, education, and management there are some critical issues and challenges related to security and privacy of data, acceptability, reliability and cost that need to be addressed.

  16. A Petri Net model for distributed energy system

    Science.gov (United States)

    Konopko, Joanna

    2015-12-01

    Electrical networks need to evolve to become more intelligent, more flexible and less costly. The smart grid is the next generation power energy, uses two-way flows of electricity and information to create a distributed automated energy delivery network. Building a comprehensive smart grid is a challenge for system protection, optimization and energy efficient. Proper modeling and analysis is needed to build an extensive distributed energy system and intelligent electricity infrastructure. In this paper, the whole model of smart grid have been proposed using Generalized Stochastic Petri Nets (GSPN). The simulation of created model is also explored. The simulation of the model has allowed the analysis of how close the behavior of the model is to the usage of the real smart grid.

  17. A Petri Net model for distributed energy system

    Energy Technology Data Exchange (ETDEWEB)

    Konopko, Joanna [Warsaw University of Technology, The Faculty of Electronics and Information Technology, Institute of Computer Science, Nowowiejska Street 15/19, Warsaw 00-665 (Poland)

    2015-12-31

    Electrical networks need to evolve to become more intelligent, more flexible and less costly. The smart grid is the next generation power energy, uses two-way flows of electricity and information to create a distributed automated energy delivery network. Building a comprehensive smart grid is a challenge for system protection, optimization and energy efficient. Proper modeling and analysis is needed to build an extensive distributed energy system and intelligent electricity infrastructure. In this paper, the whole model of smart grid have been proposed using Generalized Stochastic Petri Nets (GSPN). The simulation of created model is also explored. The simulation of the model has allowed the analysis of how close the behavior of the model is to the usage of the real smart grid.

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

    Science.gov (United States)

    Harries, David; Yellowlees, Peter M

    2013-01-01

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

  19. Leadership and transformational change in healthcare organisations: a qualitative analysis of the North East Transformation System.

    Science.gov (United States)

    Erskine, Jonathan; Hunter, David J; Small, Adrian; Hicks, Chris; McGovern, Tom; Lugsden, Ed; Whitty, Paula; Steen, Nick; Eccles, Martin Paul

    2013-02-01

    The research project 'An Evaluation of Transformational Change in NHS North East' examines the progress and success of National Health Service (NHS) organisations in north east England in implementing and embedding the North East Transformation System (NETS), a region-wide programme to improve healthcare quality and safety, and to reduce waste, using a combination of Vision, Compact, and Lean-based Method. This paper concentrates on findings concerning the role of leadership in enabling tranformational change, based on semi-structured interviews with a mix of senior NHS managers and quality improvement staff in 14 study sites. Most interviewees felt that implementing the NETS requires committed, stable leadership, attention to team-building across disciplines and leadership development at many levels. We conclude that without senior leader commitment to continuous improvement over a long time scale and serious efforts to distribute leadership tasks to all levels, healthcare organisations are less likely to achieve positive changes in managerial-clinical relations, sustainable improvements to organisational culture and, ultimately, the region-wide step change in quality, safety and efficiency that the NETS was designed to deliver. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  20. Change readiness for SAP in the Canadian healthcare system.

    Science.gov (United States)

    O'Neill, Mary Lou; Downer, Pauline

    2004-01-01

    The study described in this article was designed to assess the change readiness for e-business cost management systems (particularly SAP) within the Canadian healthcare system. Previous studies and experts suggest that change readiness is an important variable in the application of e-business cost management system implementation. One hundred and fifty-four chief executive officers within the Canadian healthcare system were surveyed. The response rate was 25.9 percent. The survey included a demographic sheet, which supported a better understanding of the profile of Canadian healthcare CEOs, their operational budget responsibilities, and their feelings toward e-business cost management systems. A change readiness instrument reviewed CEOs' change readiness scores in relation to four independent variables (implementation of an e-business cost management system, healthcare restructuring, budget size and tenure of the CEO). There was a significant difference between change readiness scores and the implementation of an e-business cost management system. Given the small sample size (n = 40), findings are limited. However the study offers more information on this issue than is found in the Canadian healthcare literature to date.

  1. Mapping healthcare systems: a policy relevant analytic tool.

    Science.gov (United States)

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

    2017-07-01

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

  2. Public trust in the healthcare system in a developing country.

    Science.gov (United States)

    Peters, Dexnell; Youssef, Farid F

    2016-04-01

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

  3. Formal Requirements Modeling for Reactive Systems with Coloured Petri Nets

    DEFF Research Database (Denmark)

    Tjell, Simon

    This dissertation presents the contributions of seven publications all concerned with the application of Coloured Petri Nets (CPN) to requirements modeling for reactive systems. The publications are introduced along with relevant background material and related work, and their contributions...... to addressing the problem of validating formal requirements models through interactive graphical animations is presented. Executable Use Cases (EUCs) provide a framework for integrating three tiers of descriptions of specifications and environment assumptions: the lower tier is an informal description...... activity. The traces are automatically recorded during execution of the model. The second publication presents a formally specified framework for automating a large part of the tasks related to integrating Problem Frames with CPN. The framework is specified in VDM++, and allows the modeler to automatically...

  4. Information security requirements in patient-centred healthcare support systems.

    Science.gov (United States)

    Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

    2013-01-01

    Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

  5. NetWeaver for EMDS user guide (version 1.1): a knowledge base development system.

    Science.gov (United States)

    Keith M. Reynolds

    1999-01-01

    The guide describes use of the NetWeaver knowledge base development system. Knowledge representation in NetWeaver is based on object-oriented fuzzy-logic networks that offer several significant advantages over the more traditional rulebased representation. Compared to rule-based knowledge bases, NetWeaver knowledge bases are easier to build, test, and maintain because...

  6. Development of space simulation / net-laboratory system

    Science.gov (United States)

    Usui, H.; Matsumoto, H.; Ogino, T.; Fujimoto, M.; Omura, Y.; Okada, M.; Ueda, H. O.; Murata, T.; Kamide, Y.; Shinagawa, H.; Watanabe, S.; Machida, S.; Hada, T.

    A research project for the development of space simulation / net-laboratory system was approved by Japan Science and Technology Corporation (JST) in the category of Research and Development for Applying Advanced Computational Science and Technology(ACT-JST) in 2000. This research project, which continues for three years, is a collaboration with an astrophysical simulation group as well as other space simulation groups which use MHD and hybrid models. In this project, we develop a proto type of unique simulation system which enables us to perform simulation runs by providing or selecting plasma parameters through Web-based interface on the internet. We are also developing an on-line database system for space simulation from which we will be able to search and extract various information such as simulation method and program, manuals, and typical simulation results in graphic or ascii format. This unique system will help the simulation beginners to start simulation study without much difficulty or effort, and contribute to the promotion of simulation studies in the STP field. In this presentation, we will report the overview and the current status of the project.

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

    Science.gov (United States)

    Jenkins, E K; Christenson, E

    2001-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Anne Marie Lyngsø

    2016-03-01

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

  9. Mobile technology and healthcare: the adoption issues and systemic problems.

    Science.gov (United States)

    Standing, Susan; Standing, Craig

    2008-01-01

    Although the benefits that are associated with mobile technology have been recognised as offering great potential in the healthcare sector, its widespread adoption has been lagging. We propose that fundamental systemic issues are likely to be the main barriers to adoption. We explain that the fragmented nature of the conservative healthcare system, the contradictory incentives and improper outcome measures conspire to make the innovative adoption of mobile technology problematic. Researchers can only gain a limited understanding of a technology's potential success by using technology adoption frameworks and need to supplement this with a 'systems' perspective that takes a more strategic view.

  10. 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.

  11. Enhancing Health-Care Services with Mixed Reality Systems

    Science.gov (United States)

    Stantchev, Vladimir

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

  12. Fault Diagnosis System of Wind Turbine Generator Based on Petri Net

    Science.gov (United States)

    Zhang, Han

    Petri net is an important tool for discrete event dynamic systems modeling and analysis. And it has great ability to handle concurrent phenomena and non-deterministic phenomena. Currently Petri nets used in wind turbine fault diagnosis have not participated in the actual system. This article will combine the existing fuzzy Petri net algorithms; build wind turbine control system simulation based on Siemens S7-1200 PLC, while making matlab gui interface for migration of the system to different platforms.

  13. Expert system for the optimisation of melt extruded net structures

    CSIR Research Space (South Africa)

    Rawal, A

    2005-01-01

    Full Text Available Net structures were produced by replacing the static die (spinneret) with two concentric dies (consisting of slots) rotating in opposite directions in a melt extrusion process. A series of net structures and filaments were produced from a square die...

  14. Fuzzy Petri nets to model vision system decisions within a flexible manufacturing system

    Science.gov (United States)

    Hanna, Moheb M.; Buck, A. A.; Smith, R.

    1994-10-01

    The paper presents a Petri net approach to modelling, monitoring and control of the behavior of an FMS cell. The FMS cell described comprises a pick and place robot, vision system, CNC-milling machine and 3 conveyors. The work illustrates how the block diagrams in a hierarchical structure can be used to describe events at different levels of abstraction. It focuses on Fuzzy Petri nets (Fuzzy logic with Petri nets) including an artificial neural network (Fuzzy Neural Petri nets) to model and control vision system decisions and robot sequences within an FMS cell. This methodology can be used as a graphical modelling tool to monitor and control the imprecise, vague and uncertain situations, and determine the quality of the output product of an FMS cell.

  15. Management system aided design: healthcare R&D center application

    OpenAIRE

    Schindler, Aude; Bocquet, Jean-Claude; Dudezert, Aurélie

    2007-01-01

    International audience; The very changing economic environment imposes on the organizations to be flexible. New design methods have to be carried out to create such agile organizations. The systemic approach can be used to contribute to the design of systems such as organizational or decision systems. This paper presents a method based on systemics and an exploratory study case relative to the design of a healthcare research center called MIRCen, especially its decision system. Organizational...

  16. An Attribute Based Access Control Framework for Healthcare System

    Science.gov (United States)

    Afshar, Majid; Samet, Saeed; Hu, Ting

    2018-01-01

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

  17. Design Principles for Achieving Integrated Healthcare Information Systems

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind

    2013-01-01

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

  18. Business Intelligence Success applied to Healthcare Information Systems

    DEFF Research Database (Denmark)

    Gaardboe, Rikke; Nyvang, Tom; Sandalgaard, Niels

    2017-01-01

    In this paper, DeLone and McLean’s IS Success Model is empirically tested on a Business Intelligence System applied to Healthcare Information Systems at 12 public hospitals in Denmark. The purpose of the study is to investigate which factors contribute to BI Success. A total of 1351 end...

  19. 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...

  20. Components of Maternal Healthcare Delivery System Contributing to ...

    African Journals Online (AJOL)

    Triangulated data from the respective medical charts and interview transcripts were analyzed using a directed approach to content analysis. Excerpts were categorized according to three main components of the maternal healthcare delivery system: skill birth attendant (SBA), enabling environment (EE) and referral system ...

  1. Secure Wireless Military Healthcare Telemedicine Enterprise System

    National Research Council Canada - National Science Library

    Lucas, Kenneth

    2003-01-01

    ...(exp TM) software and Division Tools with cross platform telemedicine systems, inclusive of computer based systems, handheld wireless PDA devices, and miniature computers, to existing DoD legacy...

  2. Secure Wireless Military Healthcare Telemedicine Enterprise System

    National Research Council Canada - National Science Library

    Lucas, Kenneth

    2002-01-01

    ...) software and Dvision Tools with cross platform telemedicine systems, inclusive of computer based systems, handheld wireless PDA devices, and miniature computers, to existing DoD legacy and developing...

  3. Accounting System in Croatian Public Healthcare Organizations: an Empirical Analysis

    Directory of Open Access Journals (Sweden)

    Davor VAŠIČEK

    2010-06-01

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

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

    Science.gov (United States)

    Martenstein, I; Wienke, A

    2016-05-01

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

  5. PhantomNet: Exploring Optimal Multicellular Multiple Antenna Systems

    Directory of Open Access Journals (Sweden)

    Foschini Gerard J

    2004-01-01

    Full Text Available We present a network framework for evaluating the theoretical performance limits of wireless data communication. We address the problem of providing the best possible service to new users joining the system without affecting existing users. Since, interference-wise, new users are required to be invisible to existing users, the network is dubbed PhantomNet. The novelty is the generality obtained in this context. Namely, we can deal with multiple users, multiple antennas, and multiple cells on both the uplink and the downlink. The solution for the uplink is effectively the same as for a single cell system since all the base stations (BSs simply amount to one composite BS with centralized processing. The optimum strategy, following directly from known results, is successive decoding (SD, where the new user is decoded before the existing users so that the new users' signal can be subtracted out to meet its invisibility requirement. Only the BS needs to modify its decoding scheme in the handling of new users, since existing users continue to transmit their data exactly as they did before the new arrivals. The downlink, even with the BSs operating as one composite BS, is more problematic. With multiple antennas at each BS site, the optimal coding scheme and the capacity region for this channel are unsolved problems. SD and dirty paper (DP are two schemes previously reported to achieve capacity in special cases. For PhantomNet, we show that DP coding at the BS is equal to or better than SD. The new user is encoded before the existing users so that the interference caused by his signal to existing users is known to the transmitter. Thus the BS modifies its encoding scheme to accommodate new users so that existing users continue to operate as before: they achieve the same rates as before and they decode their signal in precisely the same way as before. The solutions for the uplink and the downlink are particularly interesting in the way they exhibit a

  6. The Appliance Pervasive of Internet of Things in Healthcare Systems

    OpenAIRE

    Mir Sajjad Hussain Talpur

    2013-01-01

    In fact, information systems are the foundation of new productivity sources, medical organizational forms, and erection of a global economy. IoT based healthcare systems play a significant role in ICT and have contribution in growth of medical information systems, which are underpinning of recent medical and economic development strategies. However, to take advantages of IoT, it is essential that medical enterprises and community should trust the IoT systems in terms of performance, security,...

  7. Knowledge management systems success in healthcare: Leadership matters.

    Science.gov (United States)

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

    2017-01-01

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

  8. CMOS Enabled Microfluidic Systems for Healthcare Based Applications

    KAUST Repository

    Khan, Sherjeel M.

    2018-02-27

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

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

    Science.gov (United States)

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

    2012-10-01

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

  10. Polypathology, an emerging phenomenon and a challenge for healthcare systems.

    Science.gov (United States)

    Román, P; Ruiz-Cantero, A

    2017-05-01

    Improvements in living conditions and scientific advances have led to an unprecedented demographic change. The curing of numerous acute diseases and the growing adoption of unhealthy lifestyles have caused a pandemic of cumulative chronic diseases that constitute the leading cause of death worldwide. Currently, the most common situation is the coexistence of multiple chronic diseases (or polypathology). This situation undermines socio-economic development and increases inequality. This results in an overriding need to change the way in which health and disease are addressed. Healthcare systems are not prepared to meet the needs of complex polypathological patients. In this article, we summarise the challenges facing healthcare systems and states, as well as the main recommendations from the organisations responsible for healthcare. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  11. Prioritizing health system and disease burden factors: an evaluation of the net benefit of transferring health technology interventions to different districts in Zimbabwe.

    Science.gov (United States)

    Shamu, Shepherd; Rusakaniko, Simbarashe; Hongoro, Charles

    2016-01-01

    Health-care technologies (HCTs) play an important role in any country's health-care system. Zimbabwe's health-care system uses a lot of HCTs developed in other countries. However, a number of local factors have affected the absorption and use of these technologies. We therefore set out to test the hypothesis that the net benefit regression framework (NBRF) could be a helpful benefit testing model that enables assessment of intra-national variables in HCT transfer. We used an NBRF model to assess the benefits of transferring cost-effective technologies to different jurisdictions. We used the country's 57 administrative districts to proxy different jurisdictions. For the dependent variable, we combined the cost and effectiveness ratios with the districts' per capita health expenditure. The cost and effectiveness ratios were obtained from HIV/AIDS and malaria randomized controlled trials, which did either a prospective or retrospective cost-effectiveness analysis. The independent variables were district demographic and socioeconomic determinants of health. The study showed that intra-national variation resulted in different net benefits of the same health technology intervention if implemented in different districts in Zimbabwe. The study showed that population data, health data, infrastructure, demographic and health-seeking behavior had significant effects on the net margin benefit for the different districts. The net benefits also differed in terms of magnitude as a result of the local factors. Net benefit testing using local data is a very useful tool for assessing the transferability and further adoption of HCTs developed elsewhere. However, adopting interventions with a positive net benefit should also not be an end in itself. Information on positive or negative net benefit could also be used to ascertain either the level of future savings that a technology can realize or the level of investment needed for the particular technology to become beneficial.

  12. Strengthening the healthcare system through an effective General ...

    African Journals Online (AJOL)

    The SSGMC will endeavour to regain public confidence in the healthcare system by closely monitoring standards of medical professionalism. The inevitable alignment of medical practice in South Sudan with that of neighbouring East African countries may constrain some of our doctors who trained in Sudan due to linguistic.

  13. Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

    Directory of Open Access Journals (Sweden)

    Hong J. Kan

    2013-01-01

    Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

  14. Evaluating Complex Healthcare Systems: A Critique of Four Approaches

    Directory of Open Access Journals (Sweden)

    Heather Boon

    2007-01-01

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

  15. Wireless Body Area Network in a Ubiquitous Healthcare System for Physiological Signal Monitoring and Health Consulting

    OpenAIRE

    Joonyoung Jung; Kiryong Ha; Jeonwoo Lee; Youngsung Kim; Daeyoung Kim

    2008-01-01

    We developed a ubiquitous healthcare system consisted of aphysiological signal devices, a mobile system, a device provider system, a healthcare service provider system, a physician system, and a healthcare personal system. In this system, wireless body area network (WBAN) such as ZigBee is used to communicate between physiological signal devices and the mobile system. WBAN device needs a specific function for ubiquitous healthcare application. We propose a scanning algorithm, dynamic discover...

  16. Personal Healthcare System Using Smart Phone

    Directory of Open Access Journals (Sweden)

    Yee Nwe Htun

    2015-08-01

    Full Text Available Mobile health care is to provide health care services to anyone at anytime overcoming the constraints of place time and character.A huge number of people are suffering from Alzheimers disease or mentalchronically ill andCardiac disease. MoreoverElderly increase gradually and they are only staying in their home.SoPatients can feel lonely and they are spare-men.Butthe patient who use these system can get immediate medical attention use their times outside freely and work for their family as much as they can and they feel more confident than the past.This system is designed heart rate puse sensorGPS receiver and accelerometer sensor which are included in the patients senor node.And then the smart phone analyses in real-time sensors data and determines whether the person needs external help or not.Moreover.it can automatically send current location andmedical information as a message topre- assigned people who could be the patients family and friends and call the ambulance of the emergency centre when a patient is faced in emergency condition.It also acts as the personal health information system and the psychological data ferom the patient store into mobile database.

  17. New context and old challenges in the healthcare system.

    Science.gov (United States)

    Peiró, Manel; Barrubés, Joan

    2012-07-01

    The economic crisis cannot conceal the need for transformation of the National Health System. The financial difficulties of healthcare systems whose spending is growing at a faster rate than the economy have been well known for years. The development and diffusion of new technologies, increased use of health services, rising drug costs, inflation of prices, and the inefficiency of the system explain the new context. The challenges facing the healthcare system are not new: address the debt, improve funding, review the list of services, transform the governance of the system and provide the institutions with real management autonomy. The gravity of the economic situation can be an opportunity to carry out the long-awaited changes. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  18. Hospital Systems, Convenient Care Strategies, and Healthcare Reform.

    Science.gov (United States)

    Kaissi, Amer; Shay, Patrick; Roscoe, Christina

    2016-01-01

    Retail clinics (RCs) and urgent care centers (UCCs) are convenient care models that emerged on the healthcare scene in the past 10 to 15 years. Characterized as disruptive innovations, these models of healthcare delivery seem to follow a slightly different path from each other. Hospital systems, the very organizations that were originally threatened by convenient care models, are developing them and partnering with existing models. We posit that legislative changes such as the Affordable Care Act created challenges for hospital systems that accelerated their adoption of these models. In this study, we analyze 117 hospital systems in six states and report on their convenient care strategies. Our data suggest that UCCs are more prevalent than RCs among hospital systems, and that large and unexplained state-by-state variations exist in the adoption of these strategies. We also postulate about the future role of hospital systems in leading these innovations.

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

    Directory of Open Access Journals (Sweden)

    Ignacio José Godinho Delgado

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

  20. Understanding healthcare innovation systems: the Stockholm region case.

    Science.gov (United States)

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

    2016-11-21

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

  1. Managing responsible antimicrobial use: perspectives across the healthcare system.

    Science.gov (United States)

    Dyar, O J; Tebano, G; Pulcini, C

    2017-07-01

    Healthcare systems consist of building blocks. Shaping how these building blocks function and interact can promote responsible antimicrobial use, and this represents an important opportunity for managers at different points within healthcare systems to act upon. To review real-world examples of how healthcare systems can promote responsible antimicrobial use, focusing on the role of governance and managers. We searched and reviewed existing literature and official documents, which mostly focused on antibiotics. We also drew on the diverse experiences of the ESGAP (the ESCMID (European Society of Clinical Microbiology and Infectious Diseases) Study Group for Antimicrobial stewardshiP) network. First, we explored at the institution level the implementation of antimicrobial stewardship programmes, the need to embrace multidisciplinary approaches, the benefits of engaging with social sciences experts, and the role of governance and leadership. We look beyond individual institutions and highlight the urgent need for workforce capacity estimates for antimicrobial stewardship activities, how antimicrobial stewardship efforts can connect to form networks, and the importance of governance and regulation at national and international levels. Managers in the healthcare system are in a strong position to look beyond individual prescriptions and to recognize the many ways in which different healthcare system building blocks can contribute to responsible use of antimicrobials. At the institution level this can be achieved by implementing antimicrobial stewardship programmes, ensuring they are adequately resourced, and driving buy-in across clinical leadership. At regional and national levels this includes facilitating the sharing of experiences and resources between institutions, and developing the standards and regulations needed to support responsible antimicrobial use. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier

  2. System Dynamics and Feedforward Control for Tether-Net Space Robot System

    Directory of Open Access Journals (Sweden)

    Guang Zhai

    2009-06-01

    Full Text Available A new concept using flexible tether-net system to capture space debris is presented in this paper. With a mass point assumption the tether-net system dynamic model is established in orbital frame by applying Lagrange Equations. In order to investigate the net in-plane trajectories during after cast, the non-control R-bar and V-bar captures are simulated with ignoring the out-of-plane libration, the effect of in-plane libration on the trajectories of the capture net is demonstrated by simulation results. With an effort to damp the in-plane libration, the control scheme based on tether tension is investigated firstly, after that an integrated control scheme is proposed by introduced the thrusters into the system, the nonlinear close-loop dynamics is linearised by feedforward strategy, the simulation results show that feedforward controllor is effective for in-plane libration damping and enable the capture net to track an expected trajectory.

  3. System Dynamics and Feedforward Control for Tether-Net Space Robot System

    Directory of Open Access Journals (Sweden)

    Bin Liang

    2009-11-01

    Full Text Available A new concept using flexible tether-net system to capture space debris is presented in this paper. With a mass point assumption the tether-net system dynamic model is established in orbital frame by applying Lagrange Equations. In order to investigate the net in-plane trajectories during after cast, the non-control R-bar and V-bar captures are simulated with ignoring the out-of-plane libration, the effect of in-plane libration on the trajectories of the capture net is demonstrated by simulation results. With an effort to damp the in-plane libration, the control scheme based on tether tension is investigated firstly, after that an integrated control scheme is proposed by introduced the thrusters into the system, the nonlinear close-loop dynamics is linearised by feedforward strategy, the simulation results show that feedforward controllor is effective for in-plane libration damping and enable the capture net to track an expected trajectory.

  4. Distinguishing Environment and System in Coloured Petri Net Models of Reactive Systems

    DEFF Research Database (Denmark)

    Tjell, Simon

    2007-01-01

    code-generation from models. A prototypical tool has been implemented for performing the structural analysis of Coloured Petri Net models and the principles of this tool is described. The aim of the paper is to make the guidelines and their formalized definitions along with a proof......This paper introduces and formally defines the environment-and-system-partitioned property for behavioral models of reactive systems expressed in the formal modeling language Coloured Petri Net. The purpose of the formalization is to make it possible to automatically validate any CPN model...

  5. Toward a Representation of Hybrid Functional Petri Nets by MP Systems

    Science.gov (United States)

    Castellini, Alberto; Franco, Giuditta; Manca, Vincenzo

    In this work we analyse and compare Hybrid Functional Petri Nets [10], an extension of Petri Nets [12] for biopathways simulation, and Metabolic P Systems [8,9]. An introduction to both of them is given, together with highlights about respective similarities and differences for biopathways modelling. The case study of glycolytic pathway with the lac operon gene regulatory mechanism was modeled by traditional Petri Nets in [6] and recently by Hybrid Functional Petri Nets in [10,4]. This model is here mapped into an MP system having the same dynamics.

  6. Towards a Usability and Error "Safety Net": A Multi-Phased Multi-Method Approach to Ensuring System Usability and Safety.

    Science.gov (United States)

    Kushniruk, Andre; Senathirajah, Yalini; Borycki, Elizabeth

    2017-01-01

    The usability and safety of health information systems have become major issues in the design and implementation of useful healthcare IT. In this paper we describe a multi-phased multi-method approach to integrating usability engineering methods into system testing to ensure both usability and safety of healthcare IT upon widespread deployment. The approach involves usability testing followed by clinical simulation (conducted in-situ) and "near-live" recording of user interactions with systems. At key stages in this process, usability problems are identified and rectified forming a usability and technology-induced error "safety net" that catches different types of usability and safety problems prior to releasing systems widely in healthcare settings.

  7. Public trust in the Spanish health-care system.

    Science.gov (United States)

    Jovell, Albert; Blendon, Robert J; Navarro, Maria Dolors; Fleischfresser, Channtal; Benson, John M; Desroches, Catherine M; Weldon, Kathleen J

    2007-12-01

    Fifteen years ago, public opinion surveys in Spain showed substantial dissatisfaction with the health-care system. Since that time, health-care in Spain has undergone significant changes, including a decentralization of the system, an increase in spending and a change in the way the system is financed. This study examines how Spanish citizens rate the performance of their health system today, both as compared with other sectors of society and as compared with earlier time periods. Data are drawn from nationally representative telephone surveys of the non-institutionalized adult Spanish population (age 18 years and over). The study was carried out in two phases: October-November 2005 (n = 3,010) and January 2006 (n = 2,101). The majority of the Spanish population thinks the health system needs to be changed. The problems cited relate mostly to long wait times to get health-care. Nevertheless, over the last 15 years, the proportion of people who have very negative views about the health system has decreased by half. The majority believes that not enough money is spent on health-care, but few people would support an increase in taxes to provide additional funding. The survey finds the National Health System's institutions and health professionals to be more highly trusted than other institutions and professional groups in the country. Government policy-makers in Spain face a dilemma: the public wants more health spending to decrease wait times, but there is substantial resistance to increasing taxes as a means to finance improvements in the system's capacity.

  8. Development of Network Interface Cards for TRIDAQ systems with the NaNet framework

    Science.gov (United States)

    Ammendola, R.; Biagioni, A.; Cretaro, P.; Di Lorenzo, S.; Fiorini, M.; Frezza, O.; Lamanna, G.; Lo Cicero, F.; Lonardo, A.; Martinelli, M.; Neri, I.; Paolucci, P. S.; Pastorelli, E.; Piandani, R.; Pontisso, L.; Rossetti, D.; Simula, F.; Sozzi, M.; Valente, P.; Vicini, P.

    2017-03-01

    NaNet is a framework for the development of FPGA-based PCI Express (PCIe) Network Interface Cards (NICs) with real-time data transport architecture that can be effectively employed in TRIDAQ systems. Key features of the architecture are the flexibility in the configuration of the number and kind of the I/O channels, the hardware offloading of the network protocol stack, the stream processing capability, and the zero-copy CPU and GPU Remote Direct Memory Access (RDMA). Three NIC designs have been developed with the NaNet framework: NaNet-1 and NaNet-10 for the CERN NA62 low level trigger and NaNet3 for the KM3NeT-IT underwater neutrino telescope DAQ system. We will focus our description on the NaNet-10 design, as it is the most complete of the three in terms of capabilities and integrated IPs of the framework.

  9. Health-care process improvement decisions: a systems perspective.

    Science.gov (United States)

    Walley, Paul; Silvester, Kate; Mountford, Shaun

    2006-01-01

    The paper seeks to investigate decision-making processes within hospital improvement activity, to understand how performance measurement systems influence decisions and potentially lead to unsuccessful or unsustainable process changes. A longitudinal study over a 33-month period investigates key events, decisions and outcomes at one medium-sized hospital in the UK. Process improvement events are monitored using process control methods and by direct observation. The authors took a systems perspective of the health-care processes, ensuring that the impacts of decisions across the health-care supply chain were appropriately interpreted. The research uncovers the ways in which measurement systems disguise failed decisions and encourage managers to take a low-risk approach of "symptomatic relief" when trying to improve performance metrics. This prevents many managers from trying higher risk, sustainable process improvement changes. The behaviour of the health-care system is not understood by many managers and this leads to poor analysis of problem situations. Measurement using time-series methodologies, such as statistical process control are vital for a better understanding of the systems impact of changes. Senior managers must also be aware of the behavioural influence of similar performance measurement systems that discourage sustainable improvement. There is a risk that such experiences will tarnish the reputation of performance management as a discipline. Recommends process control measures as a way of creating an organization memory of how decisions affect performance--something that is currently lacking.

  10. A post-Bertalanffy Systemics Healthcare Competitive Framework Proposal.

    Science.gov (United States)

    Fiorini, Rodolfo A; Santacroce, Giulia F

    2014-01-01

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

  11. 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.

  12. Organizational attachment of interns in Poland to healthcare system.

    Science.gov (United States)

    Bolanowski, Wojciech

    2007-01-01

    Despite the profound structural reform of the health service in Poland, the present organizational system of health care is subject to severe criticism. It is described as unjust and enhancing malpractice as well as migration of young doctors abroad. The commonly expressed disapproval and own observations on the organization and functions of health care are expected to affect future performance of medical interns and suppress their motivation to pursue professional career. The purpose of the study was to evaluate the extent to which the interns approve the present healthcare system as a measure of their organizational attachment. Questionnaire survey was conducted in 992 interns (mean age 26 years) in 2004 and responses were evaluated using a specially designed scale of approval. The majority of interns expressed high disapproval of the healthcare system. This disapproval can be regarded as an indirect measure of the lack of organizational attachment on the part of the interns. These findings may have negative consequences for the future functions of healthcare in Poland. Therefore, measures should be undertaken to promote positive attitudes among medical students and interns. The disapproval of the system is a personal attitude independent of the social and economic characteristics. One should note that the personnel mobility opportunities do not seem to be playing the role of an effective "safety valve" to diminish the disapproval of the system by medical interns.

  13. M&E-NetPay: A Micropayment System for Mobile and Electronic Commerce

    Directory of Open Access Journals (Sweden)

    Xiaodi Huang

    2016-08-01

    Full Text Available As an increasing number of people purchase goods and services online, micropayment systems are becoming particularly important for mobile and electronic commerce. We have designed and developed such a system called M&E-NetPay (Mobile and Electronic NetPay. With open interoperability and mobility, M&E-NetPay uses web services to connect brokers and vendors, providing secure, flexible and reliable credit services over the Internet. In particular, M&E-NetPay makes use of a secure, inexpensive and debit-based off-line protocol that allows vendors to interact only with customers, after validating coins. The design of the architecture and protocol of M&E-NetPay are presented, together with the implementation of its prototype in ringtone and wallpaper sites. To validate our system, we have conducted its evaluations on performance, usability and heuristics. Furthermore, we compare our system to the CORBA-based (Common Object Request Broker Architecture off-line micro-payment systems. The results have demonstrated that M&E-NetPay outperforms the .NET-based M&E-NetPay system in terms of performance and user satisfaction.

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

    DEFF Research Database (Denmark)

    Edwards, Kasper; Nielsen, Anders Paarup

    of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

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

    Science.gov (United States)

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

    2006-01-01

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

  16. Novel Authentication Schemes for IoT Based Healthcare Systems

    OpenAIRE

    Jia-Li Hou; Kuo-Hui Yeh

    2015-01-01

    With the advancement of information communication technologies, the evolution of the Internet has given rise to a ubiquitous network consisting of interconnected objects (or things), called the Internet of Things (IoT). Recently, the academic community has made great strides in researching and developing security for IoT based applications, focusing, in particular, on healthcare systems based on IoT networks. In this paper, we propose a sensor (or sensor tags) based communication architecture...

  17. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    Directory of Open Access Journals (Sweden)

    Hoffman Steven J

    2011-12-01

    Full Text Available Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs. Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140, Laos (136, Senegal (100 and Tanzania (121. Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497 across Ghana (107/140, Laos (136/136, Senegal (51/100 and Tanzania (78/121. Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13% or self-reported performing all five clinical practices according to established evidence (2%. Statistically significant factors associated with higher knowledge within each country included: 1 training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73; and 2 ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70. Statistically significant factors associated with better clinical practices within each country include: 1 reading scientific journals from their own country (OR

  18. Implementation and deployment of healthcare management information system.

    Science.gov (United States)

    Zelic, I; Bercic, B; Pikec, M; Slavec, S

    2000-01-01

    In the following article we present development of the Management Information System, an implementation of our own Data Warehouse, build on top of the existing Healthcare Information System. We discuss requirements and phases of development of the system, we present the structure of the system, the experiences with end users and obstacles that we met, as well as possible improvements end extensions of the system. The system is designed as a framework that works with workload measurement sub-systems, which are defined as multidimensional arrays, and are observed through different units of time. Each of the axis has several hierarchical structures build on top of it. Setting up the system is a difficult task, because it requires a good knowledge of organisational structure of a particular hospital. We used an incremental approach in defining the organisational structure. On top of the framework we build a user customisable graphical user interface, which enables different types of end users to efficiently use the system.

  19. Application of growing nested Petri nets for modeling robotic systems operating under risk

    Science.gov (United States)

    Sorokin, E. V.; Senkov, A. V.

    2017-10-01

    The paper studies the peculiarities of modeling robotic systems engaged in mining. Existing modeling mechanisms are considered, which are based on nested Petri nets, and a new formalism of growing Petri nets is presented that allows modeling robotic systems operating under risk. Modeling is provided both for the regular operation mode and for non-standard modes in which individual elements of the system can perform uncharacteristic functions. The example shows growing Petri nets that are used for modeling extraction of flat coal seams by a robotic system consisting of several different-type autonomous robots.

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

    Directory of Open Access Journals (Sweden)

    Ramona Fernanda Ceriotti Toassi

    2013-06-01

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

  1. An Efficient Scalable Runtime System for S-Net Dataflow Component Coordination

    NARCIS (Netherlands)

    Grelck, C.U.; Gijsbers, E.J.; Zimmermann, W.

    2013-01-01

    S-Net is a declarative component coordination language aimed at radically facilitating software engineering for modern parallel compute systems by near-complete separation of concerns between application (component) engineering and concurrency orchestration. S-Net builds on the concept of stream

  2. Healthcare delivery systems at higher educational institutions in India.

    Science.gov (United States)

    Yeravdekar, Rajiv Chintaman; Yeravdekar, Vidya Rajiv

    2014-09-01

    The interrelation between health and academic performance is well established. Academic institutions have a larger mandate, beyond academic instruction alone. The objective is to contribute holistically to student development through various paradigms, ultimately culminating in student success. To meet the global challenges of a changing educational system, educational institutions today are therefore vying to be Centers of Excellence, aiming to develop the overall personality of the student. Fundamental to this ideology and with student success as the common denominator, student Wellness assumes critical significance. Higher education institutions, especially universities offer varying levels of healthcare services. Health Promoting University (HPU) projects have therefore been implemented in the West. Unlike in the West, the concept of a Health Promoting University is nascent in India. A total of 1071 responses to a structured questionnaire administered to the students were studied. In general, there appears to be a lack of awareness regarding the importance of addressing student healthcare issues. Consequently, the spectrum of healthcare services provided is varied and scattered. This encompasses infrastructure, manpower, resource allocation etc. The collective responses obtained could provide the basis for a policy formulation. The policy formulation in turn could be the basis of a national consensus for health care delivery systems operational at higher educational institutions in India.

  3. Defining Health Profession Regulators' Roles in the Canadian Healthcare System.

    Science.gov (United States)

    Tepper, Joshua; Ahmed, Humayun; Brown, Adalsteinn D

    2017-01-01

    Health professions regulation today faces a myriad of challenges, due to both the perceived performance of regulatory colleges, how health systems have evolved, and even larger political and economic shifts such as the renegotiation of NAFTA. In this issue of Healthcare Papers, Wilkie and Tzountzouris (2017) describe the work of the College of Medical Laboratory Technologists of Ontario (CMLTO) to redefine professionalism in the context of these challenges. Their paper, and the comments of the responding authors in this issue highlight that there, is an overarching perception that health regulatory structures - across a range of professions - are not working as effectively as they should. Across this issue of Healthcare Papers, attention is drawn to the fact that more can be done to improve both the function and perception of professional regulatory bodies. However, each paper presents a different approach to how improvements in function and perception are possible.

  4. Coloured Petri Nets and CPN Tools for Modelling and Validation of Concurrent Systems

    DEFF Research Database (Denmark)

    Jensen, Kurt; Kristensen, Lars Michael; Wells, Lisa Marie

    2007-01-01

    Coloured Petri Nets (CPNs) is a language for the modeling and validation og systems in which concurrency, communication, and synchronisation play a major role. Coloured Petri Nets is a descrete-event modeling language combining Petri Nets with the funcitonal programming language Standard ML. Petri...... taken to execute events in the modelled system. CPN Tolls is an industrial-strength computer tool for construction and analysing CPN models. Using CPN Tools, it is possible to investigate the behaviour of the modelled system using simulation, to verify properties by means of state sp0ece methods...

  5. Research information systems are path to high-quality healthcare.

    Science.gov (United States)

    Ziegenfuss, J T

    1987-10-01

    Research is the key to dealing with the major issues facing the healthcare industry. And an information system for organization and management research is a necessary component in healthcare organizations. Research information systems should support action, not theory. Their purpose is to educate information users about their system of services; provide data for planning, developing, directing, and evaluating both technical and management work; and provide a basis for "steering" the program. Four key subjects for a research information system are service activities, patient characteristics, costs and budget, and outcomes. The goal in developing a research information system is to integrate the various types of information into a format that provides the information for management use at a given time. Development of a research information system requires concentrating on the design and the process of developing and using the data for action research. Each design step requires an analysis of existing and future research requirements, of what clinical and managerial leaders would like to know. Identifying users is important, since they will ultimately judge the adequacy of the system. Each user has to make decisions based on the data. Such decisions include setting goals, forming policy, organizing activities, and budgeting.

  6. An enhanced healthcare system in mobile cloud computing environment

    Directory of Open Access Journals (Sweden)

    Jemal Hanen

    2016-07-01

    Full Text Available Abstract Mobile cloud computing (MCC is a new technology for mobile web services. Accordingly, we assume that MCC is likely to be of the heart of healthcare transformation. MCC offers new kinds of services and facilities for patients and caregivers. In this regard, we have tried to propose a new mobile medical web service system. To this end, we implement a medical cloud multi-agent system (MCMAS solution for polyclinic ESSALEMA Sfax—TUNISIA, using Google’s Android operating system. The developed system has been assessing using the CloudSim Simulator. This paper presents initial results of the system in practice. In fact the proposed solution shows that the MCMAS has a commanding capability to cope with the problem of traditional application. The performance of the MCMAS is compared with the traditional system in polyclinic ESSALEMA which showed that this prototype yields better recital than using usual application.

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

    Science.gov (United States)

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

    2012-08-01

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

  8. Improving Transgender Healthcare in the New York City Correctional System.

    Science.gov (United States)

    Jaffer, Mohamed; Ayad, John; Tungol, Jose Gabriel; MacDonald, Ross; Dickey, Nathaniel; Venters, Homer

    2016-04-01

    Correctional settings create unique challenges for patients with special needs, including transgender patients, who have an increased rate of overall discrimination, sexual abuse, healthcare disparities, and improper housing. As part of our correctional health quality improvement process, we sought to review and evaluate the adequacy of care for transgender patients in the New York City jail system. Using correctional pharmacy records, transgender patients receiving hormonal treatment were identified. A brief in-person survey was conducted to evaluate their care in the community before incarceration, medical care in jail, and experience in the jail environment. Survey findings and analysis of transgender patient healthcare-related complaints revealed opportunities for improvements in the provision of care and staff understanding of this population. Utilizing these findings, we conducted lesbian, gay, bisexual, and transgender (LGBT) trainings in all 12 jail clinics for medical, nursing, and mental health staff. Three months after LGBT training, patient complaints dropped by over 50%. After the development and implementation of a newly revised transgender healthcare policy, complaints dropped to zero within 6 months. Our efforts to assess the quality of care provided to transgender patients revealed significant areas for improvement. Although we have made important gains in providing quality care through the implementation of policies and procedures rooted in community standards and the express wishes of our patients, we continue to engage this patient population to identify other issues that impact their health and well-being in the jail environment.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely...... unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia...

  10. Net infiltration of the Death Valley regional ground-water flow system, Nevada and California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — Recharge in the Death Valley regional ground-water flow system (DVRFS) was estimated from net infiltration simulated by Hevesi and others (2003) using a...

  11. Demand for private healthcare in a universal public healthcare system: empirical evidence from Sri Lanka.

    Science.gov (United States)

    Pallegedara, Asankha; Grimm, Michael

    2017-11-01

    This paper examines healthcare utilization behaviour in Sri Lanka with special emphasis on the choice between costly private and free public healthcare services. We use a data set that combines nationwide household survey data and district level healthcare supply data. Our findings suggest that even with universal public healthcare policy, richer people tend to use private sector healthcare services rather than public services. We also find significant regional and ethnic discrepancies in healthcare access bearing the risk of social tensions if these are further amplified. Latent class analysis shows in addition that the choice between private and public sector healthcare significantly differs between people with and without chronic diseases. We find in particular that chronically ill people rely for their day-to-day care on the public sector, but for their inpatient care they turn more often than non-chronically ill people to the private sector, implying an additional financial burden for the chronically ill. If the observed trend continues it may not only increase further the health-income gradient in Sri Lanka but also undermine the willingness of the middle class to pay taxes to finance public healthcare. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Beam Energy and System Size Dependence of Dynamical Net Charge Fluctuations

    Energy Technology Data Exchange (ETDEWEB)

    STAR Coll

    2008-07-21

    We present measurements of net charge fluctuations in Au + Au collisions at {radical}s{sub NN} = 19.6, 62.4, 130, and 200 GeV, Cu + Cu collisions at {radical}s{sub NN} = 62.4, 200 GeV, and p + p collisions at {radical}s = 200 GeV using the dynamical net charge fluctuations measure {nu}{sub {+-},dyn}. We observe that the dynamical fluctuations are non-zero at all energies and exhibit a modest dependence on beam energy. A weak system size dependence is also observed. We examine the collision centrality dependence of the net charge fluctuations and find that dynamical net charge fluctuations violate 1/N{sub ch} scaling, but display approximate 1/N{sub part} scaling. We also study the azimuthal and rapidity dependence of the net charge correlation strength and observe strong dependence on the azimuthal angular range and pseudorapidity widths integrated to measure the correlation.

  13. Systems Design Perspective of Healthcare Provision in Humanitarian Aid

    Directory of Open Access Journals (Sweden)

    Ana Laura Santos

    2014-12-01

    Full Text Available This study focuses on the role of Systems Design in addressing the challenges of healthcare provision by international emergency relief organizations in developing countries. More specifically the challenges related to the safety and performance of medical equipment that is transferred in the aftermath of a humanitarian crisis. The aim of this paper is to describe the transfer of medical equipment and its associated challenges from a systems perspective and to reflect on the value of Systems Design as an approach to humanitarian innovation, addressing the identified systemic challenges. The concepts of Human Factors and Ergonomics, and Product-Service Systems will be presented as valuable contributions to support designers in handling a larger degree of complexity throughout the design process and to support them to make informed choices regarding this particular context.

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

    Science.gov (United States)

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

    2017-05-26

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

  15. Potentiality of Big Data in the Medical Sector: Focus on How to Reshape the Healthcare System

    National Research Council Canada - National Science Library

    Jee, Kyoungyoung; Kim, Gang-Hoon

    2013-01-01

    The main purpose of this study was to explore whether the use of big data can effectively reduce healthcare concerns, such as the selection of appropriate treatment paths, improvement of healthcare systems, and so...

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

    Science.gov (United States)

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

    2017-01-01

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

  17. Android based self-diagnostic electrocardiogram system for mobile healthcare.

    Science.gov (United States)

    Choo, Kan-Yeep; Ling, Huo-Chong; Lo, Yew-Chiong; Yap, Zuo-Han; Pua, Jun-Sheng; Phan, Raphael C-W; Goh, Vik-Tor

    2015-01-01

    Cardiovascular diseases are the most common cause of death worldwide and are characterized by arrhythmia (i.e. irregular rhythm of heartbeat). Arrhythmia occasionally happens under certain conditions, such as stress. Therefore, it is difficult to be diagnosed using electrocardiogram (ECG) devices available in hospitals for just a few minutes. Constant diagnosis and monitoring of heartbeat is required to reduce death caused by cardiovascular diseases. Mobile healthcare system has emerged as a potential solution to assist patients in monitoring their own heart condition, especially those who are isolated from the reference hospital. This paper proposes a self-diagnostic electrocardiogram system for mobile healthcare that has the capability to perform a real-time ECG diagnostic. The self-diagnostic capability of a real-time ECG signal is achieved by implementing a detrended fluctuation analysis (DFA) method. The result obtained from DFA is used to display the patient's health condition on a smartphone anytime and anywhere. If the health condition is critical, the system will alert the patient and his medical practitioner for further diagnosis. Experimental results verified the validity of the developed ECG diagnostic application on a smartphone. The proposed system can potentially reduce death caused by cardiovascular diseases by alerting the patient possibly undergoing a heart attack.

  18. Wireless Network of Collaborative Physiological Signal Devices in a U-Healthcare System

    Science.gov (United States)

    Jung, Joonyoung; Kim, Daeyoung

    We designed and implemented collaborative physiological signal devices in a u-healthcare(ubiquitous healthcare) system. In this system, wireless body area network (WBAN) such as ZigBee is used to communicate between physiological signal devices and the mobile system. WBAN device needs a specific function for ubiquitous healthcare application. We show several collaborative physiological devices and propose WBAN mechanism such as a fast scanning algorithm, a dynamic discovery and installation mechanism, a reliable data transmission, a device access control for security, and a healthcare profile for u-healthcare system.

  19. The role of privacy protection in healthcare information systems adoption.

    Science.gov (United States)

    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.

  20. Comparative analysis of net energy balance for satellite power systems (SPS) and other energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Cirillo, R.R.; Cho, B.S.; Monarch, M.R.; Levine, E.P.

    1980-04-01

    The net energy balance of seven electric energy systems is assessed: two coal-based, one nuclear, two terrestrial solar, and two solar power satellites, with principal emphasis on the latter two systems. Solar energy systems require much less operating energy per unit of electrical output. However, on the basis of the analysis used here, coal and nuclear systems are two to five times more efficient at extracting useful energy from the primary resource base than are the solar energy systems. The payback period for all systems is less than 1.5 years, except for the terrestrial photovoltaic (19.8 yr) and the solar power satellite system (6.4 yr), both of which rely on energy-intensive silicon cells.

  1. Distributed Agent Based Interoperable Virtual EMR System for Healthcare System Integration.

    Science.gov (United States)

    Yang, Xuebing; Miao, Yuan

    2011-06-01

    One of the major problems in health care system integration is the formidable cost of mediating between myriad vendors and policy makers for updating existing heterogeneous systems to support a great variety of standards or interfaces. To provide cost-effective healthcare system integration solution, this paper presents a Graphical User Interface state model (GUISM) for automatically exchanging information with existing healthcare software through their GUIs with no modifications needed to them. This can save the huge cost of upgrading, testing and redeploying the existing systems. By using the GUISM model, distributed agents are deployed to the client computers interacting with the local electronic medical system (EMR) for communicating with other EMR systems. The whole system is called virtual EMR system and each client in this system can request needed patient healthcare information without knowing the actual location of the data.

  2. Systems Medicine: The Future of Medical Genomics, Healthcare, and Wellness.

    Science.gov (United States)

    Saqi, Mansoor; Pellet, Johann; Roznovat, Irina; Mazein, Alexander; Ballereau, Stéphane; De Meulder, Bertrand; Auffray, Charles

    2016-01-01

    Recent advances in genomics have led to the rapid and relatively inexpensive collection of patient molecular data including multiple types of omics data. The integration of these data with clinical measurements has the potential to impact on our understanding of the molecular basis of disease and on disease management. Systems medicine is an approach to understanding disease through an integration of large patient datasets. It offers the possibility for personalized strategies for healthcare through the development of a new taxonomy of disease. Advanced computing will be an important component in effectively implementing systems medicine. In this chapter we describe three computational challenges associated with systems medicine: disease subtype discovery using integrated datasets, obtaining a mechanistic understanding of disease, and the development of an informatics platform for the mining, analysis, and visualization of data emerging from translational medicine studies.

  3. A Petri Net-Based Software Process Model for Developing Process-Oriented Information Systems

    Science.gov (United States)

    Li, Yu; Oberweis, Andreas

    Aiming at increasing flexibility, efficiency, effectiveness, and transparency of information processing and resource deployment in organizations to ensure customer satisfaction and high quality of products and services, process-oriented information systems (POIS) represent a promising realization form of computerized business information systems. Due to the complexity of POIS, explicit and specialized software process models are required to guide POIS development. In this chapter we characterize POIS with an architecture framework and present a Petri net-based software process model tailored for POIS development with consideration of organizational roles. As integrated parts of the software process model, we also introduce XML nets, a variant of high-level Petri nets as basic methodology for business processes modeling, and an XML net-based software toolset providing comprehensive functionalities for POIS development.

  4. Visual Control System of a Spraying Robot for Hyphantria cunea Larva Nets

    Directory of Open Access Journals (Sweden)

    Ying Zhao

    2015-01-01

    Full Text Available In order to implement automatic spraying on Hyphantria cunea larva nets, a spraying robot system with monocular hand-eye coordination and smart targeting abilities was designed according to the target net features. The system realized spatial two-dimensional motions driven by step motors on linear guide rails. Images were processed in real-time to extract the net curtain targets defined using the border area, and the optimal spraying position was then determined. An identification algorithm based on the global net image to distinguish targets before and after spray was proposed. A simulation environment was designed to verify the correctness of this method. Results showed that the highest rate of over spray is 288.5%, and the spray miss rate is 0.

  5. Wireless health data exchange for home healthcare monitoring systems.

    Science.gov (United States)

    Lee, Malrey; Gatton, Thomas M

    2010-01-01

    Ubiquitous home healthcare systems have been playing an increasingly significant role in the treatment and management of chronic diseases, such as diabetes and hypertension, but progress has been hampered by the lack of standardization in the exchange of medical health care information. In an effort to establish standardization, this paper proposes a home healthcare monitoring system data exchange scheme between the HL7 standard and the IEEE1451 standard. IEEE1451 is a standard for special sensor networks, such as industrial control and smart homes, and defines a suite of interfaces that communicate among heterogeneous networks. HL7 is the standard for medical information exchange among medical organizations and medical personnel. While it provides a flexible data exchange in health care domains, it does not provide for data exchange with sensors. Thus, it is necessary to develop a data exchange schema to convert data between the HL7 and the IEEE1451 standard. This paper proposes a schema that can exchange data between HL7 devices and the monitoring device, and conforms to the IEEE 1451 standard. The experimental results and conclusions of this approach are presented and show the feasibility of the proposed exchange schema.

  6. Wireless Health Data Exchange for Home Healthcare Monitoring Systems

    Directory of Open Access Journals (Sweden)

    Malrey Lee

    2010-04-01

    Full Text Available Ubiquitous home healthcare systems have been playing an increasingly significant role in the treatment and management of chronic diseases, such as diabetes and hypertension, but progress has been hampered by the lack of standardization in the exchange of medical health care information. In an effort to establish standardization, this paper proposes a home healthcare monitoring system data exchange scheme between the HL7 standard and the IEEE1451 standard. IEEE1451 is a standard for special sensor networks, such as industrial control and smart homes, and defines a suite of interfaces that communicate among heterogeneous networks. HL7 is the standard for medical information exchange among medical organizations and medical personnel. While it provides a flexible data exchange in health care domains, it does not provide for data exchange with sensors. Thus, it is necessary to develop a data exchange schema to convert data between the HL7 and the IEEE1451 standard. This paper proposes a schema that can exchange data between HL7 devices and the monitoring device, and conforms to the IEEE 1451 standard. The experimental results and conclusions of this approach are presented and show the feasibility of the proposed exchange schema.

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

    Science.gov (United States)

    Roig, Francesc; Saigí, Francesc

    2011-01-01

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

  8. NetCDF based data archiving system applied to ITER Fast Plant System Control prototype

    Energy Technology Data Exchange (ETDEWEB)

    Castro, R., E-mail: rodrigo.castro@visite.es [Asociacion EURATOM/CIEMAT para Fusion, Madrid (Spain); Vega, J. [Asociacion EURATOM/CIEMAT para Fusion, Madrid (Spain); Ruiz, M.; De Arcas, G.; Barrera, E.; Lopez, J.M.; Sanz, D. [Grupo de Investigacion en Instrumentacion y Acustica Aplicada, UPM, Madrid (Spain); Goncalves, B.; Santos, B. [Associacao EURATOM/IST, IPFN - Laboratorio Associado, IST, Lisboa (Portugal); Utzel, N.; Makijarvi, P. [ITER Organization, St. Paul lez Durance Cedex (France)

    2012-12-15

    Highlights: Black-Right-Pointing-Pointer Implementation of a data archiving solution for a Fast Plant System Controller (FPSC) for ITER CODAC. Black-Right-Pointing-Pointer Data archiving solution based on scientific NetCDF-4 file format and Lustre storage clustering. Black-Right-Pointing-Pointer EPICS control based solution. Black-Right-Pointing-Pointer Tests results and detailed analysis of using NetCDF-4 and clustering technologies on fast acquisition data archiving. - Abstract: EURATOM/CIEMAT and Technical University of Madrid (UPM) have been involved in the development of a FPSC (Fast Plant System Control) prototype for ITER, based on PXIe (PCI eXtensions for Instrumentation). One of the main focuses of this project has been data acquisition and all the related issues, including scientific data archiving. Additionally, a new data archiving solution has been developed to demonstrate the obtainable performances and possible bottlenecks of scientific data archiving in Fast Plant System Control. The presented system implements a fault tolerant architecture over a GEthernet network where FPSC data are reliably archived on remote, while remaining accessible to be redistributed, within the duration of a pulse. The storing service is supported by a clustering solution to guaranty scalability, so that FPSC management and configuration may be simplified, and a unique view of all archived data provided. All the involved components have been integrated under EPICS (Experimental Physics and Industrial Control System), implementing in each case the necessary extensions, state machines and configuration process variables. The prototyped solution is based on the NetCDF-4 (Network Common Data Format) file format in order to incorporate important features, such as scientific data models support, huge size files management, platform independent codification, or single-writer/multiple-readers concurrency. In this contribution, a complete description of the above mentioned solution

  9. Utilization Elementary Siphons of Petri Net to Solved Deadlocks in Flexible Manufacturing Systems

    Science.gov (United States)

    Abdul-Hussin, Mowafak Hassan

    2015-07-01

    This article presents an approach to the constructing a class structural analysis of Petri nets, where elementary siphons are mainly used in the development of a deadlock control policy of flexible manufacturing systems (FMSs), that has been exploited successfully for the design of supervisors of some supervisory control problems. Deadlock-free operation of FMSs is significant objectives of siphons in the Petri net. The structure analysis of Petri net models has efficiency in control of FMSs, however different policy can be implemented for the deadlock prevention. Petri nets models based deadlock prevention for FMS's has gained considerable interest in the development of control theory and methods for design, controlling, operation, and performance evaluation depending of the special class of Petri nets called S3PR. Both structural analysis and reachability tree analysis is used for the purposes analysis, simulation and control of Petri nets. In our ex-perimental approach based to siphon is able to resolve the problem of deadlock occurred to Petri nets that are illustrated with an FMS.

  10. Modeling reconfigurable manufacturing systems with colored timed Petri nets

    NARCIS (Netherlands)

    Zhang, L.; Rodrigues, B.

    2009-01-01

    Reconfigurable manufacturing systems (RMSs) have been acknowledged as a promising means of providing manufacturing companies with the required production capacities and capabilities. This is accomplished through reconfiguring system elements over time for a diverse set of individualised products

  11. An advanced rehabilitation robotic system for augmenting healthcare.

    Science.gov (United States)

    Hu, John; Lim, Yi-Je; Ding, Ye; Paluska, Daniel; Solochek, Aaron; Laffery, David; Bonato, Paolo; Marchessault, Ronald

    2011-01-01

    Emerging technologies such as rehabilitation robots (RehaBot) for retraining upper and lower limb functions have shown to carry tremendous potential to improve rehabilitation outcomes. Hstar Technologies is developing a revolutionary rehabilitation robot system enhancing healthcare quality for patients with neurological and muscular injuries or functional impairments. The design of RehaBot is a safe and robust system that can be run at a rehabilitation hospital under the direct monitoring and interactive supervision control and at a remote site via telepresence operation control. RehaBot has a wearable robotic structure design like exoskeleton, which employs a unique robotic actuation--Series Elastic Actuator. These electric actuators provide robotic structural compliance, safety, flexibility, and required strength for upper extremity dexterous manipulation rehabilitation training. RehaBot also features a novel non-treadmill paddle platform capable of haptics feedback locomotion rehabilitation training. In this paper, we concern mainly about the motor incomplete patient and rehabilitation applications.

  12. Applications of Petri net in power systems; Aplicacao de redes de Petri a sistemas de potencia

    Energy Technology Data Exchange (ETDEWEB)

    Yoshihiro, Claudio K.; Senger, Eduardo C.

    1995-12-31

    With the increasing automation of the electric power systems, the logic control complexity of such systems is also increasing. Even the most simple equipment or operation nowadays require complexes sequences or logics of protection and operation. This work presents some possibilities concerning the application of Petri nets in power systems. A study case is presented. 7 refs., 13 figs.

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

    Science.gov (United States)

    Azar, Jose; Adams, Nadia; Boustani, Malaz

    2015-01-01

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

  14. OPTIMED Platform: Curriculum Harmonisation System for Medical and Healthcare Education.

    Science.gov (United States)

    Komenda, Martin; Schwarz, Daniel; Vaitsis, Christos; Zary, Nabil; Štěrba, Jaroslav; Dušek, Ladislav

    2015-01-01

    This contribution introduces a new web-based OPTIMED platform for an effective harmonisation of medical and healthcare curriculum. Behind the engineering background stays an original methodology covering planning model based on formal parameterisation of curriculum, which fully support the outcome-based approach to education. With the use of developed system curriculum, designers and senior guarantors can provide a clear and transparent composition of compulsory and optional courses, and easily identify potential duplicities and overlaps across a domain of medical and healthcare education. For students, it means an absolutely new way of how to understand what is really taught during a learning period, including all necessary meta information. All members across the academic community are able to search and consequently display in detail the most important domains related to the particular year, term, course, medical discipline or topic. The presented solution significantly enhances the transparency and continuity of the environment in which the authors of the teaching materials as well as their consumers work daily. Suggestions for future improvements of the OPTIMED platform are discussed.

  15. Wearable nanosensor systems and their applications in healthcare

    Science.gov (United States)

    Ramasamy, Mouli; Kumar, Prashanth S.; Varadan, Vijay K.

    2017-04-01

    The development of intelligent miniaturized nano-bio-and info-tech based sensors capable of wireless communication will fundamentally change the way we monitor and treat patients with chronic disease and after surgery. These new sensors will allow the monitoring of the patients as they maintain their normal daily activities, and provide warning to healthcare workers when critical events arise. This will facilitate early discharge of patients from hospitals as well as providing reassurance to patients and family that potential problems will be detected at an early stage. The use of continuous monitoring allows both transient and progressive abnormalities to be reliably detected thus avoiding the problems of conventional diagnosis and monitoring methods where by data is captured only for a brief period during hospital/clinic visits. We have been working with a printable organic semiconductor and thin film transistor, and have fabricated and tested various biosensors that can measure important physiological signs before and after surgery. Integrated into "smart" fabrics - garments with wireless technology - and independent e-bandaid sensors, nanosensors in tattoos and socks, minimally invasive implantable devices, the sensor systems will be able to monitor a patient's condition in real time and thus provide point-of-care diagnostics to health-care professionals and greater freedom for patients.

  16. Control of proton exchange membrane fuel cell system breathing based on maximum net power control strategy

    Science.gov (United States)

    Li, Qi; Chen, Weirong; Liu, Zhixiang; Guo, Ai; Liu, Shukui

    2013-11-01

    In order to achieve the maximum net power, the analysis for the maximum net power characterization of a proton exchange membrane fuel cell (PEMFC) system is carried out. A maximum net power control (MNPC) strategy based on an implicit generalized predictive control (IGPC) and a reference governor is proposed to keep optimal oxygen excess ratio (OER) trajectory. The IGPC based on an effective informed adaptive particle swarm optimization (EIA-PSO) algorithm is developed to solve the predictive control law and reduce the computational complexity in the rolling optimization process. The simulations of three conditional tests are implemented and the results demonstrate that the proposed strategy can track the optimal OER trajectory, reduce the parasitic power and maximize the output net power. The comprehensive comparisons based on three conditional tests verify that the MNPC-IGPC has better robust performance in the presence of large disturbances, time delay and various noises. The experimental comparison with internal control system of Ballard 1.2 kW Nexa Power Module testifies the validity of the MNPC-IGPC for increasing the net power. Hence, this proposed strategy can provide better behavior to guarantee optimal OER trajectory and the maximum net power even though the disturbances and uncertainties occur.

  17. A Net Centric Collaborative Support System Concept: A Preliminary Investigation

    National Research Council Canada - National Science Library

    Eggleston, Robert

    2004-01-01

    .... The report lays out a conceptual framework as the basis for establishing a scientific foundation for user interface design in the enterprise system context This framework includes a joint functional...

  18. Modelling of Biometric Identification System with Given Parameters Using Colored Petri Nets

    Science.gov (United States)

    Petrosyan, G.; Ter-Vardanyan, L.; Gaboutchian, A.

    2017-05-01

    Biometric identification systems use given parameters and function on the basis of Colored Petri Nets as a modelling language developed for systems in which communication, synchronization and distributed resources play an important role. Colored Petri Nets combine the strengths of Classical Petri Nets with the power of a high-level programming language. Coloured Petri Nets have both, formal intuitive and graphical presentations. Graphical CPN model consists of a set of interacting modules which include a network of places, transitions and arcs. Mathematical representation has a well-defined syntax and semantics, as well as defines system behavioural properties. One of the best known features used in biometric is the human finger print pattern. During the last decade other human features have become of interest, such as iris-based or face recognition. The objective of this paper is to introduce the fundamental concepts of Petri Nets in relation to tooth shape analysis. Biometric identification systems functioning has two phases: data enrollment phase and identification phase. During the data enrollment phase images of teeth are added to database. This record contains enrollment data as a noisy version of the biometrical data corresponding to the individual. During the identification phase an unknown individual is observed again and is compared to the enrollment data in the database and then system estimates the individual. The purpose of modeling biometric identification system by means of Petri Nets is to reveal the following aspects of the functioning model: the efficiency of the model, behavior of the model, mistakes and accidents in the model, feasibility of the model simplification or substitution of its separate components for more effective components without interfering system functioning. The results of biometric identification system modeling and evaluating are presented and discussed.

  19. [Integrative assessment of evidence in healthcare: the GRADE system].

    Science.gov (United States)

    Schünemann, Holger

    2009-01-01

    Decisions are a double-edged sword: they always and inevitably come with positive and negative consequences. Decisions in healthcare--from a systems level to the individual patient--are not different. This approach acknowledges that for all recommendations and decisions all the important consequences need to be considered. Along these lines, one must evaluate the certainty that estimates of effects and decisions are likely to be correct. Thus, as institutions, professional societies, organisations and individuals, we should follow approaches focusing on systematic and integrative assessment of available best evidence. Longstanding and broad experience with the development of recommendations, including systematically developed guidelines, led a group of methodologists, health officers, clinicians and guideline developers to form the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. The GRADE approach differentiates the assessment of the quality of evidence from the strength of a recommendation in healthcare. For a step-by-step evaluation of the quality of evidence, one must consider all patient relevant endpoints. It is common that many relevant and acceptable studies provide evidence for single outcomes. Therefore, integrating summaries and assessments beyond meta-analyses are required. The explicit and transparent description of the single steps in these assessments and the consideration of all currently known criteria for the assessment of the quality of evidence are among the most important advantages and innovations of the GRADE system and are described here briefly. The overall quality of evidence of all outcomes that are critical for decision-making are summarized on the basis of the lowest quality of evidence. If, for example, the evidence for six of seven critical outcomes is of low quality while moderate quality evidence is available for the other critical outcome, the overall quality of evidence is considered low to

  20. [The regionalized healthcare network in Santa Catarina State, Brazil, from 2011 to 2015: governance system and oral healthcare].

    Science.gov (United States)

    Godoi, Heloisa; Andrade, Selma Regina de; Mello, Ana Lúcia Schaefer Ferreira de

    2017-09-28

    : The objective was to describe the governance system used in structuring the regionalized healthcare network in Santa Catarina State, Brazil, based on the Bipartite Inter-Managerial Commission (CIB), with a focus on structuring of oral healthcare. This was a qualitative, exploratory-descriptive documental study, based on the foundations of governance as an analytical tool through identification of the dimensions actors, norms, nodal points, and processes. Secondary data were collected from the minutes of CIB meetings held from January 2011 to December 2015. The analysis shows weaknesses in CIB governance in Santa Catarina in relation to regionalized structuring of oral healthcare from a network perspective. Structuring of oral healthcare occurs in parallel to that of other thematic networks in the state and shows the expansion of dental services, especially those with medium complexity, as an effect of the prevailing governance process. The relations established between administrators and decision-making processes allowed recognizing this network's "prescription", since there is little negotiation and local demand, limited more to following recommendations and incentives from the federal/state sphere, intermediated by staff from the State Health Secretariat. Thus, setting a policy agenda for oral healthcare for the population of Santa Catarina is weakened, with a peripheral position in relation to other health programs.

  1. Distrust in the Healthcare System and Organ Donation Intentions Among African Americans

    OpenAIRE

    Russell, Emily; Robinson, Dana H.Z.; Thompson, Nancy J.; Perryman, Jennie P.; Arriola, Kimberly R. Jacob

    2012-01-01

    The purpose of this study is to further understanding of the association between distrust in the healthcare system and written and verbal expressions of donation intentions among African Americans. We hypothesize that distrust in the healthcare system will be significantly, positively associated with both verbal and written donation intentions. Five hundred and eighty five participants completed a 98-item survey that included scales on distrust in the healthcare system and donation intentions...

  2. A Telematics Learning Environment on the European Parliament: The ParlEuNet System.

    Science.gov (United States)

    Reggiori, Alberto; Best, Clive; Loekkemyhr, Per; van Gulik, Dirk-Willem

    The ParlEuNet (European Parliament Network) under development at the Joint Research Center of the European Communities is a Web-based information system that will provide a multimedia educational platform for 10 secondary schools across Europe. Schools, teachers and pupils will use the system to teach, learn about, and prepare collaborative…

  3. Integration of Systems Network (SysNet) tools for regional land use scenario analysis in Asia

    NARCIS (Netherlands)

    Roetter, R.P.; Hoanh, C.T.; Laborte, A.G.; Keulen, van H.; Ittersum, van M.K.; Dreiser, C.; Diepen, van C.A.; Ridder, de N.; Laar, van H.H.

    2005-01-01

    This paper introduces the approach of the Systems research Network (SysNet) for land use planning in tropical Asia with a focus on its main scientific-technical output: the development of the land use planning and analysis system (LUPAS) and its component models. These include crop simulation

  4. A residential maintenance-free long-term activity monitoring system for healthcare applications

    National Research Council Canada - National Science Library

    Fafoutis, Xenofon; Tsimbalo, Evgeny; Mellios, Evangelos; Hilton, Geoffrey; Piechocki, Robert; Craddock, Ian

    2016-01-01

    Demographic changes such as the ageing population and the continuous rise of chronic medical conditions such as obesity, diabetes and depression make our healthcare systems economically unsustainable...

  5. Comparison between .NET and Java EEImplementation of Cash & Bank System

    OpenAIRE

    Waqar, Hafiz Umer

    2013-01-01

    The demands of software engineering increases with everyday passed and every organization shows interest to work on daily routine work in the computerized system to improve efficiency and accuracy of data. Most of organization demands different kinds of computerized software solutions that developed in modern technologies. There are different software development technologies that is getting popular with the passage of time and provide high quality product to their user. It is not an easy to ...

  6. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

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

    Science.gov (United States)

    Delgado, Ignacio José Godinho

    2016-11-03

    This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist), in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry. Resumo: O artigo discute as relações entre os sistemas de saúde e a indústria farmacêutica, concentrando-se no apoio do Estado à inovação farmacêutica. Salienta as trajetórias dos Estados Unidos, Reino Unido e Alemanha, países desenvolvidos, paradigmáticos dos modernos sistemas de saúde (liberais, universais e corporativos), além do Japão, um caso de emparelhamento bem-sucedido. Também enfatiza as trajetórias de China, Índia e Brasil, países em desenvolvimento, extensos, que experimentaram diferentes estratégias de emparelhamento, dispondo de sistemas de saúde e indústrias farmacêuticas com trajetórias e perfis diversos. Finalmente, com foco nas formas estatais de apoio à pesquisa em saúde, considera os mecanismos de conexão entre os sistemas de saúde e a indústria farmacêutica, avaliando as possibilidades, no Brasil, de fortalecer uma interação virtuosa que favoreça a expansão e

  8. Identifying weak points of urban drainage systems by means of VulNetUD.

    Science.gov (United States)

    Möderl, M; Kleidorfer, M; Sitzenfrei, R; Rauch, W

    2009-01-01

    This article presents the development and application of the software tool VulNetUD. VulNetUD is a tool for GIS-based identification of vulnerable sites of urban drainage systems (UDS) using hydrodynamic simulations undertaken using EPA SWMM. The benefit of the tool is the output of different vulnerability maps rating sewer surcharging, sewer flooding, combined sewer overflow (CSO) efficiency and CSO emissions. For this, seven predefined performance indicators are used to evaluate urban drainage systems under abnormal, critical and future conditions. The application on a case study highlights the capability of the tool to identify weak points of the urban drainage systems. Thereby it is possible to identify urban drainage system components which cause the highest performance decrease across the entire system. The application of the method on a real world case study shows for instance that a reduction of catchment areas which are located upstream of CSOs with relatively less capacity in the downstream sewers achieves the highest increases efficiency of the system. Finally, the application of VulNetUD is seen as a valuable tool for managers and operators of waste water utilities to improve the efficiency of their systems. Additionally vulnerability maps generated by VulNetUD support risk management e.g. decision making in urban development planning or the development of rehabilitation strategies.

  9. Net-Zero Energy Buildings: A Classification System Based on Renewable Energy Supply Options

    Energy Technology Data Exchange (ETDEWEB)

    Pless, S.; Torcellini, P.

    2010-06-01

    A net-zero energy building (NZEB) is a residential or commercial building with greatly reduced energy needs. In such a building, efficiency gains have been made such that the balance of energy needs can be supplied with renewable energy technologies. Past work has developed a common NZEB definition system, consisting of four well-documented definitions, to improve the understanding of what net-zero energy means. For this paper, we created a classification system for NZEBs based on the renewable sources a building uses.

  10. 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.

  11. Hyperion net: A distributed measurement system for monitoring background ionizing radiation

    Directory of Open Access Journals (Sweden)

    Šaponjić Đorđe P.

    2003-01-01

    Full Text Available The distributed measurement system - HYPERION NET, based on the concept of FieldBus technology, has been developed, implemented, and tested as a pilot project, the first WEB enabled on-line networked ionizing radiation monitoring and measurement system. The Net has layered the structure, tree topology, and is based on the Internet infrastructure and TCP/IP communication protocol. The Net' s core element is an intelligent GM transmitter, based on GM tube, used for measuring the absorbed dose in air in the range of 0.087 to 720 μGy/h. The transmitter makes use of an advanced count rate measurement algorithm capable of suppressing the statistical fluctuations of the measured quantity, which significantly improves its measurement performance making it suitable for environmental radiation measurements.

  12. Patient Education as an Information System, Healthcare Tool and Interaction

    Science.gov (United States)

    Pirhonen, Antti; Silvennoinen, Minna; Sillence, Elizabeth

    2014-01-01

    Patient education (PE) has a crucial role in the function of a healthcare organisation. For the care process of a patient, it is essential to get the right information at the right moment and in the right form. This paper analyses PE as the primary mode of interaction between a patient and a healthcare organisation. The approach is illustrated…

  13. Increased light-use efficiency sustains net primary productivity of shaded coffee plants in agroforestry system.

    Science.gov (United States)

    Charbonnier, Fabien; Roupsard, Olivier; le Maire, Guerric; Guillemot, Joannès; Casanoves, Fernando; Lacointe, André; Vaast, Philippe; Allinne, Clémentine; Audebert, Louise; Cambou, Aurélie; Clément-Vidal, Anne; Defrenet, Elsa; Duursma, Remko A; Jarri, Laura; Jourdan, Christophe; Khac, Emmanuelle; Leandro, Patricia; Medlyn, Belinda E; Saint-André, Laurent; Thaler, Philippe; Van Den Meersche, Karel; Barquero Aguilar, Alejandra; Lehner, Peter; Dreyer, Erwin

    2017-08-01

    In agroforestry systems, shade trees strongly affect the physiology of the undergrown crop. However, a major paradigm is that the reduction in absorbed photosynthetically active radiation is, to a certain extent, compensated by an increase in light-use efficiency, thereby reducing the difference in net primary productivity between shaded and non-shaded plants. Due to the large spatial heterogeneity in agroforestry systems and the lack of appropriate tools, the combined effects of such variables have seldom been analysed, even though they may help understand physiological processes underlying yield dynamics. In this study, we monitored net primary productivity, during two years, on scales ranging from individual coffee plants to the entire plot. Absorbed radiation was mapped with a 3D model (MAESPA). Light-use efficiency and net assimilation rate were derived for each coffee plant individually. We found that although irradiance was reduced by 60% below crowns of shade trees, coffee light-use efficiency increased by 50%, leaving net primary productivity fairly stable across all shade levels. Variability of aboveground net primary productivity of coffee plants was caused primarily by the age of the plants and by intraspecific competition among them (drivers usually overlooked in the agroforestry literature) rather than by the presence of shade trees. © 2017 John Wiley & Sons Ltd.

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

    OpenAIRE

    Wang Peng; Jiang Lingyun

    2015-01-01

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

  15. Emerging perspectives on transforming the healthcare system: redesign strategies and a call for needed research.

    Science.gov (United States)

    Doebbeling, Bradley N; Flanagan, Mindy E

    2011-12-01

    U.S. healthcare requires major redesign of its delivery systems, finances, and incentives. Healthcare operations, leadership, and payors are increasingly recognizing the need for community-business-research partnerships to transform healthcare. New models of continuous learning, research, and development should help focus and sustain redesign efforts. This study summarizes suggested strategies for transformational change in healthcare and identifies needed areas for research to inform, spread, and sustain transformational change. We developed these recommendations based on a series of review papers, invited expert discussion, and a subsequent review in the context of a health system transformation research conference (The Regenstrief Biennial Research Conference). The multidisciplinary audience included health systems researchers, clinicians, informaticians, social and engineering scientists, and operational and business leaders. Conference participants and literature reviews identified key strategies for system redesign with the following themes: using the framework of complex adaptive systems; fostering organizational redesign; developing appropriate performance measures and incentives; creating continuous learning organizations; and integrating health information, technology, and communication into practice. Sustained investment in research and development in these areas is crucial. Multiple issues influence the likelihood that healthcare leaders will make transformational changes in their healthcare systems. Healthcare leaders, clinicians, researchers, journals, and academic institutions, in partnership with payors, government and multiple other stakeholders, should apply the recommendations relevant to their own setting to redesign healthcare delivery, improve cognitive support, and sustain transformation. Fostering further research investments in these areas will increase the impact of transformation on the health and healthcare of the public.

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

    Science.gov (United States)

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

    2017-01-01

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

  17. ImBrowse.NET - A Software System for Image Database Search

    OpenAIRE

    Bjelkholm, Joel Erving

    2007-01-01

    Content-based image retrieval systems rely on computer vision to find images based on visual content rather than predefined keywords. Using images as input as opposed to text can provide the user with a novel and in some senses more intuitive way of searching for images. ImBrowse.NET is a platform for developing content-based image retrieval methods. It takes the form of an extendible stand-alone application, written using the Microsoft .NET 3.0 Framework. The application employs principal co...

  18. The Cornell Net Carbohydrate and Protein System model for evaluating herd nutrition and nutrient excretion

    National Research Council Canada - National Science Library

    Fox, D.G; Tedeschi, L.O; Tylutki, T.P; Russell, J.B; Van Amburgh, M.E; Chase, L.E; Pell, A.N; Overton, T.R

    2004-01-01

    .... The Cornell Net Carbohydrate and Protein System (CNCPS) is a mathematical model to evaluate diet and animal performance that was developed from basic principles of rumen function, microbial growth, feed digestion and passage and animal physiology. By accounting for farm-specific management, environmental and feed characteristics, more ...

  19. Net energy output from harvesting small-diameter trees using a mechanized system

    Science.gov (United States)

    Fei Pan; Han-Sup Han; Leonard R. Johnson; William J. Elliot

    2008-01-01

    What amount of extra energy can be generated after subtracting the total energy consumed to produce the biomass energy? Knowing the ratio between energy output and input is a valid question when highly mechanized systems that consume fossil fuels are used to harvest and transport forest biomass for energy. We estimated the net energy generated from mechanical fuel...

  20. Threat driven modeling framework using petri nets for e-learning system

    OpenAIRE

    Khamparia, Aditya; Pandey, Babita

    2016-01-01

    Vulnerabilities at various levels are main cause of security risks in e-learning system. This paper presents a modified threat driven modeling framework, to identify the threats after risk assessment which requires mitigation and how to mitigate those threats. To model those threat mitigations aspects oriented stochastic petri nets are used. This paper included security metrics based on vulnerabilities present in e-learning system. The Common Vulnerability Scoring System designed to provide a...

  1. Determining research knowledge infrastructure for healthcare systems: a qualitative study

    Directory of Open Access Journals (Sweden)

    Lavis John N

    2011-06-01

    Full Text Available Abstract Background This study examines research knowledge infrastructures (RKIs found in health systems. An RKI is defined as any instrument (i.e., programs, interventions, tools implemented in order to facilitate access, dissemination, exchange, and/or use of evidence in healthcare organisations. Based on an environmental scan (17 key informant interviews and scoping review (26 studies, we found support for a framework that we developed that outlines components that a health system can have in its RKI. The broad domains are climate for research use, research production, activities used to link research to action, and evaluation. The objective of the current study is to profile the RKI of three types of health system organisations--regional health authorities, primary care practices, and hospitals--in two Canadian provinces to determine the current mix of components these organisations have in their RKI, their experience with these components, and their views about future RKI initiatives. Methods This study will include semistructured telephone interviews with a purposive sample region of a senior management team member, library/resource centre manager, and a 'knowledge broker' in three regional health authorities, five or six purposively sampled hospitals, and five or six primary care practices in Ontario and Quebec, for a maximum of 71 interviewees. The interviews will explore (a which RKI components have proven helpful, (b barriers and facilitators in implementing RKI components, and (c views about next steps in further development of RKIs. Discussion This is the first qualitative examination of potential RKI efforts that can increase the use of research evidence in health system decision making. We anticipate being able to identify broadly applicable insights about important next steps in building effective RKIs. Some of the identified RKI components may increase the use of research evidence by decision makers, which may then lead to more

  2. Intelligent diagnosis and prescription for a customized physical fitness and healthcare system.

    Science.gov (United States)

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

    2015-01-01

    With the advent of the era of global high-tech industry and commerce and its associated sedentary lifestyle, opportunities for physical activity are reduced. People's physical fitness and health is deteriorating. Therefore, it is necessary to develop a system that can enhance people's physical fitness and health. However, it is difficult for general physical fitness and healthcare systems to meet individualized needs. The main purpose of this research is to develop a method of intelligent diagnosis and prescription for a customized physical fitness and healthcare system. The proposed system records all processes of the physical fitness and healthcare system via a wireless sensor network and the results of the diagnosis and prescription will be generated by fuzzy logic inference. It will improve individualized physical fitness and healthcare. Finally, we demonstrate the advantages of intelligent diagnosis and prescription for a customized physical fitness and healthcare system.

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

    Science.gov (United States)

    Ciplak, Nesli; Barton, John R

    2012-06-01

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

  4. Modeling and performance analysis of the emergency rescue logistics system based on Petri nets

    Directory of Open Access Journals (Sweden)

    Mingxin YANG

    2017-06-01

    Full Text Available In order to more effectively analyze the performance of logistics emergency rescue system, based on analyzing the characteristics and main functions of the Petri net and its advantage of describing asynchronous concurrent random image system, this paper introduces stochastic Petri net modeling method to establish emergency system model on the basis of serious natural disasters or emergencies, and analyzes the performance. Firstly, according to the emergency rescue system of logistics flow chart, the Petri net model is built, and through the analysis of accessibility, activity and safety, the validity of the model is verified; Secondly, the Markov chain is constructed using the characteristics of isostructuralism with the Markov stochastic process, the linear equations is established, and a numerical example is introduced, reflecting the problems of the system through the quantitative analysis of main performance indexes. Finally, some suggestions are put forward about the problems. On the one hand, this modeling can vividly describe the sequential and asynchronous concurrent relationships between the processes; on the other hand, its mature performance analysis method can effectively explore the key links which have significant impacts on the operational efficiency of the system. The system analysis theory provides a feasible method for the analysis of system flow, and the proposal provides a theoretical basis for the optimization of the entire emergency logistics rescue system.

  5. Distrust in the healthcare system and organ donation intentions among African Americans.

    Science.gov (United States)

    Russell, Emily; Robinson, Dana H Z; Thompson, Nancy J; Perryman, Jennie P; Arriola, Kimberly R Jacob

    2012-02-01

    The purpose of this study is to further understanding of the association between distrust in the healthcare system and written and verbal expressions of donation intentions among African Americans. We hypothesize that distrust in the healthcare system will be significantly, positively associated with both verbal and written donation intentions. Five hundred and eighty five participants completed a 98-item survey that included scales on distrust in the healthcare system and donation intentions. Bivariate analyses (t-tests, ANOVA, chi-square tests and odds ratios) were used to explore the extent to which donation intentions and distrust in the healthcare system varied by demographic characteristics and the association between the distrust in the healthcare system scale and verbal and written donation intentions. Separate logistic regressions were performed with each of the dependent variables to see if significant associations remained while controlling for confounders. Findings based on the multiple regression indicate that when controlling the participant's education level, distrust in the healthcare system was not significantly related to written donation intentions (OR = 1.04; P = .12). When controlling for education level, health insurance status, Community Health Advocates group and marital status, distrust in the healthcare system was significantly associated with verbal donation intentions (OR = 1.08; P donation intentions. Future organ donation studies should be conducted to determine the pathways through which distrust in the healthcare system impacts different types of organ donation intentions.

  6. Computerised decision support systems for healthcare professionals: an interpretative review

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2013-03-01

    Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular

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

    African Journals Online (AJOL)

    Bernt Lindtjorn

    The mean healthcare waste generation rate among health centers did not significantly vary. Segregation of wastes .... waste were daily distributed to different section of the health center. ..... Clinical Technology and Department of Protection.

  8. Integrating traditional medical practice with primary healthcare system in Eritrea.

    Science.gov (United States)

    Habtom, GebreMichael Kibreab

    2015-03-01

    The purpose of this paper was to assess the perceptions and attitudes of modern medical practitioners (MMPs) and traditional medical practitioners (TMPs) about traditional medical practice and to analyze the utilization of traditional medicine in Eritrea. The data for this study were collected in a 10-month period from January to October 2004. A cross-sectional study was conducted in three sub-zones of Eritrea: Dekemhare, Ghinda, and Maekel. A total of 500 (250 each) MMPs and TMPs, and 1657 households were included in the study. Data were collected both by questionnaire and an interview (with key informants). Our study reveals that there is a significant difference in perception and attitude between MMPs and TMPs about traditional medical practice in Eritrea. Their differences lie not only in their way of thinking but also in their perceptions of man and health. Our study further shows that in most rural communities in Eritrea, the use of traditional medicine and self-care is extensive. This is the case even in the presence of the supposedly free/subsidized health care available in government health centers. Higher confidence in traditional medicine for the treatment of serious illnesses, irrespective of availability of western medical service in many parts of Eritrea, indicates the need for selective integration of traditional medical practice with the primary healthcare system of the country.

  9. Viral hepatitis and immigration: A challenge for the healthcare system.

    Science.gov (United States)

    Cuenca-Gómez, J A; Salas-Coronas, J; Soriano-Pérez, M J; Vázquez-Villegas, J; Lozano-Serrano, A B; Cabezas-Fernández, M T

    2016-01-01

    Viral hepatitis is a significant health problem in African countries. The increase in the immigrant population from this continent represents a challenge for the Spanish healthcare system. A descriptive study was conducted on the prevalence of the serological markers of hepatitis B (HBV), C (HCV) and D (HDV) in African immigrants treated in a specialised doctor's office. The study included 2518 patients (87.7% Sub-Saharan natives), with a mean age of 31.3 years. Some 78.8% of the patients had a positive infection marker for HBV, and 638 patients (25.3%) were diagnosed with active hepatitis B (HBsAg +). In 19 cases, antibodies against HDV were detected (4 cases with detection of the viral genome). Sixty-eight patients had antibodies against HCV, 26 of whom had a positive viral load. The high prevalence of viral hepatitis in immigrants, especially HBV infection, represents a significant change in the profile of patients treated in Spain and requires measures aimed at early diagnosis and transmission prevention. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  10. ezBioNet: A modeling and simulation system for analyzing biological reaction networks

    Science.gov (United States)

    Yu, Seok Jong; Tung, Thai Quang; Park, Junho; Lim, Jongtae; Yoo, Jaesoo

    2012-10-01

    To achieve robustness against living environments, a living organism is composed of complicated regulatory mechanisms ranging from gene regulations to signal transduction. If such life phenomena are to be understand, an integrated analysis tool that should have modeling and simulation functions for biological reactions, as well as new experimental methods for measuring biological phenomena, is fundamentally required. We have designed and implemented modeling and simulation software (ezBioNet) for analyzing biological reaction networks. The software can simultaneously perform an integrated modeling of various responses occurring in cells, ranging from gene expressions to signaling processes. To support massive analysis of biological networks, we have constructed a server-side simulation system (VCellSim) that can perform ordinary differential equations (ODE) analysis, sensitivity analysis, and parameter estimates. ezBioNet integrates the BioModel database by connecting the european bioinformatics institute (EBI) servers through Web services APIs and supports the handling of systems biology markup language (SBML) files. In addition, we employed eclipse RCP (rich client platform) which is a powerful modularity framework allowing various functional expansions. ezBioNet is intended to be an easy-to-use modeling tool, as well as a simulation system, to understand the control mechanism by monitoring the change of each component in a biological network. A researcher may perform the kinetic modeling and execute the simulation. The simulation result can be managed and visualized on ezBioNet, which is freely available at http://ezbionet.cbnu.ac.kr.

  11. Do reviews of healthcare interventions teach us how to improve healthcare systems?

    Science.gov (United States)

    Pawson, Ray; Greenhalgh, Joanne; Brennan, Cathy; Glidewell, Elizabeth

    2014-08-01

    Planners, managers and policy makers in modern health services are not without ingenuity - they will always try, try and try again. They face deep-seated or 'wicked' problems, which have complex roots in the labyrinthine structures though which healthcare is delivered. Accordingly, the interventions devised to deal with such stubborn problems usually come in the plural. Many different reforms are devised to deal with a particular stumbling block, which may be implemented sequentially, simultaneously or whenever policy fashion or funding dictates. This paper examines this predicament from the perspective of evidence based policy. How might researchers go about reviewing the evidence when they are faced with multiple or indeed competing interventions addressing the same problem? In the face of this plight a rather unheralded form of research synthesis has emerged, namely the 'typological review'. We critically review the fortunes of this strategy. Separating the putative reforms into series of subtypes and producing a scorecard of their outcomes has the unintended effect of divorcing them all from an understanding of how organisations change. A more fruitful approach may lie in a 'theory-driven review' underpinned by an understanding of dynamics of social change in complex organisations. We test this thesis by examining the primary and secondary research on the many interventions designed to tackle a particularly wicked problem, namely the inexorable rise in demand for healthcare. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Threat driven modeling framework using petri nets for e-learning system.

    Science.gov (United States)

    Khamparia, Aditya; Pandey, Babita

    2016-01-01

    Vulnerabilities at various levels are main cause of security risks in e-learning system. This paper presents a modified threat driven modeling framework, to identify the threats after risk assessment which requires mitigation and how to mitigate those threats. To model those threat mitigations aspects oriented stochastic petri nets are used. This paper included security metrics based on vulnerabilities present in e-learning system. The Common Vulnerability Scoring System designed to provide a normalized method for rating vulnerabilities which will be used as basis in metric definitions and calculations. A case study has been also proposed which shows the need and feasibility of using aspect oriented stochastic petri net models for threat modeling which improves reliability, consistency and robustness of the e-learning system.

  13. 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.

  14. E3Net: a system for exploring E3-mediated regulatory networks of cellular functions.

    Science.gov (United States)

    Han, Youngwoong; Lee, Hodong; Park, Jong C; Yi, Gwan-Su

    2012-04-01

    Ubiquitin-protein ligase (E3) is a key enzyme targeting specific substrates in diverse cellular processes for ubiquitination and degradation. The existing findings of substrate specificity of E3 are, however, scattered over a number of resources, making it difficult to study them together with an integrative view. Here we present E3Net, a web-based system that provides a comprehensive collection of available E3-substrate specificities and a systematic framework for the analysis of E3-mediated regulatory networks of diverse cellular functions. Currently, E3Net contains 2201 E3s and 4896 substrates in 427 organisms and 1671 E3-substrate specific relations between 493 E3s and 1277 substrates in 42 organisms, extracted mainly from MEDLINE abstracts and UniProt comments with an automatic text mining method and additional manual inspection and partly from high throughput experiment data and public ubiquitination databases. The significant functions and pathways of the extracted E3-specific substrate groups were identified from a functional enrichment analysis with 12 functional category resources for molecular functions, protein families, protein complexes, pathways, cellular processes, cellular localization, and diseases. E3Net includes interactive analysis and navigation tools that make it possible to build an integrative view of E3-substrate networks and their correlated functions with graphical illustrations and summarized descriptions. As a result, E3Net provides a comprehensive resource of E3s, substrates, and their functional implications summarized from the regulatory network structures of E3-specific substrate groups and their correlated functions. This resource will facilitate further in-depth investigation of ubiquitination-dependent regulatory mechanisms. E3Net is freely available online at http://pnet.kaist.ac.kr/e3net.

  15. E3Net: A System for Exploring E3-mediated Regulatory Networks of Cellular Functions*

    Science.gov (United States)

    Han, Youngwoong; Lee, Hodong; Park, Jong C.; Yi, Gwan-Su

    2012-01-01

    Ubiquitin-protein ligase (E3) is a key enzyme targeting specific substrates in diverse cellular processes for ubiquitination and degradation. The existing findings of substrate specificity of E3 are, however, scattered over a number of resources, making it difficult to study them together with an integrative view. Here we present E3Net, a web-based system that provides a comprehensive collection of available E3-substrate specificities and a systematic framework for the analysis of E3-mediated regulatory networks of diverse cellular functions. Currently, E3Net contains 2201 E3s and 4896 substrates in 427 organisms and 1671 E3-substrate specific relations between 493 E3s and 1277 substrates in 42 organisms, extracted mainly from MEDLINE abstracts and UniProt comments with an automatic text mining method and additional manual inspection and partly from high throughput experiment data and public ubiquitination databases. The significant functions and pathways of the extracted E3-specific substrate groups were identified from a functional enrichment analysis with 12 functional category resources for molecular functions, protein families, protein complexes, pathways, cellular processes, cellular localization, and diseases. E3Net includes interactive analysis and navigation tools that make it possible to build an integrative view of E3-substrate networks and their correlated functions with graphical illustrations and summarized descriptions. As a result, E3Net provides a comprehensive resource of E3s, substrates, and their functional implications summarized from the regulatory network structures of E3-specific substrate groups and their correlated functions. This resource will facilitate further in-depth investigation of ubiquitination-dependent regulatory mechanisms. E3Net is freely available online at http://pnet.kaist.ac.kr/e3net. PMID:22199232

  16. Design of River System Deadlock Avoidance Supervisor by Using Petri Net

    Directory of Open Access Journals (Sweden)

    Danko Kezić

    2010-05-01

    Full Text Available Advanced function of the computer-based river traffic management system should automatically predict and prevent possible conflict and deadlock states between vessels by using adequate control policy (supervisor. This paper proposes a formal method for calculating maximally permissive deadlock prevention supervisor. To model the river system, the authors use a class of Petri net suitable for describing multiple re-entrant flowlines with disjoint sets of resources, jobs and control places, and matrix-based formal method to analyze the system. By using matrix algebra, the structural characteristics of the Petri net (circular waits, P-invariants, critical siphons and subsystem, key resource have been analyzed and the steps for supervisor design proposed. The first and the second level deadlocks can be avoided by maintaining the number of tokens in the critical subsystems and ensuring that the key resource would not be the last available resource in the system. The derived supervisor has been verified by a computer simulation using MATLAB environment. KEYWORDS: traffic management system, deadlock avoidance, discrete event system, Petri net

  17. Fuzzy Stochastic Petri Nets for Modeling Biological Systems with Uncertain Kinetic Parameters.

    Science.gov (United States)

    Liu, Fei; Heiner, Monika; Yang, Ming

    2016-01-01

    Stochastic Petri nets (SPNs) have been widely used to model randomness which is an inherent feature of biological systems. However, for many biological systems, some kinetic parameters may be uncertain due to incomplete, vague or missing kinetic data (often called fuzzy uncertainty), or naturally vary, e.g., between different individuals, experimental conditions, etc. (often called variability), which has prevented a wider application of SPNs that require accurate parameters. Considering the strength of fuzzy sets to deal with uncertain information, we apply a specific type of stochastic Petri nets, fuzzy stochastic Petri nets (FSPNs), to model and analyze biological systems with uncertain kinetic parameters. FSPNs combine SPNs and fuzzy sets, thereby taking into account both randomness and fuzziness of biological systems. For a biological system, SPNs model the randomness, while fuzzy sets model kinetic parameters with fuzzy uncertainty or variability by associating each parameter with a fuzzy number instead of a crisp real value. We introduce a simulation-based analysis method for FSPNs to explore the uncertainties of outputs resulting from the uncertainties associated with input parameters, which works equally well for bounded and unbounded models. We illustrate our approach using a yeast polarization model having an infinite state space, which shows the appropriateness of FSPNs in combination with simulation-based analysis for modeling and analyzing biological systems with uncertain information.

  18. The convergence of systemic threads shaping a future South African healthcare dispensation: A technology management perspective

    Directory of Open Access Journals (Sweden)

    Richard Weeks

    2013-02-01

    Full Text Available Orientation: Underpinning healthcare service delivery are a number of support systems. This paper focuses on the development of a healthcare services framework that reflects the systems that need to be integrated, from a technology healthcare support perspective.Research purpose: The purpose of this paper is gain an understanding of some of the intricacies associated with the management of the transition to a future South African healthcare dispensation, with reference to the convergence of technology, financial healthcare and socio-political systems.Motivation for the study: South Africa is in the process of implementing the National Health Insurance initiative and the approach adopted will have a significant impact on the business model design.Research design, approach and method: A multidisciplinary literature study was undertaken. In addition, a limited narrative enquiry was also conducted. Practitioners interviewed were from the healthcare, informatics and management and technology sectors respectively. The research study constituted an insight study – analytically descriptive and not statistical in nature.Main findings: The literature reflects two very contrasting and different business models of healthcare service provision, namely a primarily curative and preventative stance. Each assumes a very different convergence of technology, healthcare, financial and social systems and consequently gives rise to contrasting business models. The dominant model appears to be based on primary healthcare, with a different technology support infrastructure to the previously-adopted curative approach. It is a model that would also appear to necessitate a complex adaptive management approach, necessitating a bottom-up as opposed to a top-down hierarchal management orientation.Contribution/Value-add: The National Healthcare Insurance initiative entails a very fundamental restructuring of the healthcare infrastructure. The insights gained from this

  19. Decision-Oriented Project Ranking for Asset Management System: Rail Net Denmark

    DEFF Research Database (Denmark)

    Salling, Kim Bang; Moshøj, Claus Rehfeld; Timm, Henrik

    2007-01-01

    resulting in priority indices for the state-of-repair data. This paper is disposed as follows; firstly, a description of the Asset Management system is set-up including an overview of the state-of-repair data and the case study. Secondly, is the AMS-PM software model implemented through an exploratory case......The Danish rail net operator, Rail Net Denmark, has through the past years built up an Asset Management system, containing a certain percentile of all the company’s assets. This paper contains an elaborate overview on how to strengthen the system seen from a decision-support perspective. The focus...... study and finally conclusions and a perspective are given....

  20. Fatal Systemic Vasoconstriction in a Case of Metastatic Small-Intestinal NET

    Directory of Open Access Journals (Sweden)

    Stenzel Jochen

    2017-01-01

    Full Text Available An increased release of serotonin secreted by ileal NETs is thought to be the major factor causing the carcinoid syndrome. However, in acutely arising carcinoid crisis also other vasoactive factors may lead to hazardous fluctuations in blood pressure and bronchial constriction. In rare cases, systemic vasoconstriction can be observed, probably caused by catecholamines or similar acting substances. Here, we report a fatal case of fulminant systemic vasoconstriction possibly caused by catecholamines in a patient with metastasized ileal NET. The vasospasm was detected by CT-angiography, and hemodynamic monitoring revealed a high systemic vascular resistance. Epinephrine, norepinephrine, and chromogranin A levels in plasma were elevated as was the urinary 5-hydroxyindoleacetic acid (5-HIAA. The cause of death was heart failure due to severe circulatory insufficiency. The progression of the tumor disease was confirmed by autopsy.

  1. New path for health-care leadership: clinical systems management. CLMA Clinical Systems Management Task Force.

    Science.gov (United States)

    Hunter, L; Lien, J; Snyder, J R; Teixeira, R; Vernon, M; Pomerantz, P

    1998-01-01

    This article sets forth a concept and an action plan to support the educational needs for the clinical systems manager. This article describes the roles, competencies, and tasks of the clinical systems manager and defines specific intermediate and long-term steps. Clinical systems management is umbrella terminology used to describe an array of related jobs including, but not necessarily limited to, multidepartmental or interdisciplinary management, regional or health system-wide laboratory management, and traditional laboratory management. In general, clinical systems management recognizes the emergence of new jobs, with the primary responsibility of leading the integration of clinical services within health-care systems.

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

    Science.gov (United States)

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

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Borgi Lea

    2010-11-01

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

  4. The Erasure of Sex and Gender Minorities in the Healthcare System

    Directory of Open Access Journals (Sweden)

    Marianne LeBreton

    2013-09-01

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

  5. System effectiveness of a targeted free mass distribution of long lasting insecticidal nets in Zanzibar, Tanzania

    Directory of Open Access Journals (Sweden)

    Abass Ali K

    2010-06-01

    Full Text Available Abstract Background Insecticide-treated nets (ITN and long-lasting insecticidal treated nets (LLIN are important means of malaria prevention. Although there is consensus regarding their importance, there is uncertainty as to which delivery strategies are optimal for dispensing these life saving interventions. A targeted mass distribution of free LLINs to children under five and pregnant women was implemented in Zanzibar between August 2005 and January 2006. The outcomes of this distribution among children under five were evaluated, four to nine months after implementation. Methods Two cross-sectional surveys were conducted in May 2006 in two districts of Zanzibar: Micheweni (MI on Pemba Island and North A (NA on Unguja Island. Household interviews were conducted with 509 caretakers of under-five children, who were surveyed for socio-economic status, the net distribution process, perceptions and use of bed nets. Each step in the distribution process was assessed in all children one to five years of age for unconditional and conditional proportion of success. System effectiveness (the accumulated proportion of success and equity effectiveness were calculated, and predictors for LLIN use were identified. Results The overall proportion of children under five sleeping under any type of treated net was 83.7% (318/380 in MI and 91.8% (357/389 in NA. The LLIN usage was 56.8% (216/380 in MI and 86.9% (338/389 in NA. Overall system effectiveness was 49% in MI and 87% in NA, and equity was found in the distribution scale-up in NA. In both districts, the predicting factor of a child sleeping under an LLIN was caretakers thinking that LLINs are better than conventional nets (OR = 2.8, p = 0.005 in MI and 2.5, p = 0.041 in NA, in addition to receiving an LLIN (OR = 4.9, p Conclusions Targeted free mass distribution of LLINs can result in high and equitable bed net coverage among children under five. However, in order to sustain high effective coverage, there

  6. System effectiveness of a targeted free mass distribution of long lasting insecticidal nets in Zanzibar, Tanzania.

    Science.gov (United States)

    Beer, Netta; Ali, Abdullah S; de Savigny, Don; Al-Mafazy, Abdul-Wahiyd H; Ramsan, Mahdi; Abass, Ali K; Omari, Rahila S; Björkman, Anders; Källander, Karin

    2010-06-18

    Insecticide-treated nets (ITN) and long-lasting insecticidal treated nets (LLIN) are important means of malaria prevention. Although there is consensus regarding their importance, there is uncertainty as to which delivery strategies are optimal for dispensing these life saving interventions. A targeted mass distribution of free LLINs to children under five and pregnant women was implemented in Zanzibar between August 2005 and January 2006. The outcomes of this distribution among children under five were evaluated, four to nine months after implementation. Two cross-sectional surveys were conducted in May 2006 in two districts of Zanzibar: Micheweni (MI) on Pemba Island and North A (NA) on Unguja Island. Household interviews were conducted with 509 caretakers of under-five children, who were surveyed for socio-economic status, the net distribution process, perceptions and use of bed nets. Each step in the distribution process was assessed in all children one to five years of age for unconditional and conditional proportion of success. System effectiveness (the accumulated proportion of success) and equity effectiveness were calculated, and predictors for LLIN use were identified. The overall proportion of children under five sleeping under any type of treated net was 83.7% (318/380) in MI and 91.8% (357/389) in NA. The LLIN usage was 56.8% (216/380) in MI and 86.9% (338/389) in NA. Overall system effectiveness was 49% in MI and 87% in NA, and equity was found in the distribution scale-up in NA. In both districts, the predicting factor of a child sleeping under an LLIN was caretakers thinking that LLINs are better than conventional nets (OR = 2.8, p = 0.005 in MI and 2.5, p = 0.041 in NA), in addition to receiving an LLIN (OR = 4.9, p < 0.001 in MI and in OR = 30.1, p = 0.001 in NA). Targeted free mass distribution of LLINs can result in high and equitable bed net coverage among children under five. However, in order to sustain high effective coverage, there is need

  7. Investigation of neural-net based control strategies for improved power system dynamic performance

    Energy Technology Data Exchange (ETDEWEB)

    Sobajic, D.J. [Electric Power Research Institute, Palo Alto, CA (United States)

    1995-12-31

    The ability to accurately predict the behavior of a dynamic system is of essential importance in monitoring and control of complex processes. In this regard recent advances in neural-net base system identification represent a significant step toward development and design of a new generation of control tools for increased system performance and reliability. The enabling functionality is the one of accurate representation of a model of a nonlinear and nonstationary dynamic system. This functionality provides valuable new opportunities including: (1) The ability to predict future system behavior on the basis of actual system observations, (2) On-line evaluation and display of system performance and design of early warning systems, and (3) Controller optimization for improved system performance. In this presentation, we discuss the issues involved in definition and design of learning control systems and their impact on power system control. Several numerical examples are provided for illustrative purpose.

  8. NetLogger: A toolkit for distributed system performance tuning anddeb ugging

    Energy Technology Data Exchange (ETDEWEB)

    Tierney, Brian; Gunter, Dan

    2002-01-01

    Developers and users of high-performance distributed systemsoften observe performance problems such as unexpectedly low throughput orhigh latency. Determining the source of the performance problems requiresdetailed end-to-end instrumentation of all components, including theapplications, operating systems, hosts, and networks. In this paper wedescribe a methodology that enables the real-time diagnosis ofperformance problems in complex high-performance distributed systems. Themethodology includes tools for generating timestamped event logs that canbe used to provide detailed end-to-end application and system levelmonitoring; and tools for visualizing the log data and real-time state ofthe distributed system. This methodology, called NetLogger, has proveninvaluable for diagnosing problems in networks and in distributed systemscode. This approach is novel in that it combines network, host, andapplication-level monitoring, providing a complete view of the entiresystem. NetLogger is designed to be extremely light-weight, and includesa mechanism for reliably collecting monitoring events from multipledistributed locations. This technical report summarizes most importantpoints of several previous papers on NetLogger, and is meant to be usedas a general overview.

  9. A descriptive analysis of the 2008 credit crisis on multistate healthcare systems: what impact did it have on their financial performance?

    Science.gov (United States)

    McCue, Michael J

    2010-01-01

    Due to the recent credit crisis and recession of 2008, hospitals experienced substantial losses in their investment portfolios. The author analyzed key financial accounts of 15 large, multistate healthcare systems that measured their changes in value of their investments, changes in net assets, liquidity ratios, and other performance ratios. Overall, he found that the majority of these systems did incur financial losses in their investment portfolios; however, for the majority of these systems, their liquidity and cash flow margin ratios declined slightly whereas their capital expenditure and community benefits increased.

  10. Building and Evaluating Research Capacity in Healthcare Systems ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    29 juin 2016 ... ... and development programmes in Africa. Eulalia Kokuangisa Kahwa teaches at the UWI School of Nursing, University of the West Indies, Kingston, Jamaica. She is a nurse and nutritionist with over 30 years' experience in healthcare and nursing education, particularly in the fields of HIV/AIDS and asthma.

  11. Comparative study of the primary healthcare systems in China and ...

    African Journals Online (AJOL)

    The most satisfied people in both countries were those living in the poorest socioeconomic conditions, the elderly, and those who attended the healthcare meetings. Chinese households were more satisfied with the quality of the CHC services than those in Mali. The Chinese management boards proposed standardisation ...

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  14. 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.

  15. Detection and treatment of faults in manufacturing systems based on Petri Nets

    OpenAIRE

    Riascos, L. A. M.; Moscato, L. A.; Miyagi, P. E.

    2004-01-01

    This paper introduces a methodology for modeling and analyzing fault-tolerant manufacturing systems that not only optimizes normal productive processes, but also performs detection and treatment of faults. This approach is based on the hierarchical and modular integration of Petri Nets. The modularity provides the integration of three types of processes: those representing the productive process, fault detection, and fault treatment. The hierarchical aspect of the approach permits us to consi...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  18. The Role of Corruption and Healthcare Expenditure in Healthcare Systems of the Persian Gulf Region

    Directory of Open Access Journals (Sweden)

    Maryam Asghari

    2016-06-01

    Full Text Available Background and Purpose: More than a third of the world’s population lack access to essential medicines, despite the presence of several international agreements that proclaim health as a human right. Corruption, in its many forms, such as bribery and embezzlement, causes several detrimental effects on the health sector and access to medicines including economic, health, and government image and trust issues. Global health corruption remains a serious, ongoing, and under-recognized threat to global health progress. This paper aim is examination how global corruption and health-care expenditure (HE affect health statue in the Persian Gulf countries over 1980-2014 and what can be done to combat corruption in the health sector. Materials and Methods: This study is an experimental and applied research. To verify the consistency of the results of the model, this study used the appropriate panel data analysis methods such as feasible general least square method for the nine Persian Gulf countries over 1980-2014. I employ different panel data procedures to avoid estimation problems, namely, autocorrelation and heteroskedasticity. The used package id Stata version 14. Results: The level of gross domestic product per capita, the level of corruption in the country, per capita HE, the quality of air and water, population density levels have negative effect on region people’s life expectancy, but the index of environmental policy and the education, measured as years of education obtained, have positive effect on region people’s life expectancy over 1980-2014. Conclusion: The results indicate that corruption and HE have negative effect on the Persian Gulf region people‘s life expectancy.

  19. Geographic Information Systems-Transportation ISTEA management systems server-net prototype pooled fund study: Phase B summary

    Energy Technology Data Exchange (ETDEWEB)

    Espinoza, J. Jr.; Dean, C.D.; Armstrong, H.M. [and others

    1997-06-01

    The Geographic Information System-Transportation (GIS-T) ISTEA Management Systems Server Net Prototype Pooled Fund Study represents the first national cooperative effort in the transportation industry to address the management and monitoring systems as well as the statewide and metropolitan transportation planning requirements of the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA). The Study was initiated in November 1993 through the Alliance for Transportation Research and under the leadership of the New Mexico State Highway and Transportation Department. Sandia National Laboratories, an Alliance partner, and Geographic Paradigm Computing. Inc. provided technical leadership for the project. In 1992, the Alliance for Transportation Research, the New Mexico State Highway and Transportation Department, Sandia National Laboratories, and Geographic Paradigm Computing, Inc., proposed a comprehensive research agenda for GIS-T. That program outlined a national effort to synthesize new transportation policy initiatives (e.g., management systems and Intelligent Transportation Systems) with the GIS-T server net ideas contained in the NCHRP project {open_quotes}Adaptation of GIS to Transportation{close_quotes}. After much consultation with state, federal, and private interests, a project proposal based on this agenda was prepared and resulted in this Study. The general objective of the Study was to develop GIS-T server net prototypes supporting the ISTEA requirements for transportation planning and management and monitoring systems. This objective can be further qualified to: (1) Create integrated information system architectures and design requirements encompassing transportation planning activities and data. (2) Encourage the development of functional GIS-T server net prototypes. (3) Demonstrate multiple information systems implemented in a server net environment.

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

    Science.gov (United States)

    Sajid, Anam; Abbas, Haider

    2016-06-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  2. RESTful NET

    CERN Document Server

    Flanders, Jon

    2008-01-01

    RESTful .NET is the first book that teaches Windows developers to build RESTful web services using the latest Microsoft tools. Written by Windows Communication Foundation (WFC) expert Jon Flanders, this hands-on tutorial demonstrates how you can use WCF and other components of the .NET 3.5 Framework to build, deploy and use REST-based web services in a variety of application scenarios. RESTful architecture offers a simpler approach to building web services than SOAP, SOA, and the cumbersome WS- stack. And WCF has proven to be a flexible technology for building distributed systems not necessa

  3. Metaboli-Net: online groupware system providing counseling guidance for patients with metabolic syndrome.

    Science.gov (United States)

    Kuwata, Shigeki; Taniguchi, Shin-ichi; Kato, Atsuko; Inoue, Kazuoki; Yamamoto, Naoya; Ohkura, Tsuyoshi; Teramoto, Kei; Shigemasa, Chiaki; Kondoh, Hiroshi

    2010-01-01

    This study presented a newly developed online groupware system, Metaboli-Net, to yield counseling guidance on diet and exercise to patients with metabolic syndrome. A distinctive feature adopted in the system to maintain the retention rate of patients was the social network service (SNS) that enables the patients to share their dietary and relevant health information with other participants in the same group on the network. A pilot study was conducted to prove the effectiveness of the system in improving the patient's lifestyle and dietary health awareness. SNS also contributed to the participant's adherence to intervention programs.

  4. Development and User Research of a Smart Bedside Station System toward Patient-Centered Healthcare System.

    Science.gov (United States)

    Yoo, Sooyoung; Lee, Kee-Hyuck; Baek, Hyunyoung; Ryu, Borim; Chung, Eunja; Kim, Kidong; Yi, Jay Chaeyong; Park, Soo Beom; Hwang, Hee

    2015-09-01

    User experience design that reflects real-world application and aims to support suitable service solutions has arisen as one of the current issues in the medical informatics research domain. The Smart Bedside Station (SBS) is a screen that is installed on the bedside for the personal use and provides a variety of convenient services for the patients. Recently, bedside terminal systems have been increasingly adopted in hospitals due to the rapid growth of advanced technology in healthcare at the point of care. We designed user experience (UX) research to derive users' unmet needs and major functions that are frequently used in the field. To develop the SBS service, a service design methodology, the Double Diamond Design Process Model, was undertaken. The problems or directions of the complex clinical workflow of the hospital, the requirements of stakeholders, and environmental factors were identified through the study. The SBS system services provided to patients were linked to the hospital's main services or to related electronic medical record (EMR) data. Seven key services were derived from the results of the study. The primary services were as follows: Bedside Check In and Out, Bedside Room Service, Bedside Scheduler, Ready for Rounds, My Medical Chart, Featured Healthcare Content, and Bedside Community. This research developed a patient-centered SBS system with improved UX using service design methodology applied to complex and technical medical services, providing insights to improve the current healthcare system.

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

    Science.gov (United States)

    Liao, Wen-Hwa; Qiu, Wan-Li

    2016-01-01

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

  6. Advanced practice roles for nurses in tomorrow's healthcare systems.

    Science.gov (United States)

    Berger, A M; Eilers, J G; Pattrin, L; Rolf-Fixley, M; Pfeifer, B A; Rogge, J A; Wheeler, L M; Bergstrom, N I; Heck, C S

    1996-09-01

    Advanced practice nurses (APNs) have traditionally been a diverse group in terms of titles, education, credentials, and roles. The classification of APN usually encompasses the nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS). NP, CRNA, and CNM roles have been more clearly delineated than the CNS roles. In light of healthcare reform, the CNS roles have been critically reviewed and analyzed. Attempts have been made to clarify responsibilities and outcomes, and to quantify the financial impact of this role. In this article, seven APN roles clearly defined in terms of minimal qualifications and competencies critical to accomplishment of the duties, responsibilities, and expected outcomes are presented. Comparison of competency requirements are also presented. The roles presented are designed to facilitate healthcare institutions in meeting the demands for serving patients with increasingly complex needs, as well as cost-containment goals.

  7. Infection control and changing health-care delivery systems.

    OpenAIRE

    Jarvis, W R

    2001-01-01

    In the past, health care was delivered mainly in acute-care facilities. Today, health care is delivered in hospital, outpatient, transitional care, long-term care, rehabilitative care, home, and private office settings. Measures to reduce health-care costs include decreasing the number of hospitals and the length of patient stays, increasing outpatient and home care, and increasing long-term care for the elderly. The home-care industry and managed care have become major providers of health ca...

  8. Promoting patient-centred fundamental care in acute healthcare systems.

    Science.gov (United States)

    Feo, Rebecca; Kitson, Alison

    2016-05-01

    Meeting patients' fundamental care needs is essential for optimal safety and recovery and positive experiences within any healthcare setting. There is growing international evidence, however, that these fundamentals are often poorly executed in acute care settings, resulting in patient safety threats, poorer and costly care outcomes, and dehumanising experiences for patients and families. Whilst care standards and policy initiatives are attempting to address these issues, their impact has been limited. This discussion paper explores, through a series of propositions, why fundamental care can be overlooked in sophisticated, high technology acute care settings. We argue that the central problem lies in the invisibility and subsequent devaluing of fundamental care. Such care is perceived to involve simple tasks that require little skill to execute and have minimal impact on patient outcomes. The propositions explore the potential origins of this prevailing perception, focusing upon the impact of the biomedical model, the consequences of managerial approaches that drive healthcare cultures, and the devaluing of fundamental care by nurses themselves. These multiple sources of invisibility and devaluing surrounding fundamental care have rendered the concept underdeveloped and misunderstood both conceptually and theoretically. Likewise, there remains minimal role clarification around who should be responsible for and deliver such care, and a dearth of empirical evidence and evidence-based metrics. In explicating these propositions, we argue that key to transforming the delivery of acute healthcare is a substantial shift in the conceptualisation of fundamental care. The propositions present a cogent argument that counters the prevailing perception that fundamental care is basic and does not require systematic investigation. We conclude by calling for the explicit valuing and embedding of fundamental care in healthcare education, research, practice and policy. Without this

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

    Science.gov (United States)

    Kaplan, Gary S; Patterson, Sarah H

    2008-01-01

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

  10. Organisational systems approaches to improving cultural competence in healthcare: a systematic scoping review of the literature

    National Research Council Canada - National Science Library

    Janya McCalman; Crystal Jongen; Roxanne Bainbridge

    2017-01-01

    ... for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development...

  11. Engineering a learning healthcare system: a look at the future : workshop summary

    National Research Council Canada - National Science Library

    Grossmann, Claudia

    2011-01-01

    ... that medicine shares with engineering. As part of its Learning healthcare system series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a work...

  12. 2006 Foster G. McGaw Prize winner: memorial healthcare system, Hollywood, Fla.

    Science.gov (United States)

    Thrall, Terese Hudson

    2007-04-01

    Memorial Healthcare System in Hollywood, Fla., is receiving well-deserved national recognition for its myriad community benefit programs, from public housing improvements to prenatal care for uninsured mothers-to-be.

  13. Interoperability of a mobile health care solution with electronic healthcare record systems.

    Science.gov (United States)

    De Toledo, P; Lalinde, W; Del Pozo, F; Thurber, D; Jimenez-Fernandez, S

    2006-01-01

    Mobile health care solutions involving patient monitoring are an increasingly accepted element in chronic disease management strategies. When used in healthcare systems with different providers, it is essential that the information gathered from the patient is available at each of these providers information repositories. This paper describes the design of a connectivity interface based on the HL7 standard that allows the MOTOHEALTH mobile health care solution to communicate with external electronic healthcare record systems supporting HL7.

  14. Sexual Orientation Differences in Satisfaction with Healthcare: Findings from the Behavioral Risk Factor Surveillance System, 2014.

    Science.gov (United States)

    Blosnich, John R

    2017-06-01

    In the United States, the Affordable Care Act and marriage equality may have eased sexual orientation-based differences in access to healthcare coverage, but limited research has investigated sexual orientation-based differences in healthcare satisfaction. The purpose of this study was to examine whether satisfaction with healthcare varied by sexual orientation in a large population-based sample of adults. Data are from the 2014 Behavioral Risk Factor Surveillance System, including items about sexual orientation and healthcare (n = 113,317). Healthcare coverage included employer-based insurance; individually purchased insurance; Medicare; Medicaid; or TRICARE, VA, or military care. Respondents indicated whether they were "very satisfied, somewhat satisfied, or not at all satisfied" with healthcare. After adjusting for several sociodemographic covariates, lesbian, gay, and bisexual status was associated with lower satisfaction with healthcare with individually purchased insurance (adjusted odds ratio = 1.49, 95% confidence interval = 1.24-1.80). Efforts are needed to examine and reduce sexual orientation differences in satisfaction with healthcare.

  15. Potentiality of big data in the medical sector: focus on how to reshape the healthcare system.

    Science.gov (United States)

    Jee, Kyoungyoung; Kim, Gang-Hoon

    2013-06-01

    The main purpose of this study was to explore whether the use of big data can effectively reduce healthcare concerns, such as the selection of appropriate treatment paths, improvement of healthcare systems, and so on. By providing an overview of the current state of big data applications in the healthcare environment, this study has explored the current challenges that governments and healthcare stakeholders are facing as well as the opportunities presented by big data. Insightful consideration of the current state of big data applications could help follower countries or healthcare stakeholders in their plans for deploying big data to resolve healthcare issues. The advantage for such follower countries and healthcare stakeholders is that they can possibly leapfrog the leaders' big data applications by conducting a careful analysis of the leaders' successes and failures and exploiting the expected future opportunities in mobile services. First, all big data projects undertaken by leading countries' governments and healthcare industries have similar general common goals. Second, for medical data that cuts across departmental boundaries, a top-down approach is needed to effectively manage and integrate big data. Third, real-time analysis of in-motion big data should be carried out, while protecting privacy and security.

  16. Characterisation and testing of the KM3NeT acoustic positioning system

    Directory of Open Access Journals (Sweden)

    Viola S.

    2016-01-01

    Full Text Available In underwater neutrino telescopes, the search of point-like sources through the Cherenkov detection technique requires a precise knowledge of the positions of thousands of optical sensors, spread in a volume of a few cubic kilometres. In KM3NeT the optical sensors are hosted in 700 m high semi-rigid structures, called detection units, which move under the effects of underwater currents. These movements are continuously monitored through an underwater positioning system based on acoustic emitters and receivers. In this work, the tests performed on the key elements of the positioning system are presented.

  17. CEDRIC: a computerized chronic disease management system for urban, safety net clinics.

    Science.gov (United States)

    Ogunyemi, Omolola; Mukherjee, Sukrit; Ani, Chizobam; Hindman, David; George, Sheba; Ilapakurthi, Ramarao; Verma, Mary; Dayrit, Melvin

    2010-01-01

    To meet the challenge of improving health care quality in urban, medically underserved areas of the US that have a predominance of chronic diseases such as diabetes, we have developed a new information system called CEDRIC for managing chronic diseases. CEDRIC was developed in collaboration with clinicians at an urban safety net clinic, using a community-participatory partnered research approach, with a view to addressing the particular needs of urban clinics with a high physician turnover and large uninsured/underinsured patient population. The pilot implementation focuses on diabetes management. In this paper, we describe the system's architecture and features.

  18. Modelling M/G/1 queueing systems with server vacations using stochastic Petri nets

    Directory of Open Access Journals (Sweden)

    K Ramanath

    2006-12-01

    Full Text Available The theory of non-Markovian stochastic Petri nets is employed in this paper to derive an alternative method for studying the steady state behaviour of the M/G/1 vacation queueing system with a limited service discipline. Three types of vacation schemes are considered, and sytems with both a finite population and those with an infinite population (but finite capacity are considered. Simple numerical examples are also provided to illustrate the functionality of the methods and some useful performance measures for the system are obtained.

  19. Development of Intelligent Auxiliary System for Customized Physical Fitness and Healthcare

    Directory of Open Access Journals (Sweden)

    Huang Chung-Chi

    2016-01-01

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

  20. 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.

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

    Science.gov (United States)

    Aggarwal, Vinod

    2002-10-01

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

  2. Lewis Carroll's Doublets net of English words: network heterogeneity in a complex system.

    Directory of Open Access Journals (Sweden)

    Hsieh Fushing

    Full Text Available Lewis Carroll's English word game Doublets is represented as a system of networks with each node being an English word and each connectivity edge confirming that its two ending words are equal in letter length, but different by exactly one letter. We show that this system, which we call the Doublets net, constitutes a complex body of linguistic knowledge concerning English word structure that has computable multiscale features. Distributed morphological, phonological and orthographic constraints and the language's local redundancy are seen at the node level. Phonological communities are seen at the network level. And a balancing act between the language's global efficiency and redundancy is seen at the system level. We develop a new measure of intrinsic node-to-node distance and a computational algorithm, called community geometry, which reveal the implicit multiscale structure within binary networks. Because the Doublets net is a modular complex cognitive system, the community geometry and computable multi-scale structural information may provide a foundation for understanding computational learning in many systems whose network structure has yet to be fully analyzed.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    Jungho Kang

    2016-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Menke J Michael

    2008-12-01

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

  6. Dependency Modeling of a SOA Based System Through Colored Petri Nets

    Directory of Open Access Journals (Sweden)

    Pawan Kumar

    2016-09-01

    Full Text Available Dependency relationships play an important role in testing, maintenance and configuration management of software systems. The informal dependency representations fail to observe behavioral connections among subsystems and cause ambiguity in representing different types of dependency relationships. Therefore, dependency in a software system requires a formal and unambiguous representation so that its correct effects can be visualized. In this paper, we present a Colored Petri Net based dependency analysis of a Service Oriented Architecture (SOA based system that represents specification of dependency relationships and models the dependencies in a SOA based system at conceptual level. Different types of dependency relations are represented in a formal manner by using Service Algebra. A module SOA based system ‘Online Bookshop’ has been developed and used for the purpose of modeling and example demonstration. Such modeling can help in identification of inconsistency among services, and web services can be verified for safety and reliability.

  7. IoT-based Asset Management System for Healthcare-related Industries

    Directory of Open Access Journals (Sweden)

    Lee Carman Ka Man

    2015-11-01

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

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

    Science.gov (United States)

    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.

  9. Mobile healthcare.

    Science.gov (United States)

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

    Mobile technology's presence in healthcare has exploded over the past five years. The increased use of mobile devices by all segments of the US population has driven healthcare systems, providers, and payers to accept this new form of communication and to develop strategies to implement and leverage the use of mobile healthcare (mHealth) within their organizations and practices. As healthcare systems move toward a more value-driven model of care, patient centeredness and engagement are the keys to success. Mobile healthcare will provide the medium to allow patients to participate more in their care. Financially, mHealth brings to providers the ability to improve efficiency and deliver savings to both them and the healthcare consumer. However, mHealth is not without challenges. Healthcare IT departments have been reluctant to embrace this shift in technology without fully addressing security and privacy concerns. Providers have been hesitant to adopt mHealth as a form of communication with patients because it breaks with traditional models. Our healthcare system has just started the journey toward the development of mHealth. We offer an overview of the mobile healthcare environment and our approach to solving the challenges it brings to healthcare organizations.

  10. 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.

  11. Healthcare teams as complex adaptive systems: Focus on interpersonal interaction.

    Science.gov (United States)

    Pype, Peter; Krystallidou, Demi; Deveugele, Myriam; Mertens, Fien; Rubinelli, Sara; Devisch, Ignaas

    2017-11-01

    The aim of this study is to test the feasibility of a tool to objectify the functioning of healthcare teams operating in the complexity zone, and to evaluate its usefulness in identifying areas for team quality improvement. We distributed The Complex Adaptive Leadership (CAL™) Organisational Capability Questionnaire (OCQ) to all members of one palliative care team (n=15) and to palliative care physicians in Flanders, Belgium (n=15). Group discussions were held on feasibility aspects and on the low scoring topics. Data was analysed calculating descriptive statistics (sum score, mean and standard deviation). The one sample T-Test was used to detect differences within each group. Both groups of participants reached mean scores ranging from good to excellent. The one sample T test showed statistically significant differences between participants' sum scores within each group (p<0,001). Group discussion led to suggestions for quality improvement e.g. enhanced feedback strategies between team members. The questionnaire used in our study shows to be a feasible and useful instrument for the evaluation of the palliative care teams' day-to-day operations and to identify areas for quality improvement. The CAL™OCQ is a promising instrument to evaluate any healthcare team functioning. A group discussion on the questionnaire scores can serve as a starting point to identify targets for quality improvement initiatives. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. A WiMAX Networked UAV Telemetry System for Net-Centric Remote Sensing and Range Surveillance Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A WiMAX networked UAV Telemetry System (WNUTS) is designed for net-centric remote sensing and launch range surveillance applications. WNUTS integrates a MIMO powered...

  13. Accounting for the effects of a ruminal nitrogen deficiency within the structure of the Cornell Net Carbohydrate and Protein System

    National Research Council Canada - National Science Library

    Tedeschi, L. O; Fox, D. G; Russell, J. B

    2000-01-01

    .... The Cornell Net Carbohydrate and Protein System (CNCPS) prediction of fiber digestion and microbial mass production from ruminally degraded carbohydrate has been adjusted to accommodate a ruminal N deficiency...

  14. Accounting for the effects of a ruminal nitrogen deficiency within the structure of the Cornell Net Carbonhydrate and Protein System

    National Research Council Canada - National Science Library

    L O Tedeschi; D G Fox; J B Russell

    2000-01-01

      The Cornell Net Carbohydrate and Protein System (CNCPS) prediction of fiber digestion and microbial mass production from ruminally degraded carbohydrate has been adjusted to accommodate a ruminal N deficiency...

  15. Healthcare information technology infrastructures in Turkey.

    Science.gov (United States)

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

    2014-05-22

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

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

    Directory of Open Access Journals (Sweden)

    Beth A. Lown MD

    2014-11-01

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

  17. Healthcare IT system in the midst of and after Great East Japan Earthquake Disaster : Grand design for reconstruction of Tohoku-region healthcare IT system

    Science.gov (United States)

    Tanaka, Hiroshi

    In this article, we described what was really going in the disaster medical care at the Great East Japan Earthquake, mainly in Ishinomaki and Kesen-numa areas. As for exchange tools of the disaster information, in contrast to the breakdown of fixed-line and mobile phone, MCA radio system, satellite mobiles and internet, especially SNS, were greatly helpful. Learned from the disaster experiences, we are making the grand design for “disaster-robust” regional healthcare IT systems, which are composed of (1) cloud center storing whole-prefecture medical records, (2) SS-MIX based regional healthcare information systems of “the second medical care zones”, (3) ASP/SaaS typed electronic medical record system for all clinics located at Pacific coastal areas, and (4) wireless communication environment supporting comprehensive care of elderly for daily living activities.

  18. Nearly Net-Zero Exergy Districts as Models for Smart Energy Systems

    OpenAIRE

    Şiir Kilkiş

    2017-01-01

    The planning of urban settlements requires a targeted approach towards more sustainable energy, water, and environment systems. This research work analyses the city of Uppsala and a district that is an urban renewal project at the site of former high voltage power lines, namely Östra Sala backe, which will have a new energy concept. The latter is analysed based on proposals for two phases that aim to reach a net-zero district target based on the quality of energy (exergy). An indicator s...

  19. Requirements Engineering for Reactive Systems: Coloured Petri Nets for an Elevator Controller

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Fernandes, Joao Miguel; Tjell, Simon

    2007-01-01

    This paper presents a model-based approach to requirements engineering for reactive systems; we use an elevator controller as case study. We identify and justify two key properties that a model which we construct must have, namely: (1) controller-and-environment-partitioned, which means...... descriptions. For the case study, we build an executable model in the formal modelling language Coloured Petri Nets. We demonstrate how this model is useful for requirements engineering, since it provides a solid basis for addressing behavioural issues early in the development process, for example regarding...

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

    Science.gov (United States)

    Masseroli, Marco; Marchente, Mario

    2008-07-01

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

  1. 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

    2016-01-01

    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

  2. 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

  3. Postpolio syndrome: a challenge to the health-care system.

    Science.gov (United States)

    Bouza, Carmen; Muñoz, Ana; Amate, José María

    2005-01-01

    The practical eradication of poliomyelitis in industrialized countries marks one of the most important achievements of world health policy. Yet, disability induced by polio not only continues to exist among survivors with paralytic sequelae, but may also be further accentuated in a considerable number of affected subjects by the development of postpolio syndrome (PPS). PPS aggravates the motor sequelae already present in such subjects and reduces their functional capacity to the point where it affects their activities of daily living and worsens their quality of life. Inasmuch as development of PPS questions the concept of poliomyelitis as a static disease it poses a challenge not only to health professionals but also to policy-makers tasked with providing the necessary health-care measures and appropriate resources. This study sought to review research on this syndrome and to draw up some recommendations that might prove useful to the health authorities for decision-making purposes.

  4. The healthcare system and the provision of oral healthcare in European Union Member States. Part 6: Poland.

    Science.gov (United States)

    Malkiewicz, K; Malkiewicz, E; Eaton, K A; Widström, E

    2016-10-21

    Poland is one of the largest European countries in terms of area and population. The country's economic situation does not allow for the allocation of sufficient public funds for healthcare in general and oral healthcare in particular. The health policy of the state focuses primarily on prophylaxis and treatment of diseases, directly threatening the health and lives of the inhabitants. Currently, expenditure on oral health accounts for only 2.7% of the public funds allocated to healthcare. In this context, providing oral care financed from public funds at an appropriate level constitutes a challenge for state institutions, centres providing medical and dental services and private practices. Despite difficult financial conditions in Poland, therapeutic and prophylactic programmes are implemented, aimed at improving the oral health of the society, especially children and adolescents, pregnant women and patients with disabilities or developmental disorders such as cleft palate. In Poland, apart from the oral care system financed by the state, there is also an extremely well developed system of private practices and clinics providing clinical services on a commercial basis. In 2014, oral services, financed by the state, were utilised by about 30% of the population of children and youths aged 0-18 years (2,212,792 patients) and about 15% of the adult population (5,026,383 patients). Training of Polish dentists is conducted in ten state-owned universities, from which 700 graduate each year. Dentists work mainly in private practices or medical centres, some of which provide services guaranteed by the public insurer - the National Health Fund. The other dentists find employment in state clinics, hospitals, and universities and their associated clinics. In Poland dentistry is a predominantly female profession and 75% of the just over 40,000 Polish dentists are female. Accession of Poland to the European Union meant that some Polish dentists have taken up employment abroad

  5. A Security Analysis of Cyber-Physical Systems Architecture for Healthcare

    Directory of Open Access Journals (Sweden)

    Darren Seifert

    2016-10-01

    Full Text Available This paper surveys the available system architectures for cyber-physical systems. Several candidate architectures are examined using a series of essential qualities for cyber-physical systems for healthcare. Next, diagrams detailing the expected functionality of infusion pumps in two of the architectures are analyzed. The STRIDE Threat Model is then used to decompose each to determine possible security issues and how they can be addressed. Finally, a comparison of the major security issues in each architecture is presented to help determine which is most adaptable to meet the security needs of cyber-physical systems in healthcare.

  6. [Utilization of healthcare services by groups in the Israeli population as a measurement reflecting equity in the healthcare system].

    Science.gov (United States)

    Afek, Arnon

    2008-04-01

    The Israeli health care system bases itself on the principles of justice, equality, and social solidarity. In 1994 a Health Insurance Act was passed, based upon these principles, which helped to reduce the differences between Israeli population groups. People from lower socio-economic status suffer from more illnesses and have shorter life spans than their more fortunate countrymen. These differences in well-being, as well as being unnecessary and avoidable, are also unfair and unjust - and define the inequities in our health care system. Therefore, the goal of the health care system should be to reduce or eliminate these disparities, especially when they are avoidable and unjust. A study by Orna Apel Brown describes the results of a health care survey among new immigrants to Israel from the former U.S.S.R. She shows that there has been an increase in their utilization of healthcare services, excluding preventive measures such as mammography, along with a reduction in the differences in their self perception of health care status and well-being - now placing them on the same par as their fellow Israeli-born citizens. The results, although encouraging, stress the importance of the health care system's need to direct its efforts to decreasing the disparity and making the system more equitable to the underprivileged populations in Israel.

  7. How healthcare systems evaluate their advance care planning initiatives: Results from a systematic review.

    Science.gov (United States)

    Biondo, Patricia D; Lee, Lydia D; Davison, Sara N; Simon, Jessica E

    2016-09-01

    Advance care planning initiatives are being implemented across healthcare systems around the world, but how best to evaluate their implementation is unknown. To identify gaps and/or redundancies in current evaluative strategies to help healthcare systems develop future evaluative frameworks for ACP. Systematic review. Peer-reviewed and gray literature searches were conducted till February 2015 to answer: "What methods have healthcare systems used to evaluate implementation of advance care planning initiatives?" A PICOS framework was developed to identify articles describing the implementation and evaluation of a health system-level advance care planning initiative. Outcome measures were mapped onto a conceptual quality indicator framework based on the Institute of Medicine and Donabedian models of healthcare quality. A total of 46 studies met inclusion criteria for analysis. Most articles reported on single parts of a healthcare system (e.g. continuing care). The most common outcome measures pertained to document completion, followed by healthcare resource use. Patient-, family-, or healthcare provider-reported outcomes were less commonly measured. Concordance measures (e.g. dying in place of choice) were reported by only 26% of studies. The conceptual quality indicator framework identified gaps and redundancies in measurement and is presented as a potential foundation from which to develop a comprehensive advance care planning evaluation framework. Document completion is frequently used to evaluate advance care planning program implementation; capturing the quality of care appears to be more difficult. This systematic review provides health system administrators with a comprehensive summary of measures used to evaluate advance care planning and may identify gaps in evaluation within their local context. © The Author(s) 2016.

  8. Construction, criterions and levels of net culture's formedness ofteacher of informatic in system of improvement qualification

    Directory of Open Access Journals (Sweden)

    Галина Андреевна Будникова

    2011-06-01

    Full Text Available The author describes the content of idea «teacher of informatic's net culture», carries out an analysis its construction, components and criterions, leads indicators of net culture's formedness for each level.

  9. Navigating the health-care system in community: Perspectives from Asian immigrant parents of children with special health-care needs.

    Science.gov (United States)

    Son, Esther; Moring, Nechama Sammet; Igdalsky, Leah; Parish, Susan L

    2018-01-01

    Children with special health-care needs (CSHCNs) face notable barriers to health-care access and to receiving quality and family-centered care, despite higher health-care utilization rates. Within the population of CSHCNs, there are significant inequities in health-care quality impacting immigrants who have migrated to the United States. However, little is known about the experiences and needs of Asian immigrant families who have CSHCNs. This study aimed to explore how Asian immigrant parents of CSHCNs view their child's health-care access, quality, and utilization. We conducted semi-structured qualitative interviews with 22 Vietnamese- and Cantonese-speaking parents of CSHCNs. Participants were recruited through community partners. Interviews were transcribed, translated, and coded using content analysis. Participants were generally satisfied with their children's care and had strong relationships with their primary care doctors who were often culturally 'matched'. However, participants experienced several important and culturally specific barriers, including gaps in their understanding of the health-care system, language barriers, and a sense of alienation. Parents frequently turned to informal and community supports for assistance in navigating the US health-care system. Further research to understand the drivers of health disparities and policy level solutions is warranted.

  10. A PetriNet-Based Approach for Supporting Traceability in Cyber-Physical Manufacturing Systems

    Directory of Open Access Journals (Sweden)

    Jiwei Huang

    2016-03-01

    Full Text Available With the growing popularity of complex dynamic activities in manufacturing processes, traceability of the entire life of every product has drawn significant attention especially for food, clinical materials, and similar items. This paper studies the traceability issue in cyber-physical manufacturing systems from a theoretical viewpoint. Petri net models are generalized for formulating dynamic manufacturing processes, based on which a detailed approach for enabling traceability analysis is presented. Models as well as algorithms are carefully designed, which can trace back the lifecycle of a possibly contaminated item. A practical prototype system for supporting traceability is designed, and a real-life case study of a quality control system for bee products is presented to validate the effectiveness of the approach.

  11. A Petri Net-based Approach to Reconfigurable Manufacturing Systems Modeling

    Directory of Open Access Journals (Sweden)

    Brian Rodrigues

    2009-02-01

    Full Text Available Reconfigurable manufacturing systems (RMSs have been used to provide manufacturing companies with the required capacities and capabilities, when needed. Recognizing (1 the importance of dynamic modeling and visualization in decision making support in RMSs and (2 the limitations of the existing studies, we model RMSs based on Petri net (PN techniques with focus on the process of reconfiguring system elements while considering constraints and system performance. In response to the modeling difficulties identified, a new formalism of colored timed PNs is introduced. In conjunction with colored tokens and timing in colored PNs and timed PNs, we further define a reconfiguration mechanism to meet the modeling difficulties. A case study of an electronics product is reported as an application of the proposed colored timed PNs to RMS modeling.

  12. Effects of Net Metering on the Use of Small-Scale Wind Systems in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, T. L.; Pedden, M.; Gagliano, T.

    2002-11-01

    Factors such as technological advancements, steadily decreasing costs, consumer demand, and state and federal policies are combining to make wind energy the world's fastest growing energy source. State and federal policies are facilitating the growth of the domestic, large-scale wind power market; however, small-scale wind projects (those with a capacity of less than 100 kilowatts[kW]) still face challenges in many states. Net metering, also referred to as net billing, is one particular policy that states are implementing to encourage the use of small renewable energy systems. Net metering allows individual, grid-tied customers who generate electricity using a small renewable energy system to receive credit from their utility for any excess power they generate beyond what they consume. Under most state rules, residential, commercial, and industrial customers are eligible for net metering; however, some states restrict eligibility to particular customer classes. This paper illustrates how net metering programs in certain states vary considerably in terms of how customers are credited for excess power they generate; the type and size of eligible technologies and whether the utility; the state, or some other entity administers the program. This paper focuses on10 particular states where net metering policies are in place. It analyzes how the different versions of these programs affect the use of small-scale wind technologies and whether some versions are more favorable to this technology than others. The choice of citizens in some states to net meter with photovoltaics is also examined.

  13. Agent-based modeling of the immune system: NetLogo, a promising framework.

    Science.gov (United States)

    Chiacchio, Ferdinando; Pennisi, Marzio; Russo, Giulia; Motta, Santo; Pappalardo, Francesco

    2014-01-01

    Several components that interact with each other to evolve a complex, and, in some cases, unexpected behavior, represents one of the main and fascinating features of the mammalian immune system. Agent-based modeling and cellular automata belong to a class of discrete mathematical approaches in which entities (agents) sense local information and undertake actions over time according to predefined rules. The strength of this approach is characterized by the appearance of a global behavior that emerges from interactions among agents. This behavior is unpredictable, as it does not follow linear rules. There are a lot of works that investigates the immune system with agent-based modeling and cellular automata. They have shown the ability to see clearly and intuitively into the nature of immunological processes. NetLogo is a multiagent programming language and modeling environment for simulating complex phenomena. It is designed for both research and education and is used across a wide range of disciplines and education levels. In this paper, we summarize NetLogo applications to immunology and, particularly, how this framework can help in the development and formulation of hypotheses that might drive further experimental investigations of disease mechanisms.

  14. Agent-Based Modeling of the Immune System: NetLogo, a Promising Framework

    Directory of Open Access Journals (Sweden)

    Ferdinando Chiacchio

    2014-01-01

    Full Text Available Several components that interact with each other to evolve a complex, and, in some cases, unexpected behavior, represents one of the main and fascinating features of the mammalian immune system. Agent-based modeling and cellular automata belong to a class of discrete mathematical approaches in which entities (agents sense local information and undertake actions over time according to predefined rules. The strength of this approach is characterized by the appearance of a global behavior that emerges from interactions among agents. This behavior is unpredictable, as it does not follow linear rules. There are a lot of works that investigates the immune system with agent-based modeling and cellular automata. They have shown the ability to see clearly and intuitively into the nature of immunological processes. NetLogo is a multiagent programming language and modeling environment for simulating complex phenomena. It is designed for both research and education and is used across a wide range of disciplines and education levels. In this paper, we summarize NetLogo applications to immunology and, particularly, how this framework can help in the development and formulation of hypotheses that might drive further experimental investigations of disease mechanisms.

  15. Physician leadership: a health-care system's investment in the future of quality care.

    Science.gov (United States)

    Orlando, Rocco; Haytaian, Marcia

    2012-08-01

    The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system.

  16. Coordinating Healthcare Under a Pluralistic Health Insurance System: The Case of Slovakia

    Directory of Open Access Journals (Sweden)

    Juraj NEMEC

    2015-06-01

    Full Text Available The Slovak approach to decreasing health-care costs is based on a changed interpretation of the concept of ‘a minimum network of provid-ers’. This study describes the changes made in the healthcare system in Slovakia in order to keep it affordable. It shows how the initial inter-pretation of a minimum network as an assurance for general access to healthcare services slow-ly changed into a cutback making the minimum network an upper limit for healthcare. The study argues that the complexity of the network made for non-transparent policies, in which consulta-tion was nearly absent and vertical power be-came dominant, despite the semi-independence of actors in the network. This observation runs counter to the network theory suggestion that in complex networks, with semi-independent actors, vertical power becomes useless.

  17. A methodological approach for using high-level Petri Nets to model the immune system response.

    Science.gov (United States)

    Pennisi, Marzio; Cavalieri, Salvatore; Motta, Santo; Pappalardo, Francesco

    2016-12-22

    Mathematical and computational models showed to be a very important support tool for the comprehension of the immune system response against pathogens. Models and simulations allowed to study the immune system behavior, to test biological hypotheses about diseases and infection dynamics, and to improve and optimize novel and existing drugs and vaccines. Continuous models, mainly based on differential equations, usually allow to qualitatively study the system but lack in description; conversely discrete models, such as agent based models and cellular automata, permit to describe in detail entities properties at the cost of losing most qualitative analyses. Petri Nets (PN) are a graphical modeling tool developed to model concurrency and synchronization in distributed systems. Their use has become increasingly marked also thanks to the introduction in the years of many features and extensions which lead to the born of "high level" PN. We propose a novel methodological approach that is based on high level PN, and in particular on Colored Petri Nets (CPN), that can be used to model the immune system response at the cellular scale. To demonstrate the potentiality of the approach we provide a simple model of the humoral immune system response that is able of reproducing some of the most complex well-known features of the adaptive response like memory and specificity features. The methodology we present has advantages of both the two classical approaches based on continuous and discrete models, since it allows to gain good level of granularity in the description of cells behavior without losing the possibility of having a qualitative analysis. Furthermore, the presented methodology based on CPN allows the adoption of the same graphical modeling technique well known to life scientists that use PN for the modeling of signaling pathways. Finally, such an approach may open the floodgates to the realization of multi scale models that integrate both signaling pathways (intra

  18. Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems: The Bosnian Example

    Directory of Open Access Journals (Sweden)

    Line Neerup Handlos

    2016-09-01

    Full Text Available Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than was the case for those who had not left the country, as doctors considered them to be better endowed financially and therefore demanded larger bribes from them than they did from those who had remained in Bosnia. Moreover, during their stay abroad the returnees had lost the connections that could have helped them sidestep the corruption. Returned refugees are thus particularly vulnerable to the effects of corruption.

  19. An enhanced mobile-healthcare emergency system based on extended chaotic maps.

    Science.gov (United States)

    Lee, Cheng-Chi; Hsu, Che-Wei; Lai, Yan-Ming; Vasilakos, Athanasios

    2013-10-01

    Mobile Healthcare (m-Healthcare) systems, namely smartphone applications of pervasive computing that utilize wireless body sensor networks (BSNs), have recently been proposed to provide smartphone users with health monitoring services and received great attentions. An m-Healthcare system with flaws, however, may leak out the smartphone user's personal information and cause security, privacy preservation, or user anonymity problems. In 2012, Lu et al. proposed a secure and privacy-preserving opportunistic computing (SPOC) framework for mobile-Healthcare emergency. The brilliant SPOC framework can opportunistically gather resources on the smartphone such as computing power and energy to process the computing-intensive personal health information (PHI) in case of an m-Healthcare emergency with minimal privacy disclosure. To balance between the hazard of PHI privacy disclosure and the necessity of PHI processing and transmission in m-Healthcare emergency, in their SPOC framework, Lu et al. introduced an efficient user-centric privacy access control system which they built on the basis of an attribute-based access control mechanism and a new privacy-preserving scalar product computation (PPSPC) technique. However, we found out that Lu et al.'s protocol still has some secure flaws such as user anonymity and mutual authentication. To fix those problems and further enhance the computation efficiency of Lu et al.'s protocol, in this article, the authors will present an improved mobile-Healthcare emergency system based on extended chaotic maps. The new system is capable of not only providing flawless user anonymity and mutual authentication but also reducing the computation cost.

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

    Science.gov (United States)

    Happe, Laura E; Walker, Desiree'

    2013-05-13

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

  1. 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.

  2. An effectiveness analysis of healthcare systems using a systems theoretic approach

    Directory of Open Access Journals (Sweden)

    Inder Kerry

    2009-10-01

    Full Text Available Abstract Background The use of accreditation and quality measurement and reporting to improve healthcare quality and patient safety has been widespread across many countries. A review of the literature reveals no association between the accreditation system and the quality measurement and reporting systems, even when hospital compliance with these systems is satisfactory. Improvement of health care outcomes needs to be based on an appreciation of the whole system that contributes to those outcomes. The research literature currently lacks an appropriate analysis and is fragmented among activities. This paper aims to propose an integrated research model of these two systems and to demonstrate the usefulness of the resulting model for strategic research planning. Methods/design To achieve these aims, a systematic integration of the healthcare accreditation and quality measurement/reporting systems is structured hierarchically. A holistic systems relationship model of the administration segment is developed to act as an investigation framework. A literature-based empirical study is used to validate the proposed relationships derived from the model. Australian experiences are used as evidence for the system effectiveness analysis and design base for an adaptive-control study proposal to show the usefulness of the system model for guiding strategic research. Results Three basic relationships were revealed and validated from the research literature. The systemic weaknesses of the accreditation system and quality measurement/reporting system from a system flow perspective were examined. The approach provides a system thinking structure to assist the design of quality improvement strategies. The proposed model discovers a fourth implicit relationship, a feedback between quality performance reporting components and choice of accreditation components that is likely to play an important role in health care outcomes. An example involving accreditation

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

    Science.gov (United States)

    Newman-Valentine, Douglas; Duma, Sinegugu

    2014-11-21

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

  4. The NetLogger Methodology for High Performance Distributed Systems Performance Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Tierney, Brian; Johnston, William; Crowley, Brian; Hoo, Gary; Brooks, Chris; Gunter, Dan

    1999-12-23

    The authors describe a methodology that enables the real-time diagnosis of performance problems in complex high-performance distributed systems. The methodology includes tools for generating precision event logs that can be used to provide detailed end-to-end application and system level monitoring; a Java agent-based system for managing the large amount of logging data; and tools for visualizing the log data and real-time state of the distributed system. The authors developed these tools for analyzing a high-performance distributed system centered around the transfer of large amounts of data at high speeds from a distributed storage server to a remote visualization client. However, this methodology should be generally applicable to any distributed system. This methodology, called NetLogger, has proven invaluable for diagnosing problems in networks and in distributed systems code. This approach is novel in that it combines network, host, and application-level monitoring, providing a complete view of the entire system.

  5. Application of Petri nets to reliability prediction of occupant safety systems with partial detection and repair

    Energy Technology Data Exchange (ETDEWEB)

    Kleyner, Andre, E-mail: andre.v.kleyner@delphi.co [Delphi Corporation, Electronics and Safety Division, P.O. Box 9005, M.S. CTC 2E, Kokomo, IN 46904 (United States); Volovoi, Vitali, E-mail: vitali.volovoi@ae.gatech.ed [School of Aerospace Engineering, Georgia Institute of Technology, Atlanta, GA 30332 (United States)

    2010-06-15

    This paper presents an application of stochastic Petri nets (SPN) to calculate the availability of safety critical on-demand systems. Traditional methods of estimating system reliability include standards-based or field return-based reliability prediction methods. These methods do not take into account the effect of fault-detection capability and penalize the addition of detection circuitry due to the higher parts count. Therefore, calculating system availability, which can be linked to the system's probability of failure on demand (P{sub fd}), can be a better alternative to reliability prediction. The process of estimating the P{sub fd} of a safety system can be further complicated by the presence of system imperfections such as partial-fault detection by users and untimely or uncompleted repairs. Additionally, most system failures cannot be represented by Poisson process Markov chain methods, which are commonly utilized for the purposes of estimating P{sub fd}, as these methods are not well-suited for the analysis of non-Poisson failures. This paper suggests a methodology and presents a case study of SPN modeling adequately handling most of the above problems. The model will be illustrated with a case study of an automotive electronics airbag controller as an example of a safety critical on-demand system.

  6. Modeling and Application of Vehicular Cyber Physical System Based Petri Nets

    Directory of Open Access Journals (Sweden)

    Lin Chen

    2014-11-01

    Full Text Available Mobile cyber physical system (MCPS has been a hot research area, where mobile nodes can mobile, and communicate with each other. As a typical MCPS, vehicular cyber physical system (VCPS plays an important role in intelligent transportation, especially in collision avoidance. There is no, however, a formal modeling and analysis method for VCPS. In the paper, the modeling method based Petri nets (PN is presented. Furthermore, the behavior expression analysis method is also presented which can deal with arbitrary distribution timed transitions. Finally, a case is introduced to verify the effectiveness about proposed method, and the results show that VCPS can greatly reduce the reaction time of vehicles behind when emergent accident occurs and then enhance the traffic safety.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  9. Choice of health insurer and healthcare provider : An analysis of regulated competition in the Dutch healthcare system

    NARCIS (Netherlands)

    D.M.I.D. Duijmelinck (Daniëlle)

    2015-01-01

    markdownabstractConsumer choice of health insurer is an essential precondition for achieving efficiency and consumer responsiveness in healthcare. In healthcare, consumer preferences are highly heterogeneous. This implies that if groups of consumers with specific preferences feel not free to switch

  10. Hierarchical Colored Petri Nets for Modeling and Analysis of Transit Signal Priority Control Systems

    Directory of Open Access Journals (Sweden)

    Yisheng An

    2018-01-01

    Full Text Available In this paper, we consider the problem of developing a model for traffic signal control with transit priority using Hierarchical Colored Petri nets (HCPN. Petri nets (PN are useful for state analysis of discrete event systems due to their powerful modeling capability and mathematical formalism. This paper focuses on their use to formalize the transit signal priority (TSP control model. In a four-phase traffic signal control model, the transit detection and two kinds of transit priority strategies are integrated to obtain the HCPN-based TSP control models. One of the advantages to use these models is the clear presentation of traffic light behaviors in terms of conditions and events that cause the detection of a priority request by a transit vehicle. Another advantage of the resulting models is that the correctness and reliability of the proposed strategies are easily analyzed. After their full reachable states are generated, the boundness, liveness, and fairness of the proposed models are verified. Experimental results show that the proposed control model provides transit vehicles with better effectiveness at intersections. This work helps advance the state of the art in the design of signal control models related to the intersection of roadways.

  11. A Systems Approach to Healthcare Innovation Using the MIT Hacking Medicine Model.

    Science.gov (United States)

    Gubin, Tatyana A; Iyer, Hari P; Liew, Shirlene N; Sarma, Aartik; Revelos, Alex; Ribas, João; Movassaghi, Babak; Chu, Zen M; Khalid, Ayesha N; Majmudar, Maulik D; Lee, Christopher Xiang

    2017-07-26

    MIT Hacking Medicine is a student, academic, and community-led organization that uses systems-oriented "healthcare hacking" to address challenges around innovation in healthcare. The group has organized more than 80 events around the world that attract participants with diverse backgrounds. These participants are trained to address clinical needs from the perspective of multiple stakeholders and emphasize utility and implementation viability of proposed solutions. We describe the MIT Hacking Medicine model as a potential method to integrate collaboration and training in rapid innovation techniques into academic medical centers. Built upon a systems approach to healthcare innovation, the time-compressed but expertly guided nature of the events could enable more widely accessible preliminary training in systems-level innovation methodology, as well as creating a structured opportunity for interdisciplinary congregation and collaboration. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Modelling mobile health systems: an application of augmented MDA for the extended healthcare enterprise

    NARCIS (Netherlands)

    Jones, Valerie M.; Rensink, Arend; Brinksma, Hendrik

    2005-01-01

    Mobile health systems can extend the enterprise computing system of the healthcare provider by bringing services to the patient any time and anywhere. We propose a model-driven design and development methodology for the development of the m-health components in such extended enterprise computing

  13. Do It Yourself solution of Internet of Things Healthcare System: Measuring body parameters and environmental parameters affecting health.

    OpenAIRE

    Mirjana Maksimović; Vladimir Vujović; Branko Perišić

    2016-01-01

    The rapid advancements in information and communications technologies (ICT) and the increasing number of smart things shift an old-fashioned healthcare system to a model better suited for a population of the 21st century. New healthcare approaches based on Internet of Things (IoT)/Internet of Medical Things (IoMT) powered systems make health monitoring, diagnostics and treatment more personalized, timely and convenient, enabling a global approach to the healthcare system infrastructure develo...

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

    Science.gov (United States)

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

    2017-01-01

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

  15. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    Science.gov (United States)

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  16. Systems mapping workshops and their role in understanding medication errors in healthcare.

    Science.gov (United States)

    Buckle, P; Clarkson, P J; Coleman, R; Bound, J; Ward, J; Brown, J

    2010-09-01

    Systems mapping workshops have been applied to the problem of medication errors in healthcare. The workshops were designed using experiential group work principles. They involved a range of stakeholders from within the health service as well as those who supply the health sector, including designers who may be able to enhance the safety of products and systems used in healthcare. Research has shown that the method encourages stakeholder participation, provides robust results within a limited time and enhances understanding across specialist interest groups. Additional, creative design workshops that considered the same topic showed significant promise in developing concepts from which potential solutions could be developed further. 2010 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-02-01

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

  18. Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

    Science.gov (United States)

    Brand, Sarah L; Thompson Coon, Jo; Fleming, Lora E; Carroll, Lauren; Bethel, Alison; Wyatt, Katrina

    2017-01-01

    Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local

  19. The Models of a General Component of a Distributed Computing Systems Based On Stochastic Petri Nets

    OpenAIRE

    Serhan, Sami [سامي سرحان; Al-Qadi, Ziad

    1994-01-01

    In this paper we propose models of a distributed computing system (DCS) based on general stochastic Petri nets (GSPN). We also propose the means to decrease the number of states. We indicate that the complexity of DCS doesn't affect the models structure (a number of tokens is changed only). In this paper we also propose models for investigation of processes transfer, data interchange, and also the priority interchange. نطرح في هذا البحث نماذج لنظام حاسوب موزع تعتمد على شبكات بتري العشوائية...

  20. Reliability analysis of repairable systems using Petri nets and vague Lambda-Tau methodology.

    Science.gov (United States)

    Garg, Harish

    2013-01-01

    The main objective of the paper is to developed a methodology, named as vague Lambda-Tau, for reliability analysis of repairable systems. Petri net tool is applied to represent the asynchronous and concurrent processing of the system instead of fault tree analysis. To enhance the relevance of the reliability study, vague set theory is used for representing the failure rate and repair times instead of classical(crisp) or fuzzy set theory because vague sets are characterized by a truth membership function and false membership functions (non-membership functions) so that sum of both values is less than 1. The proposed methodology involves qualitative modeling using PN and quantitative analysis using Lambda-Tau method of solution with the basic events represented by intuitionistic fuzzy numbers of triangular membership functions. Sensitivity analysis has also been performed and the effects on system MTBF are addressed. The methodology improves the shortcomings of the existing probabilistic approaches and gives a better understanding of the system behavior through its graphical representation. The washing unit of a paper mill situated in a northern part of India, producing approximately 200 ton of paper per day, has been considered to demonstrate the proposed approach. The results may be helpful for the plant personnel for analyzing the systems' behavior and to improve their performance by adopting suitable maintenance strategies. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Phased mission modelling of systems with maintenance-free operating periods using simulated Petri nets

    Energy Technology Data Exchange (ETDEWEB)

    Chew, S.P.; Dunnett, S.J. [Department of Aeronautical and Automotive Engineering, Loughborough University, Loughborough, Leics (United Kingdom); Andrews, J.D. [Department of Aeronautical and Automotive Engineering, Loughborough University, Loughborough, Leics (United Kingdom)], E-mail: j.d.andrews@lboro.ac.uk

    2008-07-15

    A common scenario in engineering is that of a system which operates throughout several sequential and distinct periods of time, during which the modes and consequences of failure differ from one another. This type of operation is known as a phased mission, and for the mission to be a success the system must successfully operate throughout all of the phases. Examples include a rocket launch and an aeroplane flight. Component or sub-system failures may occur at any time during the mission, yet not affect the system performance until the phase in which their condition is critical. This may mean that the transition from one phase to the next is a critical event that leads to phase and mission failure, with the root cause being a component failure in a previous phase. A series of phased missions with no maintenance may be considered as a maintenance-free operating period (MFOP). This paper describes the use of a Petri net (PN) to model the reliability of the MFOP and phased missions scenario. The model uses Monte-Carlo simulation to obtain its results, and due to the modelling power of PNs, can consider complexities such as component failure rate interdependencies and mission abandonment. The model operates three different types of PN which interact to provide the overall system reliability modelling. The model is demonstrated and validated by considering two simple examples that can be solved analytically.

  2. Comparing the Net Ecosystem Exchange of Two Cropping Systems for Dairy Feed Production

    Science.gov (United States)

    Sulaiman, M. F.; Wagner-Riddle, C.; Brown, S. E.

    2015-12-01

    A three-year study was conducted from 2012 to 2014 to determine the net CO2 fluxes from corn and hay, the two main feed crops used in dairy production. The aim of this study is to better understand the net ecosystem exchange (NEE) in annual and perennial cropping systems used in dairy production to benefit greenhouse gas emission model developments and the life cycle analysis of dairy production. The study was conducted on two 4-ha plots where one plot was a 5-year old hayfield and the other plot was planted in a continuous cycle corn. All plots were continuously monitored using the flux-gradient method deployed with a tunable diode laser trace gas analyzer and sonic anemometers. All plots received dairy manure as fertilizer applied according to common practice. The cumulative NEE for the three years of the study was -873.15 g C m-2 for corn and -409.36 g C m-2 for hay. Differences in respiration between the two cropping systems was found to be the larger factor compared to differences in gross ecosystem production (GEP) that resulted in the contrasting cumulative NEE where cumulative respiration for the three years for hay was 3094.23 g C m-2 as opposed to 2078.11 g C m-2 for corn. Cumulative GEP for the three years was 3503.60 and 2951.31 g C m-2 for hay and corn respectively. Inter-annual and inter-crop variability of the NEE, GEP and respiration will be discussed in relation to biomass production, climatic conditions and crop physiological characteristics.

  3. From striving to thriving: systems thinking, strategy, and the performance of safety net hospitals.

    Science.gov (United States)

    Clark, Jonathan; Singer, Sara; Kane, Nancy; Valentine, Melissa

    2013-01-01

    Safety net hospitals (SNH) have, on average, experienced declining financial margins and faced an elevated risk of closure over the past decade. Despite these challenges, not all SNHs are weakening and some are prospering. These higher-performing SNHs provide substantial care to safety net populations and produce sustainable financial returns. Drawing on the alternative structural positioning and resource-based views, we explore strategic management as a source of performance differences across SNHs. We employ a mixed-method design, blending quantitative and qualitative data and analysis. We measure financial performance using hospital operating margin and quantitatively evaluate its relationship with a limited set of well-defined structural positions. We further evaluate these structures and also explore the internal resources of SNHs based on nine in-depth case studies developed from site visits and extensive interviews. Quantitative results suggest that structural positions alone are not related to performance. Comparative case studies suggest that higher-performing SNH differ in four respects: (1) coordinating patient flow across the care continuum, (2) engaging in partnerships with other providers, (3) managing scope of services, and (4) investing in human capital. On the basis of these findings, we propose a model of strategic action related to systems thinking--the ability to see wholes and interrelationships rather than individual parts alone. Our exploratory findings suggest the need to move beyond generic strategies alone and acknowledge the importance of underlying managerial capabilities. Specifically, our findings suggest that effective strategy is a function of both the internal resources (e.g., managers' systems-thinking capability) and structural positions (e.g., partnerships) of organizations. From this perspective, framing resources and positioning as distinct alternatives misses the nuances of how strategic advantage is actually achieved.

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

    Science.gov (United States)

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

    2016-10-01

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

  5. Development of a new multiple sampling trawl with autonomous opening/closing net control system for sampling juvenile pelagic fish

    Science.gov (United States)

    Oozeki, Yoshioki; Hu, Fuxiang; Tomatsu, Chiaki; Kubota, Hiroshi

    2012-03-01

    A new multiple layer sampling trawl with an autonomous net opening/closing control system was developed to sample pelagic juvenile fish quantitatively. The new trawl system, based on the Matsuda-Oozeki-Hu Trawl (MOHT), has a rigid-frame 3.3 m high and 2.35 m wide and five nets of 11.0 m length with a rectangular mouth of 2.22 m×1.81 m (4 m2 mouth area; large-scale prototype). A cambered V-shape depressor is hung below the frame and two bridles are attached at the midpoint of the side frames. A net-release controller is used, which not only controls the net release mechanism but also records the net depth, temperature and flow rate during net towing. The controller sends stored command signals to the net release mechanism as depth settings and/or time settings and does not require any commands from the surface through a conducting cable or by acoustic signals. Two other models were constructed before the construction of the large-scale prototype, which are a small-scale prototype (2 m2 mouth area) for testing the net release mechanism and a 1/4-scale model of the large-scale prototype for flume tank tests. Flume tank tests with the 1/4-scale model showed that the frame leaned forward at a tilt angle from 5 to 15 degrees at towing speeds from 0.8 to 1.4 m s-1. Opened nets closed smoothly and sequentially nets were completely opened when the trigger was released by the command. Net depth rarely changed even during changes in towing speed. Sea trials both by the small-scale and the large-scale prototype demonstrated the same towing characteristics expected from the flume tank tests. The newly developed multiple layer opening/closing MOHT (MOC-MOHT) is considered to be suitable for quantitative layer sampling of juvenile fish.

  6. FORMATION OF THE SYNTHESIS ALGORITHMS OF THE COORDINATING CONTROL SYSTEMS BY MEANS OF THE AUTOMATIC GENERATION OF PETRI NETS

    Directory of Open Access Journals (Sweden)

    A. A. Gurskiy

    2016-09-01

    Full Text Available The coordinating control system by drives of the robot-manipulator is presented in this article. The purpose of the scientific work is the development and research of the new algorithms for parametric synthesis of the coordinating control systems. To achieve this aim it is necessary to develop the system generating the required parametric synthesis algorithms and performing the necessary procedures according to the generated algorithm. This scientific work deals with the synthesis of Petri net in the specific case with the automatic generation of Petri nets.

  7. Prevalence and Causes of Sick Leave among Healthcare System Employees of Joibar Province in 2015

    Directory of Open Access Journals (Sweden)

    Siavosh Etemadi neZhad

    2017-09-01

    Full Text Available Introduction and purpose: Absenteeism is defined as being absent from work without a good reason. Sick leave among healthcare providers can have serious negative impacts on organizational performance. This study was conducted to determine the prevalence and causes of sick leave in the healthcare system of Joibar, Iran. Methods: This analytical cross-sectional study was performed on all employees of the healthcare system of Joibar, Iran (n=239. Data was collected using a checklist including demographic data and reasons for absenteeism (the number of absent days, work experience, and  employment status by presenting to the Human Resources Department of the healthcare system. Data was analyzed by using Chi-square test and Spearman’s rank correlation coefficient in SPSS, version 20. Results: The mean age of the employees was 35.72±3.3 years. Sick leave was mostly observed in the age group of 30-39, official staff, married women, and employees with work experience of 6 to 10 years (83 cases. Among the studied diseases, cold and musculoskeletal disorders were the most frequent causes of absenteeism among employees in the healthcare system. Conclusion: Based on our findings, musculoskeletal disorders were the most important causes of absenteeism, which are preventable. To improve the physical and ergonomic conditions of the staff, we suggest healthcare authorities to install ergonomy software (Office Exercise Program and provide standard and adjustable seats and office desks.

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

    Science.gov (United States)

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

    2010-01-01

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

  9. Healthcare Delivery Systems at Higher Educational Institutions in India

    Directory of Open Access Journals (Sweden)

    Rajiv Chintaman Yeravdekar

    2014-01-01

    Conclusions: The collective responses obtained could provide the basis for a policy formulation. The policy formulation in turn could be the basis of a national consensus for health care delivery systems operational at higher educational institutions in India.

  10. The enhancement of security in healthcare information systems.

    Science.gov (United States)

    Liu, Chia-Hui; Chung, Yu-Fang; Chen, Tzer-Shyong; Wang, Sheng-De

    2012-06-01

    With the progress and the development of information technology, the internal data in medical organizations have become computerized and are further established the medical information system. Moreover, the use of the Internet enhances the information communication as well as affects the development of the medical information system that a lot of medical information is transmitted with the Internet. Since there is a network within another network, when all networks are connected together, they will form the "Internet". For this reason, the Internet is considered as a high-risk and public environment which is easily destroyed and invaded so that a relevant protection is acquired. Besides, the data in the medical network system are confidential that it is necessary to protect the personal privacy, such as electronic patient records, medical confidential information, and authorization-controlled data in the hospital. As a consequence, a medical network system is considered as a network requiring high security that excellent protections and managerial strategies are inevitable to prevent illegal events and external attacks from happening. This study proposes secure medical managerial strategies being applied to the network environment of the medical organization information system so as to avoid the external or internal information security events, allow the medical system to work smoothly and safely that not only benefits the patients, but also allows the doctors to use it more conveniently, and further promote the overall medical quality. The objectives could be achieved by preventing from illegal invasion or medical information being stolen, protecting the completeness and security of medical information, avoiding the managerial mistakes of the internal information system in medical organizations, and providing the highly-reliable medical information system.

  11. Department of Defense Healthcare Management System Modernization (DHMSM)

    Science.gov (United States)

    2016-03-01

    Determined TY - Then Year U.S.C- United States Code USD(AT&L) - Under Secretary of Defense for Acquisition, Technology, & Logistics DHMSM 2016 MAR...program established two segments to support deployment of the EHR System to the MHS enterprise, serving all Active Duty, Reserve, Guard, and...beneficiaries. Fixed Facilities ( Segment 1) will deploy the EHR System to all medical and dental permanent fixed facilities worldwide, inclusive of

  12. ENERGY-NET (Energy, Environment and Society Learning Network): Enhancing opportunities for learning using an Earth systems science framework

    Science.gov (United States)

    Elliott, E. M.; Bain, D. J.; Divers, M. T.; Crowley, K. J.; Povis, K.; Scardina, A.; Steiner, M.

    2012-12-01

    We describe a newly funded collaborative NSF initiative, ENERGY-NET (Energy, Environment and Society Learning Network), that brings together the Carnegie Museum of Natural History (CMNH) with the Learning Science and Geoscience research strengths at the University of Pittsburgh. ENERGY-NET aims to create rich opportunities for participatory learning and public education in the arena of energy, the environment, and society using an Earth systems science framework. We build upon a long-established teen docent program at CMNH and to form Geoscience Squads comprised of underserved teens. Together, the ENERGY-NET team, including museum staff, experts in informal learning sciences, and geoscientists spanning career stage (undergraduates, graduate students, faculty) provides inquiry-based learning experiences guided by Earth systems science principles. Together, the team works with Geoscience Squads to design "Exploration Stations" for use with CMNH visitors that employ an Earth systems science framework to explore the intersecting lenses of energy, the environment, and society. The goals of ENERGY-NET are to: 1) Develop a rich set of experiential learning activities to enhance public knowledge about the complex dynamics between Energy, Environment, and Society for demonstration at CMNH; 2) Expand diversity in the geosciences workforce by mentoring underrepresented teens, providing authentic learning experiences in earth systems science and life skills, and providing networking opportunities with geoscientists; and 3) Institutionalize ENERGY-NET collaborations among geosciences expert, learning researchers, and museum staff to yield long-term improvements in public geoscience education and geoscience workforce recruiting.

  13. From Requirements via Colored Workflow Nets to an Implementation in Several Workflow Systems

    DEFF Research Database (Denmark)

    Mans, Ronnie S:; van der Aalst, Wil M.P.; Bakker, Piet J.M.

    2007-01-01

    Care organizations, such as hospitals, need to support complex and dynamic workflows. More- over, many disciplines are involved. This makes it important to avoid the typical disconnect between requirements and the actual implementation of the system. This paper proposes an approach where an Execu......Care organizations, such as hospitals, need to support complex and dynamic workflows. More- over, many disciplines are involved. This makes it important to avoid the typical disconnect between requirements and the actual implementation of the system. This paper proposes an approach where...... an Executable Use Case (EUC) and Colored Workflow Net (CWN) are used to close the gap between the given requirements specification and the realization of these requirements with the help of a workflow system. This paper describes a large case study where the diagnostic tra jectory of the gynaecological oncology...... care process of the Academic Medical Center (AMC) hospital is used as reference process. The process consists of hundreds of activities. These have been modeled and analyzed using an EUC and a CWN. Moreover, based on the CWN, the process has been implemented using four different workflow systems...

  14. A Comprehensive Availability Modeling and Analysis of a Virtualized Servers System Using Stochastic Reward Nets

    Directory of Open Access Journals (Sweden)

    Tuan Anh Nguyen

    2014-01-01

    Full Text Available It is important to assess availability of virtualized systems in IT business infrastructures. Previous work on availability modeling and analysis of the virtualized systems used a simplified configuration and assumption in which only one virtual machine (VM runs on a virtual machine monitor (VMM hosted on a physical server. In this paper, we show a comprehensive availability model using stochastic reward nets (SRN. The model takes into account (i the detailed failures and recovery behaviors of multiple VMs, (ii various other failure modes and corresponding recovery behaviors (e.g., hardware faults, failure and recovery due to Mandelbugs and aging-related bugs, and (iii dependency between different subcomponents (e.g., between physical host failure and VMM, etc. in a virtualized servers system. We also show numerical analysis on steady state availability, downtime in hours per year, transaction loss, and sensitivity analysis. This model provides a new finding on how to increase system availability by combining both software rejuvenations at VM and VMM in a wise manner.

  15. From Requirements via Colored Workflow Nets to an Implementation in Several Workflow Systems

    DEFF Research Database (Denmark)

    Mans, Ronny S.; van der Aalst, Willibrordus Martinus Pancratius; Molemann, A.J.

    2007-01-01

    Care organizations, such as hospitals, need to support complex and dynamic workflows. More- over, many disciplines are involved. This makes it important to avoid the typical disconnect between requirements and the actual implementation of the system. This paper proposes an approach where an Execu......Care organizations, such as hospitals, need to support complex and dynamic workflows. More- over, many disciplines are involved. This makes it important to avoid the typical disconnect between requirements and the actual implementation of the system. This paper proposes an approach where...... an Executable Use Case (EUC) and Colored Care organizations, such as hospitals, need to support complex and dynamic workflows. Moreover, many disciplines are involved. This makes it important to avoid the typical disconnect between requirements and the actual implementation of the system. This paper proposes...... an approach where an Executable Use Case (EUC) and Colored Workflow Net (CWN) are used to close the gap between the given requirements specification and the realization of these requirements with the help of a workflow system. This paper describes a large case study where the diagnostic trajectory...

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

    Science.gov (United States)

    Budrionis, Andrius; Bellika, Johan Gustav

    2016-12-01

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

  17. MONALISA for stochastic simulations of Petri net models of biochemical systems.

    Science.gov (United States)

    Balazki, Pavel; Lindauer, Klaus; Einloft, Jens; Ackermann, Jörg; Koch, Ina

    2015-07-10

    The concept of Petri nets (PN) is widely used in systems biology and allows modeling of complex biochemical systems like metabolic systems, signal transduction pathways, and gene expression networks. In particular, PN allows the topological analysis based on structural properties, which is important and useful when quantitative (kinetic) data are incomplete or unknown. Knowing the kinetic parameters, the simulation of time evolution of such models can help to study the dynamic behavior of the underlying system. If the number of involved entities (molecules) is low, a stochastic simulation should be preferred against the classical deterministic approach of solving ordinary differential equations. The Stochastic Simulation Algorithm (SSA) is a common method for such simulations. The combination of the qualitative and semi-quantitative PN modeling and stochastic analysis techniques provides a valuable approach in the field of systems biology. Here, we describe the implementation of stochastic analysis in a PN environment. We extended MONALISA - an open-source software for creation, visualization and analysis of PN - by several stochastic simulation methods. The simulation module offers four simulation modes, among them the stochastic mode with constant firing rates and Gillespie's algorithm as exact and approximate versions. The simulator is operated by a user-friendly graphical interface and accepts input data such as concentrations and reaction rate constants that are common parameters in the biological context. The key features of the simulation module are visualization of simulation, interactive plotting, export of results into a text file, mathematical expressions for describing simulation parameters, and up to 500 parallel simulations of the same parameter sets. To illustrate the method we discuss a model for insulin receptor recycling as case study. We present a software that combines the modeling power of Petri nets with stochastic simulation of dynamic

  18. NutriNet: A Deep Learning Food and Drink Image Recognition System for Dietary Assessment.

    Science.gov (United States)

    Mezgec, Simon; Koroušić Seljak, Barbara

    2017-06-27

    Automatic food image recognition systems are alleviating the process of food-intake estimation and dietary assessment. However, due to the nature of food images, their recognition is a particularly challenging task, which is why traditional approaches in the field have achieved a low classification accuracy. Deep neural networks have outperformed such solutions, and we present a novel approach to the problem of food and drink image detection and recognition that uses a newly-defined deep convolutional neural network architecture, called NutriNet. This architecture was tuned on a recognition dataset containing 225,953 512 × 512 pixel images of 520 different food and drink items from a broad spectrum of food groups, on which we achieved a classification accuracy of 86 . 72 % , along with an accuracy of 94 . 47 % on a detection dataset containing 130 , 517 images. We also performed a real-world test on a dataset of self-acquired images, combined with images from Parkinson's disease patients, all taken using a smartphone camera, achieving a top-five accuracy of 55 % , which is an encouraging result for real-world images. Additionally, we tested NutriNet on the University of Milano-Bicocca 2016 (UNIMIB2016) food image dataset, on which we improved upon the provided baseline recognition result. An online training component was implemented to continually fine-tune the food and drink recognition model on new images. The model is being used in practice as part of a mobile app for the dietary assessment of Parkinson's disease patients.

  19. NutriNet: A Deep Learning Food and Drink Image Recognition System for Dietary Assessment

    Science.gov (United States)

    Koroušić Seljak, Barbara

    2017-01-01

    Automatic food image recognition systems are alleviating the process of food-intake estimation and dietary assessment. However, due to the nature of food images, their recognition is a particularly challenging task, which is why traditional approaches in the field have achieved a low classification accuracy. Deep neural networks have outperformed such solutions, and we present a novel approach to the problem of food and drink image detection and recognition that uses a newly-defined deep convolutional neural network architecture, called NutriNet. This architecture was tuned on a recognition dataset containing 225,953 512 × 512 pixel images of 520 different food and drink items from a broad spectrum of food groups, on which we achieved a classification accuracy of 86.72%, along with an accuracy of 94.47% on a detection dataset containing 130,517 images. We also performed a real-world test on a dataset of self-acquired images, combined with images from Parkinson’s disease patients, all taken using a smartphone camera, achieving a top-five accuracy of 55%, which is an encouraging result for real-world images. Additionally, we tested NutriNet on the University of Milano-Bicocca 2016 (UNIMIB2016) food image dataset, on which we improved upon the provided baseline recognition result. An online training component was implemented to continually fine-tune the food and drink recognition model on new images. The model is being used in practice as part of a mobile app for the dietary assessment of Parkinson’s disease patients. PMID:28653995

  20. A study of the transferability of influenza case detection systems between two large healthcare systems.

    Science.gov (United States)

    Ye, Ye; Wagner, Michael M; Cooper, Gregory F; Ferraro, Jeffrey P; Su, Howard; Gesteland, Per H; Haug, Peter J; Millett, Nicholas E; Aronis, John M; Nowalk, Andrew J; Ruiz, Victor M; López Pineda, Arturo; Shi, Lingyun; Van Bree, Rudy; Ginter, Thomas; Tsui, Fuchiang

    2017-01-01

    This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD) that use clinical notes from emergency department (ED) to detect influenza cases. A BCD uses natural language processing (NLP) to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN) to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC) and Intermountain Healthcare in Utah (BCDIH). At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source) institution, development parser, application (target) institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance. Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92). When tested for transferability using the other institution's cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, pparser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task. We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the accuracy of the NLP parser.

  1. A study of the transferability of influenza case detection systems between two large healthcare systems.

    Directory of Open Access Journals (Sweden)

    Ye Ye

    Full Text Available This study evaluates the accuracy and transferability of Bayesian case detection systems (BCD that use clinical notes from emergency department (ED to detect influenza cases.A BCD uses natural language processing (NLP to infer the presence or absence of clinical findings from ED notes, which are fed into a Bayesain network classifier (BN to infer patients' diagnoses. We developed BCDs at the University of Pittsburgh Medical Center (BCDUPMC and Intermountain Healthcare in Utah (BCDIH. At each site, we manually built a rule-based NLP and trained a Bayesain network classifier from over 40,000 ED encounters between Jan. 2008 and May. 2010 using feature selection, machine learning, and expert debiasing approach. Transferability of a BCD in this study may be impacted by seven factors: development (source institution, development parser, application (target institution, application parser, NLP transfer, BN transfer, and classification task. We employed an ANOVA analysis to study their impacts on BCD performance.Both BCDs discriminated well between influenza and non-influenza on local test cases (AUCs > 0.92. When tested for transferability using the other institution's cases, BCDUPMC discriminations declined minimally (AUC decreased from 0.95 to 0.94, p<0.01, and BCDIH discriminations declined more (from 0.93 to 0.87, p<0.0001. We attributed the BCDIH decline to the lower recall of the IH parser on UPMC notes. The ANOVA analysis showed five significant factors: development parser, application institution, application parser, BN transfer, and classification task.We demonstrated high influenza case detection performance in two large healthcare systems in two geographically separated regions, providing evidentiary support for the use of automated case detection from routinely collected electronic clinical notes in national influenza surveillance. The transferability could be improved by training Bayesian network classifier locally and increasing the

  2. A Cloud-Based X73 Ubiquitous Mobile Healthcare System: Design and Implementation

    OpenAIRE

    Zhanlin Ji; Ivan Ganchev; Máirtín O’Droma; Xin Zhang; Xueji Zhang

    2014-01-01

    Based on the user-centric paradigm for next generation networks, this paper describes a ubiquitous mobile healthcare (uHealth) system based on the ISO/IEEE 11073 personal health data (PHD) standards (X73) and cloud computing techniques. A number of design issues associated with the system implementation are outlined. The system includes a middleware on the user side, providing a plug-and-play environment for heterogeneous wireless sensors and mobile terminals utilizing different communication...

  3. Modelling mobile health systems: an application of augmented MDA for the extended healthcare enterprise

    OpenAIRE

    Jones, Valerie M.; Rensink, Arend; Brinksma, Hendrik

    2005-01-01

    Mobile health systems can extend the enterprise computing system of the healthcare provider by bringing services to the patient any time and anywhere. We propose a model-driven design and development methodology for the development of the m-health components in such extended enterprise computing systems. The methodology applies a model-driven design and development approach augmented with formal validation and verification to address quality and correctness and to support model transformation...

  4. The role of pharmaceuticals in the privatization process in Vietnam's health-care system.

    Science.gov (United States)

    Wolffers, I

    1995-11-01

    The socialist republic of Vietnam had a centrally planned economy and a well-distributed health-care system that was free to all. Since 1989 the government implemented a free market policy (Doi Moi). Authorities tried to shift part of the cost to users of health care and to improve aspects of the health-care system that appeared to be ineffective. Private practice of physicians and pharmacists was introduced in Vietnam. The introduction of privatization had consequences for the public health services at provincial, district, village and hamlet level. This has changed the character of the health-care system. Pharmaceuticals play an important role in the transactions between practitioners and patients, because they are the tangible goods that are exchanged in the transactions between users and providers of health care. Medical anthropologists interprete use and ideas on pharmaceuticals in terms of local cultural categories or as metonymic signs of technologically advanced societies from whence they come. Use of pharmaceuticals can also be understood in a historical and political context. This article describes pharmaceuticals in the process of privatization in Vietnam and the way they are seen by the Vietnamese in the context of political change. Their use carries meanings of medicines about transformations in political economy and as such this can be seen as a metaphor for the changing Vietnamese health-care system.

  5. Enhancing the performance of mobile healthcare systems based on task-redistribution

    NARCIS (Netherlands)

    Mei, H.; van Beijnum, Bernhard J.F.; Widya, I.A.; Jones, Valerie M.; Hermens, Hermanus J.

    2008-01-01

    Mobile healthcare (m-health) systems have attracted a great deal of attention due to their potential to improve the quality of diagnosis, reduce medical costs and help address the challenges posed by the aging society. A generic m-health service platform has been developed and specialized to deal

  6. Validation of Autism Spectrum Disorder Diagnoses in Large Healthcare Systems with Electronic Medical Records

    Science.gov (United States)

    Coleman, Karen J.; Lutsky, Marta A.; Yau, Vincent; Qian, Yinge; Pomichowski, Magdalena E.; Crawford, Phillip M.; Lynch, Frances L.; Madden, Jeanne M.; Owen-Smith, Ashli; Pearson, John A.; Pearson, Kathryn A.; Rusinak, Donna; Quinn, Virginia P.; Croen, Lisa A.

    2015-01-01

    To identify factors associated with valid Autism Spectrum Disorder (ASD) diagnoses from electronic sources in large healthcare systems. We examined 1,272 charts from ASD diagnosed youth <18 years old. Expert reviewers classified diagnoses as confirmed, probable, possible, ruled out, or not enough information. A total of 845 were classified with…

  7. Ethics Leadership in Research, Healthcare and Organizational Systems: Commentary and Critical Reflections

    Science.gov (United States)

    Gabriele, Edward F.

    2011-01-01

    In the last decades there has arisen a greater awareness of the ever present need for critical academic reflection on the nature of ethics leadership and committees in research, healthcare, and organizational systems. Yet what is meant by ethics itself? How is ethics understood as a historical phenomenon? What challenges must ethics leaders face…

  8. [Perceived quality in hospitals of the Andalusia Healthcare System. The case of neurosurgery departments].

    Science.gov (United States)

    Cordero Tous, N; Horcajadas Almansa, Á; Bermúdez González, G J; Tous Zamora, D

    2014-01-01

    To analyse the characteristics of the perceived quality in hospitals of the Andalusia healthcare system and compare this with that in Andalusian Neurosurgery departments. Randomised surveys, adjusted for working age, were performed in Andalusia using a telephone questionnaire based on the SERVQUAL model with the appropriate modification, with the subsequent selection of a subgroup associated with neurosurgery. Perceived quality was classified as; technical, functional and infrastructure quality. The overall satisfaction was 76.3%. Frequency analysis found that variables related to the technical quality (good doctors, successful operations, trained staff, etc.) obtained more favourable outcomes. Those related to time (wait, consulting, organizing schedules) obtained worse outcomes. The care of families variables obtained poor results. There was no difference between the overall Andalusian healthcare system and neurosurgery departments. In the mean analysis, women and older people gave more favourable responses, especially for variables related to infrastructure quality. In the "cluster" analysis, there were more favourable responses by elderly people, with no differences in gender (P<.009). There is no difference in perceived quality between the Andalusian healthcare system overall and neurosurgery departments. The perceived quality of the Andalusian healthcare system is higher in the elderly people. The analysis of perceived quality is useful for promoting projects to improve clinical management. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  9. The influence of social challenges when implementing information systems in a Swedish health-care organisation.

    Science.gov (United States)

    Nilsson, Lina; Eriksén, Sara; Borg, Christel

    2016-09-01

    To describe and obtain a deeper understanding of social challenges and their influence on the implementation process when implementing Information systems in a Swedish health-care organisation. Despite positive effects when implementing Information systems in health-care organisations, there are difficulties in the implementation process. Nurses' experiences of being neglected have been dismissed as reasons for setbacks in implementation. An Institutional Ethnography design was used. A deductive content analysis was made influenced by empirically identified social challenges of power, professional identity and encounters. An abstraction was made of the analysis. Nineteen nurses at macro, meso and micro levels were interviewed in focus groups. Organisational levels are lost in different ways in how to control the reformation, how to introduce Information systems as reformation strategies and in how to translate new tools and assumptions that do not fit traditional ways of working in shaping professional identities. Different focus may affect the reformation of health-care organisations and implementation and knowledge processes. An implementation climate is needed where the system standards fit the values of the users. Nursing management needs to be visionary, engaged and work with risk factors in order to reform the hierarchical health-care organisation. © 2016 John Wiley & Sons Ltd.

  10. An ontology for telemedicine systems resiliency to technological context variations in pervasive healthcare

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Widya, I.A.; Hermens, Hermanus J.

    2015-01-01

    Clinical data are crucial for any medical case to study and understand a patient's condition and to give the patient the best possible treatment. Pervasive healthcare systems apply information and communication technology to enable the usage of ubiquitous clinical data by authorized medical persons.

  11. A Data Analytical Framework for Improving Real-Time, Decision Support Systems in Healthcare

    Science.gov (United States)

    Yahav, Inbal

    2010-01-01

    In this dissertation we develop a framework that combines data mining, statistics and operations research methods for improving real-time decision support systems in healthcare. Our approach consists of three main concepts: data gathering and preprocessing, modeling, and deployment. We introduce the notion of offline and semi-offline modeling to…

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

    Directory of Open Access Journals (Sweden)

    Kuo-Hui Yeh

    2016-12-01

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

  13. Cross-Cultural Integration of Children into the Health-Care System

    Science.gov (United States)

    Haka-Ikse, K.

    1988-01-01

    Cultural differences are directly pertinent to the practice of medicine, as they affect the health-care behaviour of families, influence parent-child relationships, and support particular developmental and personality patterns. To deliver optimal medical care tailored to the needs of the individual patient, physicians must be familiar with various cultures and understand and accept the customs, beliefs, and values of the persons who belong to them. Equipped with such understanding, the physician can involve a family co-operatively in its own health care and can help its members to participate to their greater advantage in the health-care system. PMID:21253173

  14. Apartheid and healthcare access for paediatric systemic lupus ...

    African Journals Online (AJOL)

    South Africa (SA) still faces the legacy of apartheid: the history, politics and economics have a lasting, indelible effect on the health of its people. Here, we discuss the challenges of caring for patients with chronic disease, focusing on paediatric systemic lupus erythematosus (SLE), as a framework for evaluating the structural ...

  15. Petri Net Approach of Collision Prevention Supervisor Design in Port Transport System

    Directory of Open Access Journals (Sweden)

    Danko Kezić

    2007-09-01

    Full Text Available Modern port terminals are equipped with various localtransport systems, which have the main task to transport cargobetween local storehouses and transport resources (ships,trains, trucks in the fastest and most efficient way, and at thelowest possible cost. These local transport systems consist offully automated transport units (AGV- automatic guided vehiclewhich are controlled by the computer system. The portcomputer system controls the fully automated transport units inthe way to avoid possible deadlocks and collisions betweenthem. However, beside the fully automated local transportunits, there are human operated transport units (fork-lifttrucks, cranes etc. which cross the path oftheAGVfrom timeto time. The collision of human operated transp011 unit andA GV is possible due to human inattention. To solve this problem,it is necesswy to design a supe1vismy control system thatcoordinates and controls both human driven transport unit andA G V In other words, the human-machine interactions need tobe supen·ised. The supen•ising system can be realized in the waythat the port terminal is divided into zones. Vehicle movementsare supen•ised by a video system which detects the moving ofparticular l'ehicles as a discrete event. Based on detected events,dangerous moving of certain vehicles is blocked by the supe1visi11gsystem. The paper considers the design of collision preventionsupen•isor by using discrete event dynamic themy. The portterminal is modeled by using ordi1za1y Petri nets. The design ofcollision prevention supe1visor is cmTied out by using the P-inl'ariantmethod. The verification of the supervisor is done bycomputer simulation.

  16. 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.

  17. [Nursing and the humanization of the end- of-life care within healthcare systems].

    Science.gov (United States)

    Gómez Arca, Marina

    2014-01-01

    The reflection upon the humanisation of the end-of-life process within healthcare systems and the implication of healthcare professionals is the main objective of this article. The evolution of the model of care and nurses leadership role at the end-of-life process is evaluated. This analysis starts from the first European references regarding advance wills, made in 1997 at the Oviedo Convention, until the introduction of the idea of advance directives incorporated into Spanish law in 2002. It sets the concept of advance planning in health-related decisions, which establishes a process of voluntary dialogue where every person can clarify values, preferences and wishes regarding the final moments of life, with the support of the healthcare professionals. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Izabela SZTANGRET

    2015-12-01

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

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

    Science.gov (United States)

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

    2017-11-24

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

  20. ExplaNet: A Collaborative Learning Tool and Hybrid Recommender System for Student-Authored Explanations

    Science.gov (United States)

    Masters, Jessica; Madhyastha, Tara; Shakouri, Ali

    2008-01-01

    ExplaNet is a web-based, anonymous, asynchronous explanation-sharing network. Instructors post questions to the network and students submit explanatory answers. Students then view and rank the explanations submitted by their peers before optionally resubmitting a final and revised answer. Three classroom evaluations of ExplaNet showed that by…

  1. Application of Agent Methodology in Healthcare Information Systems

    Directory of Open Access Journals (Sweden)

    Reem Abdalla

    2017-02-01

    Full Text Available This paper presents a case study to describe the features and the phases of the two agent methodologies. The Gaia methodology for agent oriented analysis and design, Tropos is a detailed agent oriented software engineering methodology to explore each methodology's ability to present solutions for small problems. Also we provide an attempt to discover whether the methodology is in fact understandable and usable. In addition we were collecting and taking notes of the advantages and weaknesses of these methodologies during the study analysis for each methodology and the relationships among their models. The Guardian Angle: Patient-Centered Health Information System (GA: PCHIS is the personal system to help track, manage, and interpret the subject's health history, and give advice to both patient and provider is used as the case study throughout the paper.

  2. Development of smart toothbrush monitoring system for ubiquitous healthcare.

    Science.gov (United States)

    Lee, Jeong-Whan; Lee, Kang-Hwi; Kim, Kyeong-Seop; Kim, Dong-Jun; Kim, Kyungho

    2006-01-01

    The design of an intelligent toothbrush, capable of monitoring brushing motion, orientation through the grip axis, during toothbrushing is described. Inappropriate tooth-brushing styles, even in adults, sometimes cause dental problems, cavities, gingivitis, etc. This smart system provides user to monitor his or her brushing pattern using accelerometer and magnetic sensors for evaluation of toothbrushing style. Directional information of toothbrush with respect to the earth's magnetic field and activity data were measured by a miniaturized low-power micro-controller, MSP430 and transmitted to personal computer by 2.4 GHz radio transmitter, nRF2401. A personal computer provides an on-line display of activity and orientation measurements during toothbrushing. The signal trace is then analyzed to extract clinically relevant information. This preliminary study showed that the proposed monitoring system was conceived to aid dental care personnel in patient education and instruction in oral hygiene regarding brushing style.

  3. Refugees, the asylum system and mental healthcare in Ireland

    OpenAIRE

    O’Connell, Molly; Duffy, Richard; Crumlish, Niall

    2016-01-01

    The number of people seeking refugee status in Ireland is increasing year on year and the burden of mental illness experienced by refugees and asylum seekers is high. The College of Psychiatrists of Ireland has recommended the establishment of a number of specialist refugee mental health teams. In this paper we discuss the Irish asylum system, the Irish evidence regarding mental illness in this population, and current health service policy regarding refugee mental health. We propose a model o...

  4. Petri net modeling and simulation of pipelined redistributions for a deadlock-free system

    Directory of Open Access Journals (Sweden)

    Stavros I. Souravlas

    2015-12-01

    Full Text Available The growing use of multiprocessing systems has given rise to the necessity for modeling, verifying, and evaluating their performance in order to fully exploit hardware. The Petri net (PN formalism is a suitable tool for modeling parallel systems due to its basic characteristics, such as parallelism and synchronization. In addition, the PN formalism allows the incorporation of more details of the real system into the model. Examples of such details include contention for shared resources (like memory or identification of blocked processes (a definition for blocked processes is found in the Introduction section. In this paper, PNs are considered as a modeling framework to verify and study the performance of parallel pipelined communications. The main strength of the pipelines is that if organized in a proper way, they lead to overlapping of computation, communication, and read/write costs that incur in parallel communications. Most of the well-known pipelined schemes have been evaluated by theoretical analysis, queueing networks, and simulations. Usually, the factors taken into account are scheduling, message classification, and buffer spacing. To the best of our knowledge, there is no work in the literature that uses PN as a modeling tool for verification of the pipeline-based scheme. Apart from verification, a more accurate and complete model should also consider other factors, such as contentions and blocked processes. These factors have a high impact on the performance of a parallel system. The PN model presented in this paper accurately captures the behavior of the pipeline-based parallel communication system. The model considers synchronization, message scheduling, and message classification, while it is proven to be free of deadlocks and contentions. Also, the model is characterized by symmetry, so it can be used for large and complex systems.

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

    Science.gov (United States)

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

    2017-06-01

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

  6. NA-NET numerical analysis net

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, J. [Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science]|[Oak Ridge National Lab., TN (United States); Rosener, B. [Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science

    1991-12-01

    This report describes a facility called NA-NET created to allow numerical analysts (na) an easy method of communicating with one another. The main advantage of the NA-NET is uniformity of addressing. All mail is addressed to the Internet host ``na-net.ornl.gov`` at Oak Ridge National Laboratory. Hence, members of the NA-NET do not need to remember complicated addresses or even where a member is currently located. As long as moving members change their e-mail address in the NA-NET everything works smoothly. The NA-NET system is currently located at Oak Ridge National Laboratory. It is running on the same machine that serves netlib. Netlib is a separate facility that distributes mathematical software via electronic mail. For more information on netlib consult, or send the one-line message ``send index`` to netlib{at}ornl.gov. The following report describes the current NA-NET system from both a user`s perspective and from an implementation perspective. Currently, there are over 2100 members in the NA-NET. An average of 110 mail messages pass through this facility daily.

  7. NA-NET numerical analysis net

    Energy Technology Data Exchange (ETDEWEB)

    Dongarra, J. (Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science Oak Ridge National Lab., TN (United States)); Rosener, B. (Tennessee Univ., Knoxville, TN (United States). Dept. of Computer Science)

    1991-12-01

    This report describes a facility called NA-NET created to allow numerical analysts (na) an easy method of communicating with one another. The main advantage of the NA-NET is uniformity of addressing. All mail is addressed to the Internet host na-net.ornl.gov'' at Oak Ridge National Laboratory. Hence, members of the NA-NET do not need to remember complicated addresses or even where a member is currently located. As long as moving members change their e-mail address in the NA-NET everything works smoothly. The NA-NET system is currently located at Oak Ridge National Laboratory. It is running on the same machine that serves netlib. Netlib is a separate facility that distributes mathematical software via electronic mail. For more information on netlib consult, or send the one-line message send index'' to netlib{at}ornl.gov. The following report describes the current NA-NET system from both a user's perspective and from an implementation perspective. Currently, there are over 2100 members in the NA-NET. An average of 110 mail messages pass through this facility daily.

  8. A sustainable and affordable support system for rural healthcare delivery

    CSIR Research Space (South Africa)

    Barjis, J

    2013-12-01

    Full Text Available et al., 2009). Furthermore, many projects that have taken place, started by government or non-government organizations, have delivered ‘white elephants’ rather than a sustainable system. The idiom of ‘white elephant’ (Robinson and Toryik, 2005, p.... The remainder of this paper is structured as follows: in part one we discuss the socio-cultural and economic context, which sets the stage for the research carried out and the results presented in this article; in part we discuss the underlying theoretical...

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

    Science.gov (United States)

    Yazdannik, Ahmadreza; Yousefy, Alireza; Mohammadi, Sepideh

    2017-01-01

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

  10. 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

  11. Light and shadows of the Korean healthcare system.

    Science.gov (United States)

    Moon, Tai Joon

    2012-05-01

    This article reviewed achievements and challenges of the National Health Insurance of the Republic of Korea and shared thoughts on its future directions. Starting with large workplaces of 500 or more employees in 1977, Korea's National Health Insurance successfully achieved universal coverage within just 12 yr in 1989. This amazing pace of growth was possible due to a positive combination of strong political will and rapid economic growth. Key features of Korea's experience in achieving universal coverage include 1) gradual expansion of coverage, 2) careful consideration to maintain sound insurance finances, and 3) introducing multiple health insurance societies (multiple payer system) at the initial stage. Introduction of the health insurance has dramatically improved Korea's health indicators and has fueled the rapid growth of basic medical infrastructure including medical institutions and professionals. On the other hand, the successful expansion was not free from side-effects. Although coverage has gradually expanded, benefits are still relatively low. The current situation warrants concern because coverage expansion is driven by welfare populism asserted by irresponsible political slogans and lacks a social consensus on basic principles and philosophy regarding the expansion. Concentration of patients to a few large prestigious hospitals as well as the inefficiencies resulting from a colossal single-payer system should also be pointed out.

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

    Science.gov (United States)

    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…

  13. Public versus Private Healthcare Systems following Discharge from the ICU: A Propensity Score-Matched Comparison of Outcomes

    Directory of Open Access Journals (Sweden)

    Felippe Leopoldo Dexheimer Neto

    2016-01-01

    Full Text Available Purpose. The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated. Materials and Methods. A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS- matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed. Results. In total, 928 patients were discharged from the ICU including 172 (18.6% patients in the public and 756 (81.4% patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%, P=0.003. The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences. Conclusions. The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge.

  14. Public versus Private Healthcare Systems following Discharge from the ICU: A Propensity Score-Matched Comparison of Outcomes

    Science.gov (United States)

    Dexheimer Neto, Felippe Leopoldo; Rosa, Regis Goulart; Duso, Bruno Achutti; Haas, Jaqueline Sanguiogo; Savi, Augusto; Cabral, Cláudia da Rocha; Maccari, Juçara Gasparetto; de Oliveira, Roselaine Pinheiro; Antônio, Ana Carolina Peçanha; Castro, Priscylla de Souza; Teixeira, Cassiano

    2016-01-01

    Purpose. The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated. Materials and Methods. A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS) 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS-) matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed. Results. In total, 928 patients were discharged from the ICU including 172 (18.6%) patients in the public and 756 (81.4%) patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%, P = 0.003). The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences. Conclusions. The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge. PMID:27123450

  15. Public versus Private Healthcare Systems following Discharge from the ICU: A Propensity Score-Matched Comparison of Outcomes.

    Science.gov (United States)

    Dexheimer Neto, Felippe Leopoldo; Rosa, Regis Goulart; Duso, Bruno Achutti; Haas, Jaqueline Sanguiogo; Savi, Augusto; Cabral, Cláudia da Rocha; Maccari, Juçara Gasparetto; de Oliveira, Roselaine Pinheiro; Antônio, Ana Carolina Peçanha; Castro, Priscylla de Souza; Teixeira, Cassiano

    2016-01-01

    Purpose. The long-term outcomes of patients after discharge from tertiary ICUs as they relate to the public versus private healthcare systems in Brazil have not yet been evaluated. Materials and Methods. A multicenter prospective cohort study was conducted to compare the all-cause mortality and the physical functional status (PFS) 24 months after discharge from the ICU between adult patients treated in the public and private healthcare systems. A propensity score- (PS-) matched comparison of all causes of mortality and PFS 24 months after discharge from the ICU was performed. Results. In total, 928 patients were discharged from the ICU including 172 (18.6%) patients in the public and 756 (81.4%) patients in the private healthcare system. The results of the PS-matched comparison of all-cause mortality revealed higher mortality rates among the patients of the public healthcare system compared to those of the private healthcare system (47.3% versus 27.6%, P = 0.003). The comparison of the PS-matched Karnofsky performance and Lawton activities of daily living scores between the ICU survivors of the public and private healthcare systems revealed no significant differences. Conclusions. The patients of private healthcare system exhibited significantly greater survival rates than the patients of the public healthcare system with similar PFS following ICU discharge.

  16. Patient complaints in healthcare services in Vietnam's health system.

    Science.gov (United States)

    Thi Thu Ha, Bui; Mirzoev, Tolib; Morgan, Rosemary

    2015-01-01

    There is growing recognition of patient rights in health sectors around the world. Patients' right to complain in hospitals, often visible in legislative and regulatory protocols, can be an important information source for service quality improvement and achievement of better health outcomes. However, empirical evidence on complaint processes is scarce, particularly in the developing countries. To contribute in addressing this gap, we investigated patients' complaint handling processes and the main influences on their implementation in public hospitals in Vietnam. The study was conducted in two provinces of Vietnam. We focused specifically on the implementation of the Law on Complaints and Denunciations and the Ministry of Health regulation on resolving complaints in the health sector. The data were collected using document review and in-depth interviews with key respondents. Framework approach was used for data analysis, guided by a conceptual framework and aided by qualitative data analysis software. Five steps of complaint handling were implemented, which varied in practice between the provinces. Four groups of factors influenced the procedures: (1) insufficient investment in complaint handling procedures; (2) limited monitoring of complaint processes; (3) patients' low awareness of, and perceived lack of power to change, complaint procedures and (4) autonomization pressures on local health facilities. While the existence of complaint handling processes is evident in the health system in Vietnam, their utilization was often limited. Different factors which constrained the implementation and use of complaint regulations included health system-related issues as well as social and cultural influences. The study aimed to contribute to improved understanding of complaint handling processes and the key factors influencing these processes in public hospitals in Vietnam. Specific policy implications for improving these processes were proposed, which include improving

  17. The Regional Healthcare Ecosystem Analyst (RHEA): a simulation modeling tool to assist infectious disease control in a health system.

    Science.gov (United States)

    Lee, Bruce Y; Wong, Kim F; Bartsch, Sarah M; Yilmaz, S Levent; Avery, Taliser R; Brown, Shawn T; Song, Yeohan; Singh, Ashima; Kim, Diane S; Huang, Susan S

    2013-06-01

    As healthcare systems continue to expand and interconnect with each other through patient sharing, administrators, policy makers, infection control specialists, and other decision makers may have to take account of the entire healthcare 'ecosystem' in infection control. We developed a software tool, the Regional Healthcare Ecosystem Analyst (RHEA), that can accept user-inputted data to rapidly create a detailed agent-based simulation model (ABM) of the healthcare ecosystem (ie, all healthcare facilities, their adjoining community, and patient flow among the facilities) of any region to better understand the spread and control of infectious diseases. To demonstrate RHEA's capabilities, we fed extensive data from Orange County, California, USA, into RHEA to create an ABM of a healthcare ecosystem and simulate the spread and control of methicillin-resistant Staphylococcus aureus. Various experiments explored the effects of changing different parameters (eg, degree of transmission, length of stay, and bed capacity). Our model emphasizes how individual healthcare facilities are components of integrated and dynamic networks connected via patient movement and how occurrences in one healthcare facility may affect many other healthcare facilities. A decision maker can utilize RHEA to generate a detailed ABM of any healthcare system of interest, which in turn can serve as a virtual laboratory to test different policies and interventions.

  18. The Regional Healthcare Ecosystem Analyst (RHEA): a simulation modeling tool to assist infectious disease control in a health system

    Science.gov (United States)

    Lee, Bruce Y; Wong, Kim F; Bartsch, Sarah M; Yilmaz, S Levent; Avery, Taliser R; Brown, Shawn T; Song, Yeohan; Singh, Ashima; Kim, Diane S; Huang, Susan S

    2013-01-01

    Objective As healthcare systems continue to expand and interconnect with each other through patient sharing, administrators, policy makers, infection control specialists, and other decision makers may have to take account of the entire healthcare ‘ecosystem’ in infection control. Materials and methods We developed a software tool, the Regional Healthcare Ecosystem Analyst (RHEA), that can accept user-inputted data to rapidly create a detailed agent-based simulation model (ABM) of the healthcare ecosystem (ie, all healthcare facilities, their adjoining community, and patient flow among the facilities) of any region to better understand the spread and control of infectious diseases. Results To demonstrate RHEA's capabilities, we fed extensive data from Orange County, California, USA, into RHEA to create an ABM of a healthcare ecosystem and simulate the spread and control of methicillin-resistant Staphylococcus aureus. Various experiments explored the effects of changing different parameters (eg, degree of transmission, length of stay, and bed capacity). Discussion Our model emphasizes how individual healthcare facilities are components of integrated and dynamic networks connected via patient movement and how occurrences in one healthcare facility may affect many other healthcare facilities. Conclusions A decision maker can utilize RHEA to generate a detailed ABM of any healthcare system of interest, which in turn can serve as a virtual laboratory to test different policies and interventions. PMID:23571848

  19. Intercultural and Interlinguistical Mediation in the Healthcare System: The Challenge of Conflict Management

    Directory of Open Access Journals (Sweden)

    Federico Farini

    2008-09-01

    Full Text Available Nowadays, young women and their children are the most important migrant users of health-care services. In particular, these people may encounter different cultural constructions of health, disease, therapy, and motherhood. The observed difficulties in intercultural communication encourage healthcare systems to promote mediation. Mediation consists of the intervention of a third person, who promotes reciprocal understanding and acceptance between participants. The research presented in this article focuses on the intercultural communication that is produced in these services between health-care personnel and migrant patients. To achieve this goal, the research aims at integrating different theoretical and methodological approaches: conversation analysis, in order to observe the interaction between healthcare personnel and patients, pointing out the cues of the participants’ turn-taking sequences; analysis of the cultural presuppositions of the healthcare system as a communication system with a specific function in society, by highlighting contextualization cues, that is, cultural presuppositions that steer the interaction system, which result from the wider social context and are cues of the cultural identities that characterize it. It was observed that the patients in most cases have very few opportunities to answer the physicians’ questions or to pose questions or doubts. Substituting the patients as the main participants in interactions, the mediator never refuses the physicians’ indications, never expresses doubts, and never asks the patients if they have some reason to doubt or refuse. In these cases, interlinguistic and intercultural mediation de-emphasizes the importance of the larger social context, of the durability of relationships between the parties, and of their social and political recognition.

  20. 3D printing of wearable fractal-based sensor systems for neurocardiology and healthcare

    Science.gov (United States)

    Ramasamy, Mouli; Varadan, Vijay K.

    2017-04-01

    Neurocardiology is the pathophysiological interplay of nervous and cardiovascular systems. The communication between the heart and brain has revealed various methodologies in healthcare that could be investigated to study the heart-brain interactions and other cardiovascular and neurological diseases. A textile based wearable nanosensor system in the form of e-bra, e-shirt, e-headband, e-brief, underwear etc, was presented in this SPIE conferences earlier for noninvasive recording of EEG and EKG, and showing the correlation between the brain and heart signals. In this paper, the technology is expanded further using fractal based geometries using 3D printing system for low cost and flexible wearable sensor system for healthcare.

  1. HL7 and DICOM based integration of radiology departments with healthcare enterprise information systems.

    Science.gov (United States)

    Blazona, Bojan; Koncar, Miroslav

    2007-12-01

    Integration based on open standards, in order to achieve communication and information interoperability, is one of the key aspects of modern health care information systems. However, this requirement represents one of the major challenges for the Information and Communication Technology (ICT) solutions, as systems today use diverse technologies, proprietary protocols and communication standards which are often not interoperable. One of the main producers of clinical information in healthcare settings represent Radiology Information Systems (RIS) that communicate using widely adopted DICOM (Digital Imaging and COmmunications in Medicine) standard, but in very few cases can efficiently integrate information of interest with other systems. In this context we identified HL7 standard as the world's leading medical ICT standard that is envisioned to provide the umbrella for medical data semantic interoperability, which amongst other things represents the cornerstone for the Croatia's National Integrated Healthcare Information System (IHCIS). The aim was to explore the ability to integrate and exchange RIS originated data with Hospital Information Systems based on HL7's CDA (Clinical Document Architecture) standard. We explored the ability of HL7 CDA specifications and methodology to address the need of RIS integration HL7 based healthcare information systems. We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers. The outcome of our pilot work proves our original assumption of HL7 standard being able to adopt radiology data into the integrated healthcare systems. Uniform DICOM to CDA translation scripts and business processes within IHCIS is desired and cost effective regarding to use of supporting IHCIS services aligned to SOA.

  2. Pragmatic oriented data interoperability for smart\\ud healthcare information systems

    OpenAIRE

    Liu, Shixiong; Li, Vicky; Liu, Kecheng

    2014-01-01

    Smart healthcare is a complex domain for systems\\ud integration due to human and technical factors and\\ud heterogeneous data sources involved. As a part of smart city, it is such a complex area where clinical functions require smartness of multi-systems collaborations for effective communications among departments, and radiology is one of the areas highly relies on intelligent information integration and communication. Therefore, it faces many challenges regarding integration and its\\ud inter...

  3. Injustice to transsexual women in a hetero-normatie healthcare system

    Directory of Open Access Journals (Sweden)

    Douglas Newman-Valentine

    2014-01-01

    Full Text Available Background: Transsexual women who are on the journey of sexual re-alignment will experience various health problems. These problems are related directly to the treatment regime that they are following in order to attain and maintain their physical embodiment as a woman. They are forced to negotiate a hetero-normative healthcare system in order to receive assistance and care for their health problems related to their sexual re-alignment process.Aim: The questions posed were: What are the unique health problems that transsexual women experience whilst on the journey of sexual re-alignment? What is the current context of the South African healthcare system in which transsexual women should negotiate healthcare? These questions were asked in order to explore the health problems with which transsexual women are faced and to describe the hetero-normative healthcare system in South Africa.Method: An electronic literature search was executed via the EBSCO host with specifi inclusion and exclusion criteria. The search words that were used were: Transsexual/s and Health/Healthcare. All studies had to be peer reviewed and published in the English language, from January 1972 up until February 2013. Literature on transsexual children was excluded.Results: Transsexual women have the potential to suffer signifiant side-effects from their sexual re-alignment treatment, including cardio-vascular problems, endocrine problems and mental ill-health. They are also vulnerable to HIV infection. They have poor access to quality holistic healthcare and this may lead an increase in the mortality and morbidity fiures of women.Conclusion: A hetero-normative healthcare system has a negative impact on the health of transsexual women and will cause them to be marginalised. This could contribute to both homoand trans-phobia that will in turn strengthen the belief that transsexual women are un-African. Normal 0 false false false EN-ZA X-NONE X-NONE

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

    Science.gov (United States)

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

    2010-03-01

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

  5. A functional natural dentition for all--and for life? The oral healthcare system needs revision.

    Science.gov (United States)

    Fejerskov, O; Escobar, G; Jøssing, M; Baelum, V

    2013-09-01

    The cost of dental care adds to the costs of the already overburdened health sector. Do we - as patients and as society -receive oral health care that is both aligned with the actual disease experience and also, critically based on up-to-date scientific knowledge about the major oral diseases? In many places, the practice of dentistry reflects a response to disease patterns that once existed and is based on diagnostic and therapeutic approaches that are no longer valid. Instead, a new cadre of dental professionals is needed, one that is capable of meeting the actual health needs of our populations. This cadre should ensure that patients maintain a functioning dentition from cradle to grave based on cost-effective disease control principles. There is an urgent need to: (i) reconsider the roles of the different oral health cadres involved in the provision of oral health care; (ii) integrate oral health into general healthcare services; and (iii) restructure the training of oral health personnel. We advocate a radical reform of the oral healthcare system involving the training of two new types of professionals integrated with the general healthcare system: The oral healthcare provider - a highly skilled professional specialised in the diagnosis and control of oral diseases and with a profound understanding of oral health as part of general health - and the oral clinical specialist - whose role is the provision of advanced oral rehabilitation, able also to treat people with complex chronic diseases and multiple medications. © 2013 John Wiley & Sons Ltd.

  6. Governance, policy and system-level efforts to support safer healthcare.

    Science.gov (United States)

    Baker, Ross G

    2014-01-01

    Over the past 10 years there have been concerted efforts across Canada to create safer healthcare systems both by improving practices at the frontline and by creating an environment that encourages the development of effective safety practices and a safety culture. There have been major changes in organizational policies regarding the disclosure of adverse events to patient and families, the reporting of patient safety incidents to facilitate learning, and new accreditation requirements. Governing bodies for healthcare organizations have been given clearer accountabilities for quality of care and patient safety, and improved performance measurement, greater engagement of patients and families, and a trend toward greater transparency have aided efforts to improve patient safety. However, some areas where changes were anticipated, including the reform of medical liability processes and changes to regulations that govern health professional practices have not progressed as much as some expected. Overall, a decade following the release of the Canadian Adverse Events Study and the creation of the Canadian Patient Safety Institute many healthcare organizations have made only limited progress toward the creation of "a culture of safety" and a safer healthcare system.

  7. 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.

  8. A cloud-based X73 ubiquitous mobile healthcare system: design and implementation.

    Science.gov (United States)

    Ji, Zhanlin; Ganchev, Ivan; O'Droma, Máirtín; Zhang, Xin; Zhang, Xueji

    2014-01-01

    Based on the user-centric paradigm for next generation networks, this paper describes a ubiquitous mobile healthcare (uHealth) system based on the ISO/IEEE 11073 personal health data (PHD) standards (X73) and cloud computing techniques. A number of design issues associated with the system implementation are outlined. The system includes a middleware on the user side, providing a plug-and-play environment for heterogeneous wireless sensors and mobile terminals utilizing different communication protocols and a distributed "big data" processing subsystem in the cloud. The design and implementation of this system are envisaged as an efficient solution for the next generation of uHealth systems.

  9. Coloured Petri Nets

    DEFF Research Database (Denmark)

    Jensen, Kurt

    1991-01-01

    This paper describes how Coloured Petri Nets (CP-nets) have been developed — from being a promising theoretical model to being a full-fledged language for the design, specification, simulation, validation and implementation of large software systems (and other systems in which human beings and...... use of CP-nets — because it means that the function representation and the translations (which are a bit mathematically complex) no longer are parts of the basic definition of CP-nets. Instead they are parts of the invariant method (which anyway demands considerable mathematical skills...

  10. Game Coloured Petri Nets

    DEFF Research Database (Denmark)

    Westergaard, Michael

    2006-01-01

    This paper introduces the notion of game coloured Petri nets. This allows the modeler to explicitly model what parts of the model comprise the modeled system and what parts are the environment of the modeled system. We give the formal definition of game coloured Petri nets, a means of reachability...... analysis of this net class, and an application of game coloured Petri nets to automatically generate easy-to-understand visualizations of the model by exploiting the knowledge that some parts of the model are not interesting from a visualization perspective (i.e. they are part of the environment...

  11. ASAS centennial paper: net energy systems for beef cattle--concepts, application, and future models.

    Science.gov (United States)

    Ferrell, C L; Oltjen, J W

    2008-10-01

    Development of nutritional energetics can be traced to the 1400s. Lavoisier established relationships among O(2) use, CO(2) production and heat production in the late 1700s, and the laws of thermodynamics and law of Hess were discovered during the 1840s. Those discoveries established the fundamental bases for nutritional energetics and enabled the fundamental entity ME = retained energy + heat energy to be established. Objectives became: 1) to establish relationships between gas exchange and heat energy, 2) to devise bases for evaluation of foods that could be related to energy expenditures, and 3) to establish causes of energy expenditures. From these endeavors, the basic concepts of energy partitioning by animals were developed, ultimately resulting in the development of feeding systems based on NE concepts. The California Net Energy System, developed for finishing beef cattle, was the first to be based on retained energy as determined by comparative slaughter and the first to use 2 NE values (NE(m) and NE(g)) to describe feed and animal requirements. The system has been broadened conceptually to encompass life cycle energy requirements of beef cattle and modified by the inclusion of numerous adjustments to address factors known to affect energy requirements and value of feed to meet those needs. The current NE system remains useful but is empirical and static in nature and thus fails to capture the dynamics of energy utilization by diverse animals as they respond to changing environmental conditions. Consequently, efforts were initiated to develop dynamic simulation models that captured the underlying biology and thus were sensitive to variable genetic and environmental conditions. Development of a series of models has been described to show examples of the conceptual evolution of dynamic, mechanistic models and their applications. Generally with each new system, advances in prediction accuracy came about by adding new terms to conceptually validated models

  12. Nearly Net-Zero Exergy Districts as Models for Smart Energy Systems

    National Research Council Canada - National Science Library

    Şiir Kilkiş

    2017-01-01

    ... Östra Sala backe, which will have a new energy concept. The latter is analysed based on proposals for two phases that aim to reach a net-zero district target based on the quality of energy (exergy...

  13. Perceptions of dental students regarding dentistry, the job market and the public healthcare system.

    Science.gov (United States)

    Costa, Simone de Melo; Silveira, Marise Fagundes; Durães, Sarah Jane Alves; Abreu, Mauro Henrique Nogueira Guimarães de; Bonan, Paulo Rogério Ferreti

    2012-05-01

    The scope was to analyze the perceptions of dentistry students at the State University of Montes Claros, Brazil, regarding dentistry, the job market and the public healthcare system. For this, a triangulation method was employed, using a self-administered questionnaire and interviews. The quantitative data were submitted to univariate and multivariate analysis, using Poisson regression, where pdentistry course prepares students for this market as the curriculum integrates both teaching and service, reported being in favor of greater experience in the public healthcare system and said they would not take classes in Public Health if they were optional. Contact with the social context through teaching/service integration in the advanced semesters of the dentistry course appears to contribute to the development of new professional skills for working in the public sector. However, the students' perceptions revealed contradictions, considering the low value they attributed to the classes on Public Health and their perception of the public system as a residual job option.

  14. Petri Net Decomposition Approach for Bi-Objective Routing for AGV Systems Minimizing Total Traveling Time and Equalizing Delivery Time

    Science.gov (United States)

    Eda, Shuhei; Nishi, Tatsushi; Mariyama, Toshisada; Kataoka, Satomi; Shoda, Kazuya; Matsumura, Katsuhiko

    In this paper, we propose Petri net decomposition approach for bi-objective optimization of conflict-free routing for AGV systems. The objective is minimizing total traveling time and equalizing delivery time simultaneously. The dispatching and conflict-free routing problem for AGVs is represented as a bi-objective optimal firing sequence problem for Petri Net. A Petri net decomposition approach is proposed to solve the bi-objective optimization problem efficiently. The convergence of the proposed algorithm is improved reducing search region by the proposed coordination method. The effectiveness of the proposed method is compared with that of a nearest neighborhood dispatching method. Computational results are provided to show the effectiveness of the proposed method.

  15. NaNet: a flexible and configurable low-latency NIC for real-time trigger systems based on GPUs

    CERN Document Server

    Ammendola, R; Frezza, O; Lamanna, G; Lonardo, A; Cicero, F Lo; Paolucci, P S; Pantaleo, F; Rossetti, D; Simula, F; Sozzi, M; Tosoratto, L; Vicini, P

    2014-01-01

    NaNet is an FPGA-based PCIe X8 Gen2 NIC supporting 1/10 GbE links and the custom 34~Gbps APElink channel. The design has GPUDirect RDMA capabilities and features a network stack protocol offloading module, making it suitable for building low-latency, real-time GPU-based computing systems. We provide a detailed description of the NaNet hardware modular architecture. Benchmarks for latency and bandwidth for GbE and APElink channels are presented, followed by a performance analysis on the case study of the GPU-based low level trigger for the RICH detector in the NA62 CERN experiment, using either the NaNet GbE and APElink channels. Finally, we give an outline of project future activities.

  16. NaNet: a low-latency NIC enabling GPU-based, real-time low level trigger systems

    Science.gov (United States)

    Ammendola, Roberto; Biagioni, Andrea; Fantechi, Riccardo; Frezza, Ottorino; Lamanna, Gianluca; Lo Cicero, Francesca; Lonardo, Alessandro; Stanislao Paolucci, Pier; Pantaleo, Felice; Piandani, Roberto; Pontisso, Luca; Rossetti, Davide; Simula, Francesco; Sozzi, Marco; Tosoratto, Laura; Vicini, Piero

    2014-06-01

    We implemented the NaNet FPGA-based PCIe Gen2 GbE/APElink NIC, featuring GPUDirect RDMA capabilities and UDP protocol management offloading. NaNet is able to receive a UDP input data stream from its GbE interface and redirect it, without any intermediate buffering or CPU intervention, to the memory of a Fermi/Kepler GPU hosted on the same PCIe bus, provided that the two devices share the same upstream root complex. Synthetic benchmarks for latency and bandwidth are presented. We describe how NaNet can be employed in the prototype of the GPU-based RICH low-level trigger processor of the NA62 CERN experiment, to implement the data link between the TEL62 readout boards and the low level trigger processor. Results for the throughput and latency of the integrated system are presented and discussed.

  17. NaNet:a low-latency NIC enabling GPU-based, real-time low level trigger systems

    CERN Document Server

    Ammendola, Roberto; Fantechi, Riccardo; Frezza, Ottorino; Lamanna, Gianluca; Cicero, Francesca Lo; Lonardo, Alessandro; Paolucci, Pier Stanislao; Pantaleo, Felice; Piandani, Roberto; Pontisso, Luca; Rossetti, Davide; Simula, Francesco; Sozzi, Marco; Tosoratto, Laura; Vicini, Piero

    2014-01-01

    We implemented the NaNet FPGA-based PCI2 Gen2 GbE/APElink NIC, featuring GPUDirect RDMA capabilities and UDP protocol management offloading. NaNet is able to receive a UDP input data stream from its GbE interface and redirect it, without any intermediate buffering or CPU intervention, to the memory of a Fermi/Kepler GPU hosted on the same PCIe bus, provided that the two devices share the same upstream root complex. Synthetic benchmarks for latency and bandwidth are presented. We describe how NaNet can be employed in the prototype of the GPU-based RICH low-level trigger processor of the NA62 CERN experiment, to implement the data link between the TEL62 readout boards and the low level trigger processor. Results for the throughput and latency of the integrated system are presented and discussed.

  18. NaNet: a flexible and configurable low-latency NIC for real-time trigger systems based on GPUs

    Science.gov (United States)

    Ammendola, R.; Biagioni, A.; Frezza, O.; Lamanna, G.; Lonardo, A.; Lo Cicero, F.; Paolucci, P. S.; Pantaleo, F.; Rossetti, D.; Simula, F.; Sozzi, M.; Tosoratto, L.; Vicini, P.

    2014-02-01

    NaNet is an FPGA-based PCIe X8 Gen2 NIC supporting 1/10 GbE links and the custom 34 Gbps APElink channel. The design has GPUDirect RDMA capabilities and features a network stack protocol offloading module, making it suitable for building low-latency, real-time GPU-based computing systems. We provide a detailed description of the NaNet hardware modular architecture. Benchmarks for latency and bandwidth for GbE and APElink channels are presented, followed by a performance analysis on the case study of the GPU-based low level trigger for the RICH detector in the NA62 CERN experiment, using either the NaNet GbE and APElink channels. Finally, we give an outline of project future activities.

  19. Nearly Net-Zero Exergy Districts as Models for Smart Energy Systems

    Directory of Open Access Journals (Sweden)

    Şiir Kilkiş

    2017-03-01

    Full Text Available The planning of urban settlements requires a targeted approach towards more sustainable energy, water, and environment systems. This research work analyses the city of Uppsala and a district that is an urban renewal project at the site of former high voltage power lines, namely Östra Sala backe, which will have a new energy concept. The latter is analysed based on proposals for two phases that aim to reach a net-zero district target based on the quality of energy (exergy. An indicator set with five main categories is introduced based on per capita values to enable a comparable basis between the scales of the city and the district, including exergy per capita as a new indicator. The present status of Uppsala is further analysed based on Sankey diagrams to provide insight into the present urban metabolism of the city. The results indicate that the best practice values of Östra Sala backe based on phase two can achieve significant savings in per capita values, which include 5.5 MWh of energy usage, 6.1 MWh of exergy consumption, 33 m3 of water consumption, 22 kg of waste generation, and 4.2 tonnes of carbon dioxide (CO2 emissions. Additional scenarios for Uppsala indicate that the district can be about 10 years ahead of the city’s existing performance.

  20. Net environmental benefit: introducing a new LCA approach on wastewater treatment systems.

    Science.gov (United States)

    Godin, D; Bouchard, C; Vanrolleghem, P A

    2012-01-01

    Life cycle assessment (LCA) allows evaluating the potential environmental impacts of a product or a service in relation to its function and over its life cycle. In past LCAs applied to wastewater treatment plants (WWTPs), the system function definition has received little attention despite its great importance. This has led to some limitations in LCA results interpretation. A new methodology to perform LCA on WWTPs is proposed to avoid those limitations. It is based on net environmental benefit (NEB) evaluation and requires assessing the potential impact of releasing wastewater without and with treatment besides assessing the impact of the WWTP's life cycle. The NEB allows showing the environmental trade-offs between avoided impact due to wastewater treatment and induced impact by the WWTP's life cycle. NEB is compared with a standard LCA through the case study of a small municipal WWTP consisting of facultative aerated lagoons. The NEB and standard LCA show similar results for impact categories solely related to the WWTP's life cycle but differ in categories where wastewater treatment environmental benefit is accounted for as NEB considers influent wastewater quality whereas standard LCA does not.

  1. Do It Yourself solution of Internet of Things Healthcare System: Measuring body parameters and environmental parameters affecting health.

    Directory of Open Access Journals (Sweden)

    Mirjana Maksimović

    2016-03-01

    Full Text Available The rapid advancements in information and communications technologies (ICT and the increasing number of smart things shift an old-fashioned healthcare system to a model better suited for a population of the 21st century. New healthcare approaches based on Internet of Things (IoT/Internet of Medical Things (IoMT powered systems make health monitoring, diagnostics and treatment more personalized, timely and convenient, enabling a global approach to the healthcare system infrastructure development. Commercial systems in this area exist in various forms but usually do not fit the general patient needs, and those that do are usually economically unacceptable due to the high operational and development costs. Do It Yourself (DIY healthcare, including mobile applications and consumer medical devices, nowadays is the top healthcare trend. Therefore, this paper, based on well-known low-cost technologies, presents a DIY IoMT solution for observing human vital parameter as well as environmental factors affecting health.

  2. System-Level Shared Governance Structures and Processes in Healthcare Systems With Magnet®-Designated Hospitals: A Descriptive Study.

    Science.gov (United States)

    Underwood, Carlisa M; Hayne, Arlene N

    The purpose was to identify and describe structures and processes of best practices for system-level shared governance in healthcare systems. Currently, more than 64.6% of US community hospitals are part of a system. System chief nurse executives (SCNEs) are challenged to establish leadership structures and processes that effectively and efficiently disseminate best practices for patients and staff across complex organizations, geographically dispersed locations, and populations. Eleven US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities participated in a 35-multiquestion interview based on Kanter's Theory of Organizational Empowerment. Most SCNEs reported the presence of more than 50% of the empowerment structures and processes in system-level shared governance. Despite the difficulties and complexities of growing health systems, SCNEs have replicated empowerment characteristics of hospital shared governance structures and processes at the system level.

  3. Who pays for healthcare in Bangladesh? An analysis of progressivity in health systems financing.

    Science.gov (United States)

    Molla, Azaher Ali; Chi, Chunhuei

    2017-09-06

    The relationship between payments towards healthcare and ability to pay is a measure of financial fairness. Analysis of progressivity is important from an equity perspective as well as for macroeconomic and political analysis of healthcare systems. Bangladesh health systems financing is characterized by high out-of-pocket payments (63.3%), which is increasing. Hence, we aimed to see who pays what part of this high out-of-pocket expenditure. To our knowledge, this was the first progressivity analysis of health systems financing in Bangladesh. We used data from Bangladesh Household Income and Expenditure Survey, 2010. This was a cross sectional and nationally representative sample of 12,240 households consisting of 55,580 individuals. For quantification of progressivity, we adopted the 'ability-to-pay' principle developed by O'Donnell, van Doorslaer, Wagstaff, and Lindelow (2008). We used the Kakwani index to measure the magnitude of progressivity. Health systems financing in Bangladesh is regressive. Inequality increases due to healthcare payments. The differences between the Gini coefficient and the Kakwani index for all sources of finance are negative, which indicates regressivity, and that financing is more concentrated among the poor. Income inequality increases due to high out-of-pocket payments. The increase in income inequality caused by out-of-pocket payments is 89% due to negative vertical effect and 11% due to horizontal inequity. Our findings add substantial evidence of health systems financing impact on inequitable financial burden of healthcare and income. The heavy reliance on out-of-pocket payments may affect household living standards. If the government and people of Bangladesh are concerned about equitable financing burden, our study suggests that Bangladesh needs to reform the health systems financing scheme.

  4. Technology governance strategies for maximizing healthcare economic value. Developing management systems for IT.

    Science.gov (United States)

    Langabeer, James; Delgado, Rigoberto; Mikhail, Osama

    2007-01-01

    Based on industry averages, healthcare providers spend from 1.5 percent to 3 percent of their revenues on information technology. That can equate to a million dollars a year for even the smallest hospitals and as much as $50 million or $60 million a year for large health systems. That significant amount of capital must be wisely managed because these investments are long-term assets that can help transform the enterprise and contribute to the organization's strategic goals. Unfortunately, in many hospitals these investments are often made without regard for the actual return on investment that the systems will generate. ROI, or economic value, is difficult to quantify in healthcare because of the complex multi-dimensional processes and perspectives that exist. Administrators and providers often question how a clinical system can be quantified and compared with an ERP, research technology or any other information system. When value can be defined in so many ways - such as improvements in clinical outcomes, improvements in system uptime or reliability, or enhancements in productivity and operational business processes-quantification of economic value becomes much more ambiguous and therefore easy to neglect. However, business value can be created by any combination of shifts in performance. Reductions in waiting lines, improvements in imaging capabilities, increased procedures per labor hour, extensions of system life and higher transaction processing all have potential value. However, ROI cannot be calculated or maximized if underlying key performance indicators are not defined and measured, both pre- and post-implementation. This article will build on solid governance strategies for IT that will help to ensure positive economics and improved productivity in healthcare. It also will discuss specific strategies and methods for extracting the most value out of IT in healthcare.

  5. International Clean Energy System Using Hydrogen Conversion (WE-NET). subtask 3. Conceptual design of the total system; Suiso riyo kokusai clean energy system gijutsu (WE-NET). subtask 3. Zentai system gainen sekkei

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    This paper describes the research result on the conceptual design of the total system for the WE-NET project in 1996. Basic conditions are as follows: solid polymer water electrolysis, hydrogen combustion turbine power generation, hydrogen transport/storage through ammonia medium, power generation scale of 1000-4000MW (2-5 yen/kWh), and transport distance of 5000-20000km between supply and consumption places. The system efficiency was estimated to be 68% and 23% at an ammonia arrival time and power sending end, respectively, and it was dependent on a transport distance, while no power generation scale. The power cost was estimated to be 7 yen/Mcal and 33 yen/kWh, respectively. The system efficiency at a sending end was lower by 15% and 2% than that of the liquid hydrogen and methanol system, while the power cost was higher by 0 and 8 yen/kWh, respectively. It was necessary for loss reduction of this ammonia system to develop a new high-efficiency ammonia synthesis process, and hydrogen separation (decomposition/refining) process. 80 figs., 52 tabs.

  6. Geospatial Information System Analysis of Healthcare Need and Telemedicine Delivery in California.

    Science.gov (United States)

    Kaufman, Taylor; Geraghty, Estella M; Dullet, Navjit; King, Jesse; Kissee, Jamie; Marcin, James P

    2017-05-01

    Geospatial Information Systems (GIS) superimpose data on geographical maps to provide visual representations of data by region. Few studies have used GIS data to investigate if telemedicine services are preferentially provided to communities of greatest need. This study compared the healthcare needs of communities with and without telemedicine services from a university-based telemedicine program. Originating sites for all telemedicine consultations between July 1996 and December 2013 were geocoded using ArcGIS software. ZIP Code Tabulation Areas (ZCTAs) were extracted from the 2010 U.S. Census Bureau's Topologically Integrated Geographic Encoding and Referencing file and assigned a community needs index (CNI) score to reflect the ZCTA community's healthcare needs based on evidence-based barriers to healthcare access. CNI scores were compared across communities with and without active telemedicine services. One hundred ninety-four originating telemedicine clinic sites in California were evaluated. The mean CNI score for ZCTAs with at least one telemedicine clinic was significantly higher (3.32 ± 0.84) than those without a telemedicine site (2.95 ± 0.99) and higher than the mean ZCTAs for all of California (2.99 ± 1.01). Of the 194 telemedicine clinics, 71.4% were located in communities with above average need and 33.2% were located in communities with very high needs. Originating sites receiving telemedicine services from a university-based telemedicine program were located in regions with significantly higher community healthcare needs. Leveraging a geospatial information system to understand community healthcare needs provides an opportunity for payers, hospitals, and patients to be strategic in the allocation of telemedicine services.

  7. Ignorance is not bliss: The effect of systematic information on immigrants' knowledge of and satisfaction with the Danish healthcare system.

    Science.gov (United States)

    Jervelund, Signe Smith; Maltesen, Thomas; Wimmelmann, Camilla Lawaetz; Petersen, Jørgen Holm; Krasnik, Allan

    2017-03-01

    Suboptimal healthcare utilisation and lower satisfaction with the patient-doctor encounter among immigrants has been documented. Immigrants' lack of familiarity with the healthcare system has been proposed as an explanation for this. This study investigated whether a systematic delivery of information affected immigrants' knowledge of and satisfaction with the Danish healthcare system. A prospective, randomised intervention study of 1158 adult immigrants attending two language schools in Copenhagen was conducted. Two intervention groups received written information or a 12-hour course on the Danish healthcare system, while a control group received nothing. Survey data included self-assessed knowledge, true/false questions on access and questions relating to satisfaction with the healthcare system. Data were linked to socioeconomic registry data. Logistic regression analyses were performed. The course improved knowledge of who to contact in the event of an accident (odds ratio (OR) = 2.67, 95% confidence interval (CI) = 1.56-4.59) but not in the event of illness. Further, it positively affected correct answers for nine out of 11 questions on the healthcare system (varying from OR = 1.87, 95% CI = 1.08-3.24 to OR = 3.11, 95% CI = 1.58-6.11). Written information positively affected correct answers for three out of 11 questions, but negatively affected one out of 11 compared with the control group. Neither intervention affected immigrants' satisfaction with the healthcare system. Knowledge of the healthcare system is necessary for optimal healthcare-seeking behaviour. The results may form the basis of national and international changes in immigrant reception and optimise immigrants' contact with the healthcare system.

  8. Citizens' participation in the Italian health-care system: the experience of the Mixed Advisory Committees.

    Science.gov (United States)

    Serapioni, Mauro; Duxbury, Nancy

    2014-08-01

    In 1994, the region of Emilia-Romagna recognized the importance of citizens' participation in the regional health-care system and recommended the institution of Mixed Advisory Committees in the health districts and hospitals with the objective of monitoring and assessing health-care quality from the users' perspective. This paper reports findings from a qualitatively based evaluation involving direct observations of the committees and 39 semi-structured interviews: 20 with representatives of patients and users' associations and 19 with health professionals and managers involved in the activities of the committees. The Mixed Advisory Committees introduced for the first time in the Italian health system an ongoing deliberative approach that gave patients and users' representatives the opportunity to be involved in health service governance. The committees enabled the creation of a method of collective participation that overcame the reductive individualistic 'approach' to health-care participation. MAC participants evaluated the committees positively for their mixed composition, which integrated different cultures, experiences and professional profiles with the potential to contribute to solving health-care problems, in a consultative role. Although patients and users' representatives were able to exert some form of influence, their expectations were greater than the results obtained. The study illuminated some weak points of public consultation, such as a decline in participation by citizen representatives and a weak influence on decision making. MACs developed a mechanism of participation that provides health-care users' representatives with the opportunity to contribute to the identification and analysis of critical points of the health-care system. A strength of the MACs is their level of institutionalization within the health system in the region of Emilia-Romagna. However, they contain a problem of representativeness, lacking a formal system of determining a

  9. The Construction of Social Rights and Healthcare Systems: the Challenges of Borders

    Directory of Open Access Journals (Sweden)

    Roser Pérez Jiménez

    2009-01-01

    Full Text Available This article presents the asymmetries between economic and social globalization, revealing the existing territorial inequalities in healthcare, as well as the rise of new demands with repercussion for social rights. The movements of capital and of productive processes take place in an intense manner, contrary to what occurs with the processes of social protection and healthcare, which continue to be limited to nation states. The initiatives in the countries of the European Union and Mercosur have not transcended isolated interventions, marked by the urgency of attention, and have not achieved the construction of rights on a regional level. The different healthcare systems and characteristics of coverage have not been placed in harmony, while there is a great diversity of attention to healthcare in the border regions. This is the case of the situations presented in the two regions in Spain, Estremadura and Catalunha, and in the region of the Brazil, Argentina and Paraguay border – in the cities of Foz de Iguaçu, Porto Iguaçu and Cidade do Leste.

  10. The role of healthcare system in dental check-ups in 27 European countries: multilevel analysis.

    Science.gov (United States)

    Kino, Shiho; Bernabé, Eduardo; Sabbah, Wael

    2017-06-01

    To examine whether public expenditure on health and Euro Health Consumer Index (EHCI) are associated with dental check-ups in European countries. Individual data were from Eurobarometer 72.3, 2009 a cross-national survey of 27 European countries. Eligible participants were those aged 18 years and older in 27 European countries. Dental check-ups reflected dental visits for oral examination and getting advice on oral health in the last 12 months. Individual factors included age, gender, marital status, urbanisation, education, subjective social status, and difficulty in paying bills. Public expenditure on health as a percentage of gross domestic product (GDP) and EHCI were used as contextual factors. A set of multilevel logistic regression models was used to examine the relationship between dental check-ups and each of healthcare expenditure and EHCI adjusting for demographic factors, GDP per capita and socioeconomic indicators. Total number included in the analysis was 23,842. Participants in countries with greater healthcare expenditure and higher score of EHCI were significantly 1.17 (95% CI: 1.03, 1.32) and 1.30 times (95% CI: 1.04, 1.64) more likely to report dental check-ups within the past 12 months after accounting for demographic characteristics, GDP per capita, and all socioeconomic indicators. The findings suggest that greater governmental support for the healthcare and better characteristics of healthcare system are positively associated with routine dental attendance. © 2017 American Association of Public Health Dentistry.

  11. A wearable healthcare system for cardiac signal monitoring using conductive textile electrodes.

    Science.gov (United States)

    Lim, Chae Young; Jang, Kuk Jin; Kim, Hyun-Woo; Kim, Young Hwan

    2013-01-01

    Accurate cardiac signal monitoring feasible for long-term monitoring is important for a practical, cost-effective health monitoring system. In this study, we propose a wearable healthcare system based on conductive fabric-based electrodes allowing monitoring of electrocardiogram (ECG) waveforms and demonstrated the potential for arrhythmia detection using the system. The measurement system uses conductive fabric-based electrodes arranged in a modified bipolar electrode configuration on the chest area of the patient. An adaptive impulse correlation filter (AICF) algorithm and a band pass filter to enable accurate R-peak detection in noisy environments.

  12. Performance analysis of multiple Indoor Positioning Systems in a healthcare environment.

    Science.gov (United States)

    Van Haute, Tom; De Poorter, Eli; Crombez, Pieter; Lemic, Filip; Handziski, Vlado; Wirström, Niklas; Wolisz, Adam; Voigt, Thiemo; Moerman, Ingrid

    2016-02-03

    The combination of an aging population and nursing staff shortages implies the need for more advanced systems in the healthcare industry. Many key enablers for the optimization of healthcare systems require provisioning of location awareness for patients (e.g. with dementia), nurses, doctors, assets, etc. Therefore, many Indoor Positioning Systems (IPSs) will be indispensable in healthcare systems. However, although many IPSs have been proposed in literature, most of these have been evaluated in non-representative environments such as office buildings rather than in a hospital. To remedy this, the paper evaluates the performance of existing IPSs in an operational modern healthcare environment: the "Sint-Jozefs kliniek Izegem" hospital in Belgium. The evaluation (data-collecting and data-processing) is executed using a standardized methodology and evaluates the point accuracy, room accuracy and latency of multiple IPSs. To evaluate the solutions, the position of a stationary device was requested at 73 evaluation locations. By using the same evaluation locations for all IPSs the performance of all systems could objectively be compared. Several trends can be identified such as the fact that Wi-Fi based fingerprinting solutions have the best accuracy result (point accuracy of 1.21 m and room accuracy of 98%) however it requires calibration before use and needs 5.43 s to estimate the location. On the other hand, proximity based solutions (based on sensor nodes) are significantly cheaper to install, do not require calibration and still obtain acceptable room accuracy results. As a conclusion of this paper, Wi-Fi based solutions have the most potential for an indoor positioning service in case when accuracy is the most important metric. Applying the fingerprinting approach with an anchor installed in every two rooms is the preferred solution for a hospital environment.

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

    Directory of Open Access Journals (Sweden)

    Kamel Boulos Maged N

    2012-06-01

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

  14. The role of regional planning and management strategies in the transformation of the healthcare system.

    Science.gov (United States)

    Fleury, Marie-Josée; Denis, Jean-Louis; Sicotte, Claude

    2003-02-01

    Drawing on a case study, this article questions the role of planning and management strategies in the process of transforming a regional public healthcare system that involves a number of organizations and is characterized by fluidity in its functions and division of power. It examines the efficacy of the Regional Plan for the Organization of Health Services (PROS) in reforming the mental health sector in a health and social service district in Quebec, in terms of integrated regional management of mental healthcare and activities at the local level. The regional planning procedure involves a major transformation in management of the mental health system, organizational roles and clinical and professional practices. Our assessment of PROS highlights the importance of taking into account the context of implementation and the instrumental value of planning, before judging its efficacy. To transform a complex healthcare system at the regional and local level, the study suggests a revised conception of the main roles played by planning and of the process shaping its implementation. Our study concludes in favour of developing management strategies at the operational, clinical and professional levels, and integrating them as a planning aid that allows a more corporate and matrix-based system to be set up.

  15. A telemedicine system for wireless home healthcare based on Bluetooth and the Internet.

    Science.gov (United States)

    Zhao, Xiaoming; Fei, Ding-Yu; Doarn, Charles R; Harnett, Brett; Merrell, Ronald

    2004-01-01

    The VitalPoll Telemedicine System (VTS) was designed and developed for wireless home healthcare. The aims of this study were: to design the architecture and communication methods for a telemedicine system; to implement a physiologic routing hub to collect data from different medical devices and sensors; and to evaluate the feasibility of this system for applications in wireless home healthcare. The VTS was built using Bluetooth wireless and Internet technologies with client/server architecture. Several medical devices, which acquire vital signs, such as real-time electrocardiogram signals, heart rate, body temperature, and activity (physical motion), were integrated into the VTS. Medical information and data were transmitted over short-range interface (USB, RS232), wireless communication, and the Internet. The medical results were stored in a database and presented using a web browser. The patient's vital signals can be collected, transmitted, and displayed in real time by the VTS. The experiments verified no data loss during Bluetooth and Internet communication. Bluetooth and the Internet provide enough bandwidth channels to tranmit these vital signs. The experimental results show that VTS may be suitable for a practical telemedicine system in home healthcare.

  16. Is variation management included in regional healthcare governance systems? Some proposals from Italy.

    Science.gov (United States)

    Nuti, Sabina; Seghieri, Chiara

    2014-01-01

    The Italian National Health System, which follows a Beveridge model, provides universal healthcare coverage through general taxation. Universal coverage provides uniform healthcare access to citizens and is the characteristic usually considered the added value of a welfare system financed by tax revenues. Nonetheless, wide differences in practice patterns, health outcomes and regional usages of resources that cannot be justified by differences in patient needs have been demonstrated to exist. Beginning with the experience of the health care system of the Tuscany region (Italy), this study describes the first steps of a long-term approach to proactively address the issue of geographic variation in healthcare. In particular, the study highlights how the unwarranted variation management has been addressed in a region with a high degree of managerial control over the delivery of health care and a consolidated performance evaluation system, by first, considering it a high priority objective and then by actively integrating it into the regional planning and control mechanism. The implications of this study can be useful to policy makers, professionals and managers, and will contribute to the understanding of how the management of variation can be implemented with performance measurements and financial incentives. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  17. Using the World Health Organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities.

    Science.gov (United States)

    Manyazewal, Tsegahun

    2017-01-01

    Acknowledging the health system strengthening agenda, the World Health Organization (WHO) has formulated a health systems framework that describes health systems in terms of six building blocks. This study aimed to determine the current status of the six WHO health system building blocks in public healthcare facilities in Ethiopia. A quantitative, cross-sectional study was conducted in five public hospitals in central Ethiopia which were in a post-reform period. A self-administered, structured questionnaire which covered the WHO's six health system building blocks was used to collect data on healthcare professionals who consented. Data was analyzed using IBM SPSS version 20. The overall performance of the public hospitals was 60% when weighed against the WHO building blocks which, in this procedure, needed a minimum of 80% score. For each building block, performance scores were: information 53%, health workforce 55%, medical products and technologies 58%, leadership and governance 61%, healthcare financing 62%, and service delivery 69%. There existed a significant difference in performance among the hospitals (p building blocks are useful for assessing the process of strengthening health systems in Ethiopia. The six blocks allow identifying different improvement opportunities in each one of the hospitals. There was no contradiction between the indicators of the WHO building blocks and the health sustainable development goal (SDG) objectives. However, such SDG objectives should not be a substitute for strategies to strengthen health systems.

  18. 'I think it will eventually be done away with': Attitudes among healthcare professionals towards the current system of animal experimentation.

    Science.gov (United States)

    Dignon, Andrée

    2016-08-01

    This article describes a study of attitudes to the current system of animal experimentation (for the production of health interventions) among 52 UK healthcare professionals. These healthcare professionals participated in three separate focus groups (of 18, 17 and 17 participants) and were invited to respond to the question 'what is your opinion about the current system of animal testing?' The study focused specifically on their views of the current system (rather than their views of animal testing in general). The healthcare professionals were critical of the current system, particularly with regard to regulation, secrecy, validity, unnecessary suffering and welfare. © The Author(s) 2014.

  19. A healthcare Lean Six Sigma System for postanesthesia care unit workflow improvement.

    Science.gov (United States)

    Kuo, Alex Mu-Hsing; Borycki, Elizabeth; Kushniruk, Andre; Lee, Te-Shu

    2011-01-01

    The aim of this article is to propose a new model called Healthcare Lean Six Sigma System that integrates Lean and Six Sigma methodologies to improve workflow in a postanesthesia care unit. The methodology of the proposed model is fully described. A postanesthesia care unit case study is also used to demonstrate the benefits of using the Healthcare Lean Six Sigma System model by combining Lean and Six Sigma methodologies together. The new model bridges the service gaps between health care providers and patients, balances the requirements of health care managers, and delivers health care services to patients by taking the benefits of the Lean speed and Six Sigma high-quality principles. The full benefits of the new model will be realized when applied at both strategic and operational levels. For further research, we will examine how the proposed model is used in different real-world case studies.

  20. An Ethical Analysis of Performance-Based Supplementary Payment in Turkey's Healthcare System.

    Science.gov (United States)

    Kadioglu, Funda Gulay

    2016-07-01

    In 2003 Turkey introduced the Health Transition Program to develop easily accessible, high-quality, and effective healthcare services for the population. This program, like other health reforms, has three primary goals: to improve health status, to enhance financial protection, and to ensure patients' satisfaction. Although there is considerable literature on the anticipated positive results of such health reforms, little evidence exists on their current effectiveness. One of the main initiatives of this health reform is a performance-based supplementary payment system, an additional payment healthcare professionals receive each month in addition to their regular salaries. This system may cause some ethical problems. Physicians have an ethical duty to provide high-quality care to each patient; however, pay-for-performance and other programs that create strong incentives for high-quality care set up a potential conflict between this duty and the competing interest of complying with a performance measure.

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

    NARCIS (Netherlands)

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

    2017-01-01

    Background: Since the introduction of non-invasive prenatal testing (NIPT) in 2011, mainly by commercial companies, a growing demand for NIPT from the public and healthcare professionals has been putting pressure on the healthcare systems of various countries. This study identifies the challenges of

  2. 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

  3. households' choices of healthcare services in the north west region ...

    African Journals Online (AJOL)

    Efficient healthcare systems in developing economies are significant indicators of development. ... access to quality healthcare can be improved with efficient healthcare support programs and deferred payment options. ... Healthcare Services; Healthcare Providers; Multinomial Logistic Model; Healthcare Systems; Primary.

  4. Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

    Directory of Open Access Journals (Sweden)

    Sarah L Brand

    Full Text Available Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff.This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of these recommendations and determine whether they improve staff health and wellbeing.A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward in collective activities to improve physical or mental health or promote healthy behaviours.Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1 pre-determined (one-size-fits-all and no choice of activities (two studies; or 2 pre-determined and some choice of activities (one study; 3 A wide choice of a range of activities and some adaptation to local needs (five studies; or, 3 a participatory approach to creating programmes responsive and adaptive to

  5. An Intelligent Virtual Human System For Providing Healthcare Information And Support

    Science.gov (United States)

    2011-01-01

    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...3 (2005), 220- 230. [5] F.D. Rose, B.M. Brooks & A.A. Rizzo, Virtual Reality in Brain Damage Rehabilitation: Review, CyberPsychology and Behavior

  6. Healthcare under the Panchayati Raj Institutions (PRIs) in a decentralised health system.

    Science.gov (United States)

    Kumar, Virendra; Jayanta Mishra, Anindya

    2016-05-03

    Purpose This paper aims to explore the challenges and benefits arising from the involvement of Panchayati Raj Institutions (PRIs) in the provisioning of primary healthcare in a decentralised health system of India. Design/methodology/approach A qualitative study design was used in this study. Data were collected through semi-structured interviews from 89 respondents selected from nine primary health centres across the district. A thematic analytical framework approach was used to analyse the data. Findings The research results indicate that there are several challenges resulting from PRIs involvement, including prioritisation of service providers and users, coercive unethical work and lack of communication. However, there are some benefits associated with the involvement of the PRIs in service provisioning, including improved availability and regularity of healthcare providers at the health centres. Research limitations/implications The implications of the findings suggest that the PRIs play an important role in healthcare provisioning; however, their involvement is ineffective due to their partial capabilities and approach, which creates a non-conducive environment. Practical implications Health issues are among the most important human concerns, and recognising and addressing the grassroot challenges help to locate, and overcome the challenges that hinder the smooth healthcare provisioning process. Originality/value National Rural Health Mission has recognised the PRIs as a platform to promote decentralised health planning and for achieving its goals in India. The PRIs are significantly involved in planning, monitoring and provisioning of primary healthcare services at grassroot level. This paper addresses the challenges and benefits that emerged due to their involvement.

  7. Programming NET Web Services

    CERN Document Server

    Ferrara, Alex

    2007-01-01

    Web services are poised to become a key technology for a wide range of Internet-enabled applications, spanning everything from straight B2B systems to mobile devices and proprietary in-house software. While there are several tools and platforms that can be used for building web services, developers are finding a powerful tool in Microsoft's .NET Framework and Visual Studio .NET. Designed from scratch to support the development of web services, the .NET Framework simplifies the process--programmers find that tasks that took an hour using the SOAP Toolkit take just minutes. Programming .NET

  8. Annotating Coloured Petri Nets

    DEFF Research Database (Denmark)

    Lindstrøm, Bo; Wells, Lisa Marie

    2002-01-01

    -net. An example of such auxiliary information is a counter which is associated with a token to be able to do performance analysis. Modifying colour sets and arc inscriptions in a CP-net to support a specific use may lead to creation of several slightly different CP-nets – only to support the different uses...... a method which makes it possible to associate auxiliary information, called annotations, with tokens without modifying the colour sets of the CP-net. Annotations are pieces of information that are not essential for determining the behaviour of the system being modelled, but are rather added to support...

  9. Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up.

    Science.gov (United States)

    Bitsaki, Marina; Koutras, George; Heep, Hansjoerg; Koutras, Christos

    2017-01-01

    Long-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing. We propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden. The estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied. We propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

  10. Advances of FishNet towards a fully automatic monitoring system for fish migration

    Science.gov (United States)

    Kratzert, Frederik; Mader, Helmut

    2017-04-01

    Restoring the continuum of river networks, affected by anthropogenic constructions, is one of the main objectives of the Water Framework Directive. Regarding fish migration, fish passes are a widely used measure. Often the functionality of these fish passes needs to be assessed by monitoring. Over the last years, we developed a new semi-automatic monitoring system (FishCam) which allows the contact free observation of fish migration in fish passes through videos. The system consists of a detection tunnel, equipped with a camera, a motion sensor and artificial light sources, as well as a software (FishNet), which helps to analyze the video data. In its latest version, the software is capable of detecting and tracking objects in the videos as well as classifying them into "fish" and "no-fish" objects. This allows filtering out the videos containing at least one fish (approx. 5 % of all grabbed videos) and reduces the manual labor to the analysis of these videos. In this state the entire system has already been used in over 20 different fish passes across Austria for a total of over 140 months of monitoring resulting in more than 1.4 million analyzed videos. As a next step towards a fully automatic monitoring system, a key feature is the automatized classification of the detected fish into their species, which is still an unsolved task in a fully automatic monitoring environment. Recent advances in the field of machine learning, especially image classification with deep convolutional neural networks, sound promising in order to solve this problem. In this study, different approaches for the fish species classification are tested. Besides an image-only based classification approach using deep convolutional neural networks, various methods that combine the power of convolutional neural networks as image descriptors with additional features, such as the fish length and the time of appearance, are explored. To facilitate the development and testing phase of this approach

  11. International Clean Energy System Using Hydrogen Conversion (WE-NET). subtask 2. Research study on promotion of international cooperation; Suiso riyo kokusai clean energy system gijutsu (WE-NET). subtask 2. Kokusai kyoryoku suishin no tame no chosa kento

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    This paper describes the research result on promotion of international cooperation in the WE-NET project in fiscal 1996. The WE-NET project aims at development of the total system for hydrogen production, transport, storage and utilization, and construction of the earth-friendly innovative global clean energy network integrating elemental technologies. Since the standpoint is different between latent resource supplying countries and technology supplying countries, the WE-NET project should be constantly promoted under international understanding and cooperation. The committee distributed the annual summary report prepared by NEDO to overseas organizations, and made positive PR activities in the 11th World Conference and others. The committee made the evaluation on the improvement effect of air pollution by introducing a hydrogen vehicle in combination with Stanford University, and preparation of PR video tapes for hydrogen energy. Preliminary arrangement of Internet home pages, establishment of a long-term vision for international cooperation, and proposal toward the practical WE-NET are also made. 9 figs., 13 tabs.

  12. Smart healthcare textile sensor system for unhindered-pervasive health monitoring

    Science.gov (United States)

    Rai, Pratyush; Kumar, Prashanth S.; Oh, Sechang; Kwon, Hyeokjun; Mathur, Gyanesh N.; Varadan, Vijay K.; Agarwal, M. P.

    2012-04-01

    Simultaneous monitoring of physiological parameters- multi-lead Electrocardiograph (ECG), Heart rate variability, and blood pressure- is imperative to all forms of medical treatments. Using an array of signal recording devices imply that the patient will have to be confined to a bed. Textiles offer durable platform for embedded sensor and communication systems. The smart healthcare textile, presented here, is a mobile system for remote/wireless data recording and conditioning. The wireless textile system has been designed to monitor a patient in a non-obstructive way. It has a potential for facilitating point of care medicine and streamlining ambulatory medicine. The sensor systems were designed and fabricated with textile based components for easy integration on textile platform. An innovative plethysmographic blood pressure monitoring system was designed and tested as an alternative to inflatable blood pressure sphygmomanometer. Flexible dry electrodes technology was implemented for ECG. The sensor systems were tested and conditioned to daily activities of patients, which is not permissible with halter type systems. The signal quality was assessed for it applicability to medical diagnosis. The results were used to corroborate smart textile sensor system's ability to function as a point of care system that can provide quality healthcare.

  13. Using heterogeneous wireless sensor networks in a telemonitoring system for healthcare.

    Science.gov (United States)

    Corchado, Juan M; Bajo, Javier; Tapia, Dante I; Abraham, Ajith

    2010-03-01

    Ambient intelligence has acquired great importance in recent years and requires the development of new innovative solutions. This paper presents a distributed telemonitoring system, aimed at improving healthcare and assistance to dependent people at their homes. The system implements a service-oriented architecture based platform, which allows heterogeneous wireless sensor networks to communicate in a distributed way independent of time and location restrictions. This approach provides the system with a higher ability to recover from errors and a better flexibility to change their behavior at execution time. Preliminary results are presented in this paper.

  14. Repeatability and reproducibility of the Cornell Net Carbohydrate and Protein System analytical determinations

    Directory of Open Access Journals (Sweden)

    Arianna Buccioni

    2010-01-01

    Full Text Available The increasing use in Italy of the Cornell Net Carbohydrate and Protein System (CNCPS led researchers of five Italianuniversities to carry out a collaborative study to evaluate the precision of the CNCPS chemical analysis and derivate fractions.Each laboratory conducted in duplicate the chemical analyses according to the Weende (dry matter; crude protein;ether extract; crude fibre; ash, Van Soest (neutral and acid detergent fibre, NDF and ADF; acid detergent lignin; ADLand CNCPS (soluble proteins, SP; non-protein nitrogen, NPN; neutral and acid detergent insoluble protein, NDIP andADIP; starch, ST schemes on the same five feeds (barley meal, wheat straw, maize silage, dried lucerne and fieldbeans. Anomalous analytical data were identified and corrected by the “box-plot” graphic tool before the calculation ofthe CNCPS protein (B1, B2 and B3 and carbohydrate (A, B2 and C fractions. Finally, repeatability (chemical analysis andreproducibility (chemical analysis and fractions were calculated and expressed as relative values (repeatability andreproducibility standard deviation as percentage of the corresponding mean, RSDr and RSDR, respectively. Chemicalanalyses of the Weende scheme, together with NDF, ADF and ST analyses, have satisfactory repeatability (0.3-6.2% andreproducibility (0.3-11.2% values. On the contrary the ADL, NPN, NDIP and ADIP analyses showed high variability, bothwithin and between laboratories (RSDr and RSDR between 20 and 45%. The SP analysis had an intermediate value ofprecision (RSDr=10.6%; RSDR=16.4%.Finally, since different combinations of several chemical analyses with scarce (ADL, NPN, NDIP, ADIP, SP or average precision(e.g. NDF and starch are used to calculate CNCPS fractions (excluding B2 protein fraction, also the reproducibilitiesof these fractions are poor and range from 10 to 20%.

  15. Net energy production and emissions mitigation of domestic wastewater treatment system: a comparison of different biogas-sludge use alternatives.

    Science.gov (United States)

    Chen, Shaoqing; Chen, Bin

    2013-09-01

    Wastewater treatment systems are increasingly designed for the recovery of valuable chemicals and energy in addition to waste stream disposal. Herein, the life-cycle energy production and emissions mitigation of a typical domestic wastewater treatment system were assessed, in which different combinations of biogas use and sludge processing lines for industrial or household applications were considered. The results suggested that the reuse of biogas and sludge was so important in the system's overall energy balance and environmental performance that it may offset the cost in the plant's installation and operation. Combined heat and power and household utilization were two prior options for net energy production, provided an ideal power conversion efficiency and biogas production. The joint application of household biogas use and sludge nutrient processing achieved both high net energy production and significant environmental remediation across all impact categories, representing the optimal tradeoff for domestic wastewater treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Quantifying Human Appropriated Net Primary Productivity (HANPP) in a Ghanaian Cocoa System

    Science.gov (United States)

    Morel, A.; Adu-Bredu, S.; Adu Sasu, M.; Ashley Asare, R.; Boyd, E.; Hirons, M. A.; Malhi, Y.; Mason, J.; Norris, K.; Robinson, E. J. Z.; McDermott, C. L.

    2015-12-01

    Ghana is the second largest producer of cocoa (Theobroma cacoa), exporting approximately 18 percent of global volumes. These cocoa farms are predominantly small-scale, ranging in size from 2-4 hectares (ha). Traditionally, the model of cocoa expansion in Ghana relied on clearing new areas of forest and establishing a farm under remnant forest trees. This is increasingly less practical due to few unprotected forest areas remaining and management practices favoring close to full sun cocoa to maximize short-term yields. This study is part of a larger project, ECOLMITS, which is an interdisciplinary, ESPA-funded[1] initiative exploring the ecological limits of ecosystem system services (ESS) for alleviating poverty in small-scale agroforestry systems. The ecological study plots are situated within and around the Kakum National Forest, a well-protected, moist-evergreen forest of the Lower Guinea Forest region. Net primary productivity (NPP) is a measure of the rate at which carbon dioxide (CO2) is incorporated into plant tissues (e.g. canopy, stem and root). For this study, NPP was monitored in situ using methods developed by the Global Environmental Monitoring Network (GEM, http://gem.tropicalforests.ox.ac.uk/). By comparing NPP measured in intact forest and farms, the human appropriated NPP (HANPP) of this system can be estimated. The forest measures provide the "potential" NPP of the region, and then the reduction in NPP for farm plots is calculated for both land-cover change (HANPPLUC) and cocoa harvesting (HANPPHARV). The results presented are of the first year of NPP measurements across the cocoa landscape, including measurements from intact forest, logged forest and cocoa farms across a shade gradient and located at varying distances from the forest edge (e.g. 100 m, 500 m, 1 km and 5 km). These measures will have implications for carbon sequestration potential over the region and long-term sustainability of the Ghanaian cocoa sector. [1] Ecosystem Services for

  17. The dichotomy of the application of a systems approach in UK healthcare the challenges and priorities for implementation.

    Science.gov (United States)

    Pickup, Laura; Lang, Alexandra; Atkinson, Sarah; Sharples, Sarah

    2018-01-01

    There is increasing demand for a systems approach within national healthcare guidelines to provide a systematic and sustainable framework for improvements in patient safety. Supported by this is the growing body of evidence within Human Factors/Ergonomics (HFE) healthcare literature for the inclusion of this approach in health service design, provision and evaluation. This paper considers the current interpretation of this within UK healthcare systems and the dichotomy which exists in the challenge to implement a systems approach. Three case studies, from primary and secondary care, present a systems approach, offering a novel perspective of primary care and blood sampling. These provide practical illustrations of how HFE methods have been used in collaboration with healthcare staff to understand the system for the purpose of professional education, design and safety of clinical activities. The paper concludes with the challenge for implementation and proposes five roles for systems HFE to support patient safety. Practitioner Summary: healthcare is classified as a complex and dynamic system within this paper and as such HFE system methods are presented as desirable to understand the system, to develop HFE tools, to deliver education and integrate HFE within healthcare systems.

  18. Net Locality

    DEFF Research Database (Denmark)

    de Souza e Silva, Adriana Araujo; Gordon, Eric

    Provides an introduction to the new theory of Net Locality and the profound effect on individuals and societies when everything is located or locatable. Describes net locality as an emerging form of location awareness central to all aspects of digital media, from mobile phones, to Google Maps...... of emerging technologies, from GeoCities to GPS, Wi-Fi, Wiki Me, and Google Android....

  19. Net Neutrality

    DEFF Research Database (Denmark)

    Savin, Andrej

    2017-01-01

    Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else.......Repealing “net neutrality” in the US will have no bearing on Internet freedom or security there or anywhere else....

  20. RFID sensor-tags feeding a context-aware rule-based healthcare monitoring system.

    Science.gov (United States)

    Catarinucci, Luca; Colella, Riccardo; Esposito, Alessandra; Tarricone, Luciano; Zappatore, Marco

    2012-12-01

    Along with the growing of the aging population and the necessity of efficient wellness systems, there is a mounting demand for new technological solutions able to support remote and proactive healthcare. An answer to this need could be provided by the joint use of the emerging Radio Frequency Identification (RFID) technologies and advanced software choices. This paper presents a proposal for a context-aware infrastructure for ubiquitous and pervasive monitoring of heterogeneous healthcare-related scenarios, fed by RFID-based wireless sensors nodes. The software framework is based on a general purpose architecture exploiting three key implementation choices: ontology representation, multi-agent paradigm and rule-based logic. From the hardware point of view, the sensing and gathering of context-data is demanded to a new Enhanced RFID Sensor-Tag. This new device, de facto, makes possible the easy integration between RFID and generic sensors, guaranteeing flexibility and preserving the benefits in terms of simplicity of use and low cost of UHF RFID technology. The system is very efficient and versatile and its customization to new scenarios requires a very reduced effort, substantially limited to the update/extension of the ontology codification. Its effectiveness is demonstrated by reporting both customization effort and performance results obtained from validation in two different healthcare monitoring contexts.

  1. Review and analysis of quality healthcare system enhancement in developing countries.

    Science.gov (United States)

    Kurji, Zohra; Premani, Zahra Shaheen; Mithani, Yasmin

    2015-07-01

    Quality has multidimensional perspectives. It is a continuous and dynamic process. A systematic search of national and international literature was conducted from peer-reviewed databases MEDLINE, CINAHL and PubMed during January to July 2012. There are many frameworks to assess and measure quality. All frameworks give some levels in which quality could be assessed. Therefore, multiple frameworks should be used for measuring quality based on the situation and environment. Measuring quality is very important for primary healthcare programme, especially for developing countries because if we will not do quality assessment, our resources will not be utilised effectively and people may divert to curative services. Thus, in developing countries where healthcare system needs to optimise resources for increased population coverage and scale up the care, quality approaches can suggest workable solutions to using resources appropriately.

  2. [Integrative and personalized health care--requirements for a timely health-care system].

    Science.gov (United States)

    Heusser, P; Neugebauer, E; Berger, B; Hahn, E G

    2013-03-01

    In medical and public debates, the concept "personalized" or "individualized" medicine (PM) is increasingly used for the orientation of medicine towards individual genetic, molecular and biological characteristics. However, this tunnel view neglects that the human "person" or "individual" encompasses more than just the molecular and biological side, and that patients increasingly call for a more holistic and more person-centred form of health care. Therefore the authors propose to extend the concept of PM in the framework of an integrative health-care concept, so that with respect to a modern and patient-centred health-care system not only the biological, but also the relevant psychological, mental, social, cultural, spiritual, and economic aspects of the human individual are accounted for in health care. The Faculty of Health of Witten/Herdecke University proposes the term "integrative and personalised health care" for such a holistic form of PM. © Georg Thieme Verlag KG Stuttgart · New York.

  3. An exploration of the enablers and barriers in access to the Dutch healthcare system among Ghanaians in Amsterdam

    Directory of Open Access Journals (Sweden)

    Boateng Linda

    2012-03-01

    Full Text Available Abstract Background Sub-Saharan African populations are growing in many European countries. Data on the health of these populations are rare. Additionally, many sub-Saharan African migrants are confronted with issues of low socio-economic status, acculturation and language difficulties, which may hamper their access to health care. Despite the identification of some of those barriers, little is known about the enabling factors. Knowledge about the enablers and barriers in access to healthcare experienced is important in addressing their health needs and promoting healthcare access. This study aimed to investigate the enabling factors as well as barriers in access to the Dutch healthcare system among the largest sub-Saharan African migrant group (Ghanaians living in Amsterdam, the Netherlands. Methods Six focus groups were conducted from November 2009 to February 2010. A semi-structured interview guideline was used. Discussions were conducted in English or Twi (Ghanaian dialect, recorded and transcribed verbatim. Analysis was based on the Andersen model of healthcare utilisation using MAXQDA software. Results Knowledge and perceived quality of the health system, awareness of diseases, family and community support, community initiatives and availability of social support were the main enablers to the healthcare system. Difficulties with the Dutch language and mistrust in health care providers were major barriers in access to healthcare. Conclusions Access to healthcare is facilitated mainly by knowledge of and the perceived efficiency and quality of the Dutch healthcare system. However, poor Dutch language proficiency and mistrust in health care providers appear to be important barriers in accessing healthcare. The enablers and barriers identified by this study provide useful information for promoting healthcare access among this and similar Sub-Saharan African communities.

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    Wee Shiong Lim

    2017-11-01

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

  6. Involving private healthcare practitioners in an urban NCD sentinel surveillance system: lessons learned from Pune, India.

    Science.gov (United States)

    Kroll, Mareike; Phalkey, Revati; Dutta, Sayani; Shukla, Sharvari; Butsch, Carsten; Bharucha, Erach; Kraas, Frauke

    2016-01-01

    Despite the rising impact of non-communicable diseases (NCDs) on public health in India, lack of quality data and routine surveillance hampers the planning process for NCD prevention and control. Current surveillance programs focus largely on communicable diseases and do not adequately include the private healthcare sector as a major source of care in cities. The objective of the study was to conceptualize, implement, and evaluate a prototype for an urban NCD sentinel surveillance system among private healthcare practitioners providing primary care in Pune, India. We mapped all private healthcare providers in three selected areas of the city, conducted a knowledge, attitude, and practice survey with regard to surveillance among 258 consenting practitioners, and assessed their willingness to participate in a routine NCD surveillance system. In total, 127 practitioners agreed and were included in a 6-month surveillance study. Data on first-time diagnoses of 10 selected NCDs alongside basic demographic and socioeconomic patient information were collected onsite on a monthly basis using a paper-based register. Descriptive and regression analyses were performed. In total, 1,532 incident cases were recorded that mainly included hypertension (n=622, 41%) and diabetes (n=460, 30%). Dropout rate was 10% (n=13). The monthly reporting consistency was quite constant, with the majority (n=63, 50%) submitting 1-10 cases in 6 months. Average number of submitted cases was highest among allopathic practitioners (17.4). A majority of the participants (n=104, 91%) agreed that the surveillance design could be scaled up to cover the entire city. The study indicates that private primary healthcare providers (allopathic and alternate medicine practitioners) play an important role in the diagnosis and treatment of NCDs and can be involved in NCD surveillance, if certain barriers are addressed. Main barriers observed were lack of regulation of the private sector, cross-practices among

  7. Self Configurable Intelligent Distributed Antenna System for Resource Management in Multilayered Dense-nets

    DEFF Research Database (Denmark)

    Kumar, Ambuj; Mihovska, Albena Dimitrova; Prasad, Ramjee

    2016-01-01

    with their respective base stations, spectrum pooling and management at antenna end is not efficient. The situation worsens in Heterogeneous and Dense-net conditions in an Area of Interest (AoI). In this paper, we propose a DAS based intelligent architecture referred to as Self Configurable Intelligent Distributed...

  8. DrumNet : Building a GSM-enabled Information System for ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2009-08-19

    ... the case of DrumNet in Kenya; paper presented at IAAE eARN Africa Symposium, Beijing, August 19, 2009. Documents. Inventory of innovative farmer advisory services using ICTs. Articles de revue. Farmers turn to SMS to sell their produce. Articles de revue. By cell phone, scientists assist African farmers facing effects of ...

  9. A Timed Colored Petri Net Simulation-Based Self-Adaptive Collaboration Method for Production-Logistics Systems

    Directory of Open Access Journals (Sweden)

    Zhengang Guo

    2017-03-01

    Full Text Available Complex and customized manufacturing requires a high level of collaboration between production and logistics in a flexible production system. With the widespread use of Internet of Things technology in manufacturing, a great amount of real-time and multi-source manufacturing data and logistics data is created, that can be used to perform production-logistics collaboration. To solve the aforementioned problems, this paper proposes a timed colored Petri net simulation-based self-adaptive collaboration method for Internet of Things-enabled production-logistics systems. The method combines the schedule of token sequences in the timed colored Petri net with real-time status of key production and logistics equipment. The key equipment is made ‘smart’ to actively publish or request logistics tasks. An integrated framework based on a cloud service platform is introduced to provide the basis for self-adaptive collaboration of production-logistics systems. A simulation experiment is conducted by using colored Petri nets (CPN Tools to validate the performance and applicability of the proposed method. Computational experiments demonstrate that the proposed method outperforms the event-driven method in terms of reductions of waiting time, makespan, and electricity consumption. This proposed method is also applicable to other manufacturing systems to implement production-logistics collaboration.

  10. A Survey on Wireless Body Area Networks for eHealthcare Systems in Residential Environments

    Directory of Open Access Journals (Sweden)

    Mohammad Ghamari

    2016-06-01

    Full Text Available Current progress in wearable and implanted health monitoring technologies has strong potential to alter the future of healthcare services by enabling ubiquitous monitoring of patients. A typical health monitoring system consists of a network of wearable or implanted sensors that constantly monitor physiological parameters. Collected data are relayed using existing wireless communication protocols to a base station for additional processing. This article provides researchers with information to compare the existing low-power communication technologies that can potentially support the rapid development and deployment of WBAN systems, and mainly focuses on remote monitoring of elderly or chronically ill patients in residential environments.

  11. Critical Study Regarding the Evolution of Incomes and Expenses of the Romanian Healthcare System in the Context of Budgetary Decentralization

    Directory of Open Access Journals (Sweden)

    Violeta ISAI

    2016-04-01

    Full Text Available The healthcare system in Romania is continuously under a reform process, in order to make more efficient the medical care and to allow a wide access for the population to the healthcare services. The incomes of the healthcare system mainly come from the contribution to the social healthcare insurance, but also from other taxes, the system also benefits from subsidies from the state budget. The public healthcare expenses have a relatively low percentage from the total public expenses, being mainly oriented towards hospitals, subsidized drugs and primary medical assistance. The integration of Romania into the EU brought for the healthcare system opportunities as well as threats: the increase of the competence and quality of the medical act, the favourable context of decentralization but also the increase of the costs for medical services, the mobility of the patients and the pronounced migration of the qualified medical staff to other countries of the EU. The paper wants to analyse the incomes and expenses from the healthcare, taking into account all these aspects.

  12. Effectiveness of an electronic hand hygiene monitoring system on healthcare workers' compliance to guidelines.

    Science.gov (United States)

    Al Salman, J M; Hani, S; de Marcellis-Warin, N; Isa, Sister Fatima

    2015-01-01

    Hand hygiene is a growing concern among populations and is a crucial element in ensuring patient safety in a healthcare environment. Numerous management efforts have been conducted in that regard, including education, awareness and observations. To better evaluate the possible impact of technology on a healthcare setting, we observed the impact of a particular niche technology developed as an answer to the growing hand hygiene concerns. A study was conducted at Salmaniya Medical Complex (SMC) in Bahrain on a total of 16 Coronary Care Unit (CCU) beds where the system was installed, and the hand hygiene activity of healthcare workers (HCWs) in this area was monitored for a total period of 28 days. Comments, remarks and suggestions were noted, and improvements were made to the technology during the course of the trial. While resistance to change was significant, overall results were satisfactory. Compliance with hand hygiene techniques went from 38-42% to 60% at the beginning of the trial and then increased to an average of 75% at the end of the 28-day trial. In some cases, compliance peaked at 85% or even at 100%. Our case study demonstrates that technology can be used effectively in promoting and improving hand hygiene compliance in hospitals, which is one way to prevent cross-infections, especially in critical care areas. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  13. 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.

  14. Systems approach to address incivility and disruptive behaviors in health-care organizations.

    Science.gov (United States)

    Holloway, Elizabeth; Kusy, Mitchell

    2011-01-01

    In response to the growing evidence that disruptive behaviors within health-care teams constitute a major threat to the quality of care, the Joint Commission on Accreditation of Healthcare Organization (JCAHO; Joint Commission Resources, 2008) has a new leadership standard that addresses disruptive and inappropriate behaviors effective January 1, 2009. For professionals who work in human resources and organization development, these standards represent a clarion call to design and implement evidence-based interventions to create health-care communities of respectful engagement that have zero tolerance for disruptive, uncivil, and intimidating behaviors by any professional. In this chapter, we will build an evidence-based argument that sustainable change must include organizational, team, and individual strategies across all professionals in the organization. We will then describe an intervention model--Toxic Organization Change System--that has emerged from our own research on toxic behaviors in the workplace (Kusy & Holloway, 2009) and provide examples of specific strategies that we have used to prevent and ameliorate toxic cultures.

  15. Learning to navigate the healthcare system in a new country: a qualitative study.

    Science.gov (United States)

    Straiton, Melanie L; Myhre, Sonja

    2017-12-01

    Learning to navigate a healthcare system in a new country is a barrier to health care. Understanding more about the specific navigation challenges immigrants experience may be the first step towards improving health information and thus access to care. This study considers the challenges that Thai and Filipino immigrant women encounter when learning to navigate the Norwegian primary healthcare system and the strategies they use. A qualitative interview study using thematic analysis. Norway. Fifteen Thai and 15 Filipino immigrant women over the age of 18 who had been living in Norway at least one year. The women took time to understand the role of the general practitioner and some were unaware of their right to an interpreter during consultations. In addition to reliance on family members and friends in their social networks, voluntary and cultural organisations provided valuable tips and advice on how to navigate the Norwegian health system. While some women actively engaged in learning more about the system, they noted a lack of information available in multiple languages. Informal sources play an important role in learning about the health care system. Formal information should be available in different languages in order to better empower immigrant women.

  16. Initiation and continuation of long-acting reversible contraception in the United States military healthcare system.

    Science.gov (United States)

    Chiles, Daniel P; Roberts, Timothy A; Klein, David A

    2016-09-01

    Long-acting reversible contraception is more effective for pregnancy prevention than shorter-acting contraceptive methods and has the potential to reduce healthcare disparities and costs. However, long-acting reversible contraception is underused in the United States. One population of interest is beneficiaries of the United States military healthcare system who have access to universal healthcare, including no-cost, no-copay contraception with unlimited method switching, and comprise a large, actual use cohort. Efforts to increase long-acting reversible contraception initiation and continuation in this population may improve health outcomes and mitigate the profound consequences of unintended or mistimed pregnancy on readiness and cost to the military. We aimed to determine long-acting reversible contraception initiation and continuation rates among the diverse population with universal healthcare who are enrolled in the US military healthcare system. This study is a retrospective cohort of >1.7 million women, aged 14-40 years, who were enrolled in the US military healthcare system, TRICARE Prime, between October 2009 and September 2014. Individuals were assessed for long-acting reversible contraception initiation and continuation with the use of medical billing records. Method continuation and factors that were associated with early method discontinuation were evaluated with the Kaplan-Meier estimator and Cox proportional hazard models. During the study dates, 188,533 women initiated long-acting reversible contraception. Of these, 74.6% women selected intrauterine contraceptives. Method initiation rates remained relatively stable (41.7-50.1/1000 women/year) for intrauterine methods, although the rate for subdermal implants increased from 6.1-23.0/1000 women/year. In analysis of women who selected intrauterine contraceptives, 61.2% continued their method at 36 months, and 48.8% continued at 60 months. Among women who selected the implant, 32.0% continued their

  17. Increasing value for money in the Canadian healthcare system: new findings and the case for integrated care for seniors.

    Science.gov (United States)

    Hollander, Marcus J; Miller, Jo Ann; MacAdam, Margaret; Chappell, Neena; Pedlar, David

    2009-01-01

    Given the recent economic climate and increasing costs in the Canadian healthcare system, we must ensure that we are getting the best value for money possible. This article presents new findings and a broad weight of evidence to make the case that it is possible to obtain better value for money in our healthcare system by adopting models of integrated care delivery for seniors and others with ongoing care needs.

  18. A Cloud-Based X73 Ubiquitous Mobile Healthcare System: Design and Implementation

    Directory of Open Access Journals (Sweden)

    Zhanlin Ji

    2014-01-01

    Full Text Available Based on the user-centric paradigm for next generation networks, this paper describes a ubiquitous mobile healthcare (uHealth system based on the ISO/IEEE 11073 personal health data (PHD standards (X73 and cloud computing techniques. A number of design issues associated with the system implementation are outlined. The system includes a middleware on the user side, providing a plug-and-play environment for heterogeneous wireless sensors and mobile terminals utilizing different communication protocols and a distributed “big data” processing subsystem in the cloud. The design and implementation of this system are envisaged as an efficient solution for the next generation of uHealth systems.

  19. 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.

  20. The Relationship Between Burnout Syndrome Among the Medical Staff and Work Conditions in the Polish Healthcare System.

    Science.gov (United States)

    Głębocka, Alicja

    2017-01-01

    Psychologists emphasize that people employed in social service organizations are vulnerable to chronic stress and burnout syndrome caused by a close and unsatisfied interpersonal relationship. However, emotional exhaustion, depersonalization, and a feeling of diminished personal accomplishment can be attributed to other external factors. One of them is poor living and occupational conditions. According to a report by OECD, the healthcare system in Poland is the worst among the member countries. The aim of the present study was to define the relationship between occupational burnout and the rating of the Polish healthcare system among the medical staff. The study included 224 participants. The Maslach Burnout Inventory and the Dehumanized Behavior and the Głębocka and Rużyczka scale of Behavioral Indicators of Patient's Dehumanization were applied. The evaluations of the healthcare system were also collected. The results demonstrate that physicians were the group of most emotionally exhausted and, simultaneously, most life-satisfied persons, while nurses presented the highest level of dehumanization and the lowest level of satisfaction from life achievements. Only did physicians evaluate the healthcare system as a relatively good one. They were also more tolerant of latent dehumanization. A relationship between the dimensions of burnout and the evaluation of healthcare system were observed. The emotionally exhausted or prone to dehumanization persons were more likely to evaluate the Polish healthcare system negatively.

  1. Distributed embedded controller development with petri nets application to globally-asynchronous locally-synchronous systems

    CERN Document Server

    Moutinho, Filipe de Carvalho

    2016-01-01

    This book describes a model-based development approach for globally-asynchronous locally-synchronous distributed embedded controllers.  This approach uses Petri nets as modeling formalism to create platform and network independent models supporting the use of design automation tools.  To support this development approach, the Petri nets class in use is extended with time-domains and asynchronous-channels. The authors’ approach uses models not only providing a better understanding of the distributed controller and improving the communication among the stakeholders, but also to be ready to support the entire lifecycle, including the simulation, the verification (using model-checking tools), the implementation (relying on automatic code generators), and the deployment of the distributed controller into specific platforms. Uses a graphical and intuitive modeling formalism supported by design automation tools; Enables verification, ensuring that the distributed controller was correctly specified; Provides flex...

  2. Net-energy analysis of integrated food and bioenergy systems exemplified by a model of a self-sufficinet system of dairy farms

    DEFF Research Database (Denmark)

    Markussen, Mads Ville; Pugesgaard, Siri; Oleskowicz-Popiel, Piotr

    2015-01-01

    rye grain and whey, and (4) a combination of (1) and (2). When assessing the energetic net-contribution to society from bioenergy systems, two types of problems arise: how to aggregate non-equivalent types of energy services and how to account for non-equivalent types of inputs and coproducts from...... the farming? To avoid the first type, the net output of liquid fuels, electricity, useful heat, and food were calculated separately. Furthermore, to avoid the second type, all scenarios were designed to provide self-sufficiency with fodder and fertilizer and to utilize coproducts within the system...

  3. Collaborative Product/Service-Systems – On conceptualisation of PSS offerings and business nets

    DEFF Research Database (Denmark)

    Mougaard, Krestine; Neugebauer, Line Maria; McAloone, Tim C.

    2012-01-01

    Collaborative PSS development and operation, where multiple stakeholders are involved, is an emerging research area. This articles looks at the intra and inter-organisational company considerations in the industry case of company collaboration in the maritime branch. Initial steps are taken towar...... a framework that aligns service strategies and their unique value proposition with a set of business nets that seeks lights on the value-logic and management mechanisms to design and control each network....

  4. The effect of electronic medical record system sophistication on preventive healthcare for women.

    Science.gov (United States)

    Tundia, Namita L; Kelton, Christina M L; Cavanaugh, Teresa M; Guo, Jeff J; Hanseman, Dennis J; Heaton, Pamela C

    2013-01-01

    To observe the effect of electronic medical record (EMR) system sophistication on preventive women's healthcare. Providers in the National Ambulatory Medical Care Survey (NAMCS), 2007-8, were included if they had at least one visit by a woman at least 21 years old. Based on 16 questions from NAMCS, the level of a provider's EMR system sophistication was classified as non-existent, minimal, basic, or fully functional. A two-stage residual-inclusion method was used with ordered probit regression to model the level of EMR system sophistication, and outcome-specific Poisson regressions to predict the number of examinations or tests ordered or performed. Across the providers, 29.23%, 49.34%, 15.97%, and 5.46% had no, minimal, basic, and fully functional EMR systems, respectively. The breast examination rate was 20.27%, 34.96%, 37.21%, and 44.98% for providers without or with minimal, basic, and fully functional EMR systems, respectively. For breast examinations, pelvic examinations, Pap tests, chlamydia tests, cholesterol tests, mammograms, and bone mineral density (BMD) tests, an EMR system increased the number of these tests and examinations. Furthermore, the level of sophistication increased the number of breast examinations and Pap, chlamydia, cholesterol, and BMD tests. The use of advanced EMR systems in obstetrics and gynecology was limited. Given the positive results of this study, specialists in women's health should consider investing in more sophisticated systems. The presence of an EMR system has a positive impact on preventive women's healthcare; the more functions that the system has, the greater the number of examinations and tests given or prescribed.

  5. Healthcare costs among men with favorable risk prostate cancer managed with observation strategies versus immediate treatment in an integrated healthcare system.

    Science.gov (United States)

    Kariburyo, Furaha; Wang, Yuexi; Cheng, I-Ning Elaine; Wang, Lisa; Morgenstern, David; Asner, Igor; Xie, Lin; Meadows, Eric; Danella, John

    2017-08-01

    This study explored short-term healthcare costs of men managed with observation strategies (OBS) vs immediate treatment (IMT) for favorable risk prostate cancer (PCa) from the Geisinger Health System, a single integrated health system in Pennsylvania, as evidence from the community setting is limited. A retrospective cohort study was conducted using electronic health records from men aged ≥40 years diagnosed with favorable risk PCa (T1 or 2, PSA ≤15 ng/mL, Gleason ≤7 [3 + 4]) between January 2005 and October 2013. Prostate-specific healthcare costs were compared between the OBS and IMT cohorts in men with ≥3 years of follow-up and available linked claims data. Sub-group analyses focused on those men with low-risk PCa (T1-2a, PSA ≤10 ng/mL, Gleason ≤6). Sensitivity analysis stratified the study sample in three cohorts: OBS, switched from OBS to definitive treatment (OBS switch), and IMT. A total of 352 patients were included (OBS = 70 and IMT = 282). Compared with IMT, OBS resulted in significantly lower cumulative PCa-related healthcare costs for the first 3 years ($15,785 vs $23,177; p-value management costs compared with IMT.

  6. Fit for the Future? A New Approach in the Debate about What Makes Healthcare Systems Really Sustainable

    Directory of Open Access Journals (Sweden)

    Matthias Fischer

    2014-12-01

    Full Text Available As healthcare systems face enormous challenges, sustainability is seen as a crucial requirement for making them fit for the future. However, there is no consensus with regard to either the definition of the term or the factors that characterize a “sustainable healthcare system”. Therefore, the aim of this article is twofold. First, it gives examples of the existing literature about sustainable healthcare systems and analyzes this literature with regard to its understanding of sustainability and the strengths and weaknesses of the different approaches. The article then identifies crucial factors for sustainable healthcare systems, and the result, a conceptual framework consisting of five distinct and interacting factors, can be seen as a starting point for further research.

  7. An Integrated Model to Compare Net Electricity Generation for Carbon Dioxide- and Water-Based Geothermal Systems

    Science.gov (United States)

    Agarwal, Vikas

    Utilization of supercritical CO2 as a geothermal fluid instead of water has been proposed by Brown in 2000 and its advantages have been discussed by him and other researchers such as Karsten Pruess and Fouillac. This work assesses the net electricity that could be generated by using supercritical CO2 as a geothermal working fluid and compares it with water under the same temperature and pressure reservoir conditions. This procedure provides a method of direct comparison of water and CO2 as geothermal working fluids, in terms of net electricity generation over time given a constant geothermal fluid flow rate. An integrated three-part model has been developed to determine net electricity generation for CO2- and water-based geothermal reservoirs. This model consists of a wellbore model, reservoir simulation, and surface plant simulation. To determine the bottomhole pressure and temperature of the geothermal fluid (either water or CO2) in the injection well, a wellbore model was developed using fluid-phase, thermodynamic equations of state, fluid dynamics, and heat transfer models. A computer program was developed that solves for the temperature and pressure of the working fluid (either water or CO 2) down the wellbore by simultaneously solving for the fluid thermophysical properties, heat transfer, and frictional losses. For the reservoir simulation, TOUGH2, a general purpose numerical simulator has been used to model the temperature and pressure characteristics of the working fluid in the reservoir. The EOS1 module of TOUGH2 has been used for the water system and the EOS2 module of the TOUGH2 code has been employed for the CO2 case. The surface plant is simulated using CHEMCAD, a chemical process simulator, to determine the net electricity generated. A binary organic (iso-pentane) Rankine cycle is simulated. The calculated net electricity generated for the optimized water and CO2 systems are compared over the working time of the reservoir. Based on the theoretical

  8. Organisational systems' approaches to improving cultural competence in healthcare: a systematic scoping review of the literature.

    Science.gov (United States)

    McCalman, Janya; Jongen, Crystal; Bainbridge, Roxanne

    2017-05-12

    Healthcare organisations serve clients from diverse Indigenous and other ethnic and racial groups on a daily basis, and require appropriate client-centred systems and services for provision of optimal healthcare. Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competency strategies aimed at health promotion initiatives, workforce development and student education. This paper aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically mapping key concepts, types of evidence, and gaps in research. A literature search was completed as part of a larger systematic search of evaluations and measures of cultural competence interventions in health care in Canada, the United States, Australia and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched from 2002 to 2015. Overall, 109 studies were found, with 15 evaluating systems-level interventions or describing measurements. Thematic analysis was used to identify key implementation principles, intervention strategies and outcomes reported. Twelve intervention and three measurement studies met our inclusion criteria. Key principles for implementing systems approaches were: user engagement, organisational readiness, and delivery across multiple sites. Two key types of intervention strategies to embed cultural competence within health systems were: audit and quality improvement approaches and service-level policies or strategies. Outcomes were found for organisational systems, the client/practitioner encounter, health, and at national policy level. We could not determine the overall effectiveness of systems-level interventions to reform health systems because interventions were context-specific, there were too few comparative studies and studies did not use the same outcome measures. However, examined together, the intervention and measurement

  9. Using Ontologies for the E-learning System in Healthcare Human Resources Management

    Directory of Open Access Journals (Sweden)

    Lidia BAJENARU

    2015-01-01

    Full Text Available This paper provides a model for the use of ontology in e-learning systems for structuring educational content in the domain of healthcare human resources management (HHRM in Romania. In this respect we propose an effective method to improve the learning system by providing personalized learning paths created using ontology and advanced educational strategies to provide a personalized learning content for the medical staff. Personalization of e-learning process for the chosen target group will be achieved by setting up learning path for each user according to his profile. This will become possible using: domain ontology, learning objects, modeling student knowledge. Developing an ontology-based system for competence management allows complex interactions, providing intelligent interfacing. This is a new approach for the healthcare system managers in permanent training based on e-learning technologies and specific ontologies in a complex area that needs urgent modernization and efficiency to meet the public health economic, social and political context of Romania.

  10. [Ophthalmological service quality offered to outpatients of the Public Healthcare System].

    Science.gov (United States)

    Santos Hercos, Benigno Vicente; Berezovsky, Adriana

    2006-01-01

    To identify the perception of the ophthalmic service quality provided for outpatients of the public healthcare system as well as to detect which actions should be considered necessary and priority in order to improve its quality. A quantitative descriptive study was carried out on 100 outpatients of the public healthcare system which were submitted to ophthalmic tests at Fundação Hilton Rocha--Belo Horizonte-MG, from July 1st-July 30th 2004. Individual interviews were carried out by giving the interviewees two structured questionnaires adapted from the modified SERVQUAL. This scale is in agreement with the reality of the studied institute. The adapted SERVQUAL scale was submitted to statistical validation and it showed a suitable internal consistency index. In general terms, a slight general dissatisfaction was detected regarding ophthalmological service quality. The interviewees cared more about safety and reliability. A higher degree of dissatisfaction was detected mainly concerning fulfillment of procedures at scheduled appointments related to the execution of services within due time-limits. The institute is supposed to plan as well as carry out actions which lead to a general improvement in the patient's satisfaction regarding service quality and mainly reliability. Service quality monitoring through periodic use of the SERVQUAL scale will not only make it possible to plan highly precise and effective intervention strategies in these and in other healthcare services but it will also allow monitoring the responses to these actions. All these actions will contribute to the improvement of the service in the system as a whole.

  11. Academic productivity and its relationship to physician salaries in the University of California Healthcare System.

    Science.gov (United States)

    Fijalkowski, Natalia; Zheng, Luo Luo; Henderson, Michael T; Moshfeghi, Andrew A; Maltenfort, Mitchell; Moshfeghi, Darius M

    2013-07-01

    To evaluate whether physicians with higher academic productivity, as measured by the number of publications in Scopus and the Scopus Hirsch index (h-index), earn higher salaries. This was a cross-sectional study. Participants were ophthalmologists, otolaryngologists, neurosurgeons, and neurologists classified as "top earners" (>$100,000 annually) within the University of California (UC) healthcare system in 2008. Bibliometric searches on Scopus were conducted to retrieve the total number of publications and Hirsch indices (h-index), a measure of academic productivity. The association between the number of publications and h-index on physicians' total compensation was determined with multivariate regression models after controlling for the four specialties (ophthalmology, otolaryngology, neurosurgery, and neurology), the five institutions (UC San Francisco, UC Los Angeles, UC San Diego, UC Irvine, and UC Davis), and academic rank (assistant professor, associate professor, and professor). The UC healthcare system departments reported 433 faculty physicians among the four specialties, with 71.6% (n = 310) earning more than $100,000 in 2008 and classifying as top earners. After controlling for the specialty, institution, and ranking, there was a significant association between the number of publications on salary (P Scopus number of publications and h-index were correlated (P Scopus h-index was of borderline significance in predicting physician salary (P = 0.12). Physicians with higher Scopus publications had higher total salaries across all four specialties. Every 10 publications were associated with a 2.40% increase in total salary after controlling for specialty, institution, rank, and chair. Ophthalmologists, otolaryngologists, neurosurgeons, and neurologists in the UC healthcare system who are more academically productive receive greater remuneration.

  12. Development of an ease-of-use remote healthcare system architecture using RFID and networking technologies.

    Science.gov (United States)

    Lin, Shih-Sung; Hung, Min-Hsiung; Tsai, Chang-Lung; Chou, Li-Ping

    2012-12-01

    The study aims to provide an ease-of-use approach for senior patients to utilize remote healthcare systems. An ease-of-use remote healthcare system (RHS) architecture using RFID (Radio Frequency Identification) and networking technologies is developed. Specifically, the codes in RFID tags are used for authenticating the patients' ID to secure and ease the login process. The patient needs only to take one action, i.e. placing a RFID tag onto the reader, to automatically login and start the RHS and then acquire automatic medical services. An ease-of-use emergency monitoring and reporting mechanism is developed as well to monitor and protect the safety of the senior patients who have to be left alone at home. By just pressing a single button, the RHS can automatically report the patient's emergency information to the clinic side so that the responsible medical personnel can take proper urgent actions for the patient. Besides, Web services technology is used to build the Internet communication scheme of the RHS so that the interoperability and data transmission security between the home server and the clinical server can be enhanced. A prototype RHS is constructed to validate the effectiveness of our designs. Testing results show that the proposed RHS architecture possesses the characteristics of ease to use, simplicity to operate, promptness in login, and no need to preserve identity information. The proposed RHS architecture can effectively increase the willingness of senior patients who act slowly or are unfamiliar with computer operations to use the RHS. The research results can be used as an add-on for developing future remote healthcare systems.

  13. The electronics readout and data acquisition system of the KM3NeT neutrino telescope node

    Energy Technology Data Exchange (ETDEWEB)

    Real, Diego [IFIC, Instituto de Física Corpuscular, CSIC-Universidad de Valencia, C/Catedrático José Beltrán, 2, 46980 Paterna (Spain); Collaboration: KM3NeT Collaboration

    2014-11-18

    The KM3NeT neutrino telescope will be composed by tens of thousands of glass spheres, called Digital Optical Module (DOM), each of them containing 31 PMTs of small photocathode area (3'). The readout and data acquisition system of KM3NeT have to collect, treat and send to shore, in an economic way, the enormous amount of data produced by the photomultipliers and at the same time to provide time synchronization between each DOM at the level of 1 ns. It is described in the present article the Central Logic Board, that integrates the Time to Digital Converters and the White Rabbit protocol used for the DOM synchronization in a transparent way, the Power Board used in the DOM, the PMT base to readout the photomultipliers and the respective collecting boards, the so called Octopus Board.

  14. The E-net model for the Risk Analysis and Assessment System for the Information Security of Communication and Information Systems ("Defining" Subsystem)

    OpenAIRE

    Stoianov, Nikolai; Aleksandrova, Veselina

    2010-01-01

    This paper presents one suggestion that comprises the authors' experience in development and implementation of systems for information security in the Automated Information Systems of the Bulgarian Armed Forces. The architecture of risk analysis and assessment system for the communication and information system's information security (CIS IS) has been presented. E-net model of "Defining" Subsystem as a tool that allows to examine the subsystems is proposed as well. Such approach can be applie...

  15. Geographic information system-based healthcare waste management planning for treatment site location and optimal transportation routeing.

    Science.gov (United States)

    Shanmugasundaram, Jothiganesh; Soulalay, Vongdeuane; Chettiyappan, Visvanathan

    2012-06-01

    In Lao People's Democratic Republic (Lao PDR), a growth of healthcare centres, and the environmental hazards and public health risks typically accompanying them, increased the need for healthcare waste (HCW) management planning. An effective planning of an HCW management system including components such as the treatment plant siting and an optimized routeing system for collection and transportation of waste is deemed important. National government offices at developing countries often lack the proper tools and methodologies because of the high costs usually associated with them. However, this study attempts to demonstrate the use of an inexpensive GIS modelling tool for healthcare waste management in the country. Two areas were designed for this study on HCW management, including: (a) locating centralized treatment plants and designing optimum travel routes for waste collection from nearby healthcare facilities; and (b) utilizing existing hospital incinerators and designing optimum routes for collecting waste from nearby healthcare facilities. Spatial analysis paved the way to understand the spatial distribution of healthcare wastes and to identify hotspots of higher waste generating locations. Optimal route models were designed for collecting and transporting HCW to treatment plants, which also highlights constraints in collecting and transporting waste for treatment and disposal. The proposed model can be used as a decision support tool for the efficient management of hospital wastes by government healthcare waste management authorities and hospitals.

  16. INVESTMENTS AS A FACTOR OF STABILITY OF THE RUSSIAN HEALTHCARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Lyudmila Valentinovna Tokun

    2016-01-01

    Full Text Available In this article the author examines the structure of public expenditure on health in Russia and analyzes the adequacy of the investments in the health system. Goal / Objectives. The aim of this article is to analyze the expenses of the project “Development strategy of the Russian healthcare system for the long-term period 2015–2030”. The main objectives of this article are the definition of the technical condition of the buildings and improvement of health facilities, evaluation of the value of fixed assets in the healthcare and medical equipment depreciation, evaluation of tariff s in the compulsory health insurance system. Methodology. the method of comparative analysis of 10 past years indicators is used in this article Results. From 2005 to 2014 healthcare expenditures have increased 3 times, which is comparable to GDP growth. In the same period, investments in health have increased by 2 times. The main increase in expenditures occurred in the wages. These trends may indicate a lack of attention in relation to fixed assets. In relation to the renovation and the depreciation factor, rate of growth and the level of investment cast doubt on the adequacy and sustainability of the healthcare’s material basis for the provision of necessary medical assistance. It is required to calculate the standard, which includes continuous updating of fixed assets based on the each region of RF, depending on the regional characteristics and the structure of fixed assets. Conclusions / Significance. The study concluded that at the moment the size of the annual investment in health by the federal and regional budgets do not meet the needs of even simple reproduction, not to mention the modernization and development. Planning budget investment requirements can be carried out based on a special standard ratio, which takes into account the volume, composition and structure of fixed assets. Financial stability of the Russian healthcare depends not only on

  17. A Novel Fractional-Discrete-Cosine-Transform-Based Reversible Watermarking for Healthcare Information Management Systems

    Directory of Open Access Journals (Sweden)

    Lu-Ting Ko

    2012-01-01

    Full Text Available Digital watermarking is a good tool for healthcare information management systems. The well-known quantization-index-modulation- (QIM- based watermarking has its limitations as the host image will be destroyed; however, the recovery of medical image is essential to avoid misdiagnosis. A transparent yet reversible watermarking algorithm is required for medical image applications. In this paper, we propose a fractional-discrete-cosine-transform- (FDCT- based watermarking to exactly reconstruct the host image. Experimental results show that the FDCT-based watermarking is preferable to the QIM-based watermarking for the medical image applications.

  18. Nanoparticles functionalized with supramolecular host-guest systems for nanomedicine and healthcare.

    Science.gov (United States)

    Wu, Zilong; Song, Nan; Menz, Ryan; Pingali, Bharadwaj; Yang, Ying-Wei; Zheng, Yuebing

    2015-05-01

    Synthetic macrocyclic host compounds can interact with suitable guest molecules via noncovalent interactions to form functional supramolecular systems. With the synergistic integration of the response of molecules and the unique properties at the nanoscale, nanoparticles functionalized with the host-guest supramolecular systems have shown great potentials for a broad range of applications in the fields of nanoscience and nanotechnology. In this review article, we focus on the applications of the nanoparticles functionalized with supramolecular host-guest systems in nanomedicine and healthcare, including therapeutic delivery, imaging, sensing and removal of harmful substances. A large number of examples are included to elucidate the working mechanisms, advantages, limitations and future developments of the nanoparticle-supramolecule systems in these applications.

  19. 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.

  20. Turning toward data uniformity: how open systems put healthcare in command.

    Science.gov (United States)

    Egan, R

    1993-11-01

    Recent programming and design techniques result in the benefits of flexibility in system selection and reduced system cost. Open systems and the use of relational database managers with structured query languages allow the healthcare industry to set standards in database design, content and access, if it chooses. Such standards would facilitate creation of applications that could be interchangeable among vendors because basic functions remain constant. This interchangeability equates to flexibility in selecting specific applications, which then can be based on the best match of features required or desired, instead of compatibility with a vendor's system. The goal of reduced costs can be achieved since interface programs would not have to be written to integrate other vendors' software.

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

    Science.gov (United States)

    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

  2. Telemedicine and its transformation of emergency care: a case study of one of the largest US integrated healthcare delivery systems.

    Science.gov (United States)

    Sharma, Rahul; Fleischut, Peter; Barchi, Daniel

    2017-12-01

    Innovative methods for delivering healthcare via the use of technology are rapidly growing. Despite the passage of the Affordable Care Act, emergency department visits have continued to rise nationally. Healthcare systems must devise solutions to face these increasing volumes and also deliver high quality care. In response to the changing healthcare landscape, New York Presbyterian Hospital has implemented a comprehensive enterprise wide digital health portfolio which includes the first mobile stroke treatment unit on the east coast and the first emergency department-based digital emergency care program in New York City.

  3. [Analysis of health terminologies for use as ontologies in healthcare information systems].

    Science.gov (United States)

    Romá-Ferri, Maria Teresa; Palomar, Manuel

    2008-01-01

    Ontologies are a resource that allow the concept of meaning to be represented informatically, thus avoiding the limitations imposed by standardized terms. The objective of this study was to establish the extent to which terminologies could be used for the design of ontologies, which could be serve as an aid to resolve problems such as semantic interoperability and knowledge reusability in healthcare information systems. To determine the extent to which terminologies could be used as ontologies, six of the most important terminologies in clinical, epidemiologic, documentation and administrative-economic contexts were analyzed. The following characteristics were verified: conceptual coverage, hierarchical structure, conceptual granularity of the categories, conceptual relations, and the language used for conceptual representation. MeSH, DeCS and UMLS ontologies were considered lightweight. The main differences among these ontologies concern conceptual specification, the types of relation and the restrictions among the associated concepts. SNOMED and GALEN ontologies have declaratory formalism, based on logical descriptions. These ontologies include explicit qualities and show greater restrictions among associated concepts and rule combinations and were consequently considered as heavyweight. Analysis of the declared representation of the terminologies shows the extent to which they could be reused as ontologies. Their degree of usability depends on whether the aim is for healthcare information systems to solve problems of semantic interoperability (lightweight ontologies) or to reuse the systems' knowledge as an aid to decision making (heavyweight ontologies) and for non-structured information retrieval, extraction, and classification.

  4. Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management.

    Science.gov (United States)

    Notara, Venetia; Koupidis, Sotirios A; Vaga, Elissavet; Grammatikopoulos, Ilias A

    2010-07-01

    Despite several reform efforts, the Greek health care system still faces problems related to misdistribution of trained health staff and finance between geographical areas. The objectives of the present study were to describe the current situation of the delivery of the healthcare service in Greece, to explore the basic implications of the economic crisis from a nursing management perspective and to examine future practices opening a debate in policy developments. The principal finding of this study was the serious shortage of trained nurses, the imbalances in nursing personnel, an excess of doctors and the complete absence of a Primary Healthcare System in civil areas provided by general doctors. It is important that health care policy makers become aware and seriously consider rearranging the Health Care System to become more effective and efficient for the population (client). Special attention should be paid to strengthening areas such as primary health care, public health and health promotion in the direction of minimizing the demand of hospital services. Any implementation of major health care reforms should consider seriously the role of the nursing management which formulates the substantial link between the health services and the patient.

  5. CARDIOLOGY CLINICAL TRIAL PARTICIPATION IN COMMUNITY-BASED HEALTHCARE SYSTEMS: OBSTACLES AND OPPORTUNITIES

    Science.gov (United States)

    Somkin, Carol P.; Altschuler, Andrea; Ackerson, Lynn; Tolsma, Dennis; Rolnick, Sharon J.; Yood, Robert; Weaver, W. Douglas; Von Worley, Ann; Hornbrook, Mark; Magid, David J.; Go, Alan S.

    2008-01-01

    Background The objective of our study was to examine cardiologists’ and organizational leaders’ interest in clinical trial participation and perceived barriers and facilitators to participation within ten diverse non-profit healthcare delivery systems. Trials play a pivotal role in advancing knowledge about the safety and efficacy of cardiovascular interventions and tests. Although cardiovascular trials successfully enroll patients, recruitment challenges persist. Community-based health systems could be an important source of participants and investigators, but little is known about community cardiologists’ experiences with trials. Methods We interviewed 25 cardiology and administrative leaders and mailed questionnaires to all 280 cardiologists at 10 U.S. healthcare organizations. Results The survey received a 73% response rate. While 60% of respondents had not participated in any trials in the past year, nearly 75% wanted greater participation. Cardiologists reported positive attitudes toward trial participation; more than half agreed that trials were their first choice of therapy for patients, if available. Almost all leaders described their organizations as valuing research but not necessarily trials. Major barriers to participation were lack of physician time and insufficient skilled research nurses. Conclusions Cardiologists have considerable interest in trial participation. Major obstacles to increased participation are lack of time and effective infrastructure to support trials. These results suggest that community-based health systems are a rich source for cardiovascular research but additional funding and infrastructure are needed to leverage this resource. PMID:18397842

  6. Developing Tacit Knowledge of Complex Systems: The Value of Early Empirical Inquiry in Healthcare Design

    Directory of Open Access Journals (Sweden)

    Chantal Trudel

    2016-09-01

    Full Text Available Infection prevention and control has been the subject of much study in medical and epidemiological research and a variety of best practice guidelines have been developed to support healthcare workers and related stakeholders. Yet, despite the availability of information, managing healthcare-associated infections remains a challenge because the relevant explicit knowledge is not being adequately developed and mobilized as tacit knowledge for use "on the front lines". Some researchers have called for a human factors perspective to help address challenges in designing for infection prevention and control, but relatively few studies have been conducted to date. Researchers also suggest that empirical inquiry is needed to better inform the design process, and particularly the design of complex systems where attention to detailed processes and interactions can support the success of an intervention. A human factors approach can help designers develop a deeper understanding of work processes, technology considerations, as well as physiological, psychological, cultural, and organizational factors. The need is particularly pressing in low-resource healthcare environments where funds, time, and human resources may be scarce and strategic design decisions based on evidence are needed to support meaningful and effective changes. With this in mind, a human factors study was conducted in an existing neonatal intensive care unit to identify the influence of product and environment design on infection prevention and control and to inform recommendations for improvement. In this case study, we illustrate how the application of an empirical, methodical approach can help design professionals and stakeholders develop tacit knowledge of complex systems – knowledge that can be used to better inform design priorities, the design process, decision making, and the allocation of resources to help maximize improvements.

  7. Provincial Health Accounts in Kerman, Iran: An Evidence of a “Mixed” Healthcare Financing System

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Mehrolhassani

    2014-02-01

    Full Text Available Background Provincial Health Accounts (PHA as a subset of National Health Accounts (NHA present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC. This study aimed to examine Health Accounts in Kerman Province. Methods The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General’s office. In order to classify the data, the International Classification for Health Accounts (ICHA method was used, in which data set was adjusted for the province. Results During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41 was related to private household funds, of which the Out-of-Pocket (OOP payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs (65.19% was related to curative services. Conclusion The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By performing the Family Physician Program (FPP and emphasizing Social Determinant of Health (SDH approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Optimizing Patient Surgical Management Using WhatsApp Application in the Italian Healthcare System.

    Science.gov (United States)

    Nardo, Bruno; Cannistrà, Marco; Diaco, Vincenzo; Naso, Agostino; Novello, Matteo; Zullo, Alessandra; Ruggiero, Michele; Grande, Raffaele; Sacco, Rosario

    2016-09-01

    Smartphones changed the method by which doctors communicate with each other, offer modern functionalities sensitive to the context of use, and can represent a valuable ally in the healthcare system. Studies have shown that WhatsApp™ application can facilitate communication within the healthcare team and provide the attending physician a constant oversight of activities performed by junior team members. The aim of the study was to use WhatsApp between two distant surgical teams involved in a program of elective surgery to verify if it facilitates communication, enhances learning, and improves patient care preserving their privacy. We conducted a focused group of surgeons over a 28-month period (from March 2013 to July 2015), and from September 2014 to July 2015, a group of selected specialists communicated healthcare matters through the newly founded "WhatsApp Surgery Group." Each patient enrolled in the study signed a consent form to let the team communicate his/her clinical data using WhatsApp. Communication between team members, response times, and types of messages were evaluated. Forty six (n = 46) patients were enrolled in the study. A total of 1,053 images were used with an average of 78 images for each patient (range 41-143). 125 h of communication were recorded, generating 354 communication events. The expert surgeon had received the highest number of questions (P, 0.001), while the residents asked clinical questions (P, 0.001) and were the fastest responders to communications (P, 0.001). Our study investigated how two distant clinical teams may exploit such a communication system and quantifies both the direction and type of communication between surgeons. WhatsApp is a low cost, secure, and fast technology and it offers the opportunity to facilitate clinical and nonclinical communications, enhance learning, and improve patient care preserving their privacy.

  10. A new primary health-care system in the Syrian opposition territories: Good effort but far from being perfect.

    Science.gov (United States)

    Alsaied, Tarek; Mawas, Abdullah; Al Sayah, Fatima; Kental, Abdulrazzak; Saqqur, Maher

    2017-01-01

    The primary health-care system in Syria has suffered a great deal of damage over the past 6 years. A large number of physicians and health-care providers have left the country. The objectives of this study are to describe our experience in establishing a primary health-care system in the opposition territories (OTs) in Syria and report the most common treated diseases. The administrative databases of ten primary care centers in the OT from January 2014 to December 2015 were reviewed. All patients' encounters, including children and adults, in these centers were included in the study. Within the study period, the ten centers served 46,039 patients encounter per month (and average of 4600 patients encounters per center per month). A high number of communicable diseases were noted. Cutaneous leishmaniasis was the most common communicable disease (1170 cases a month). Tuberculosis was treated in 14 patients a month. Other infectious diseases that were almost eradicated before the crises were seen increasingly (29 mumps cases/month, 6 measles cases/month, and 34 cases of typhoid fever/month). The primary health-care system in Syria has been greatly damaged, and tremendous efforts are ongoing to provide access to various basic health-care services including primary care services. Despite these efforts, the current system is very vulnerable and not sustainable. This study summarizes basic health services provided by primary health-care centers in Syrian OTs.

  11. An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

    Science.gov (United States)

    Takeda, Hiroshi; Matsumura, Yasushi; Kuwata, Shigeki; Nakano, Hirohiko; Shanmai, Ji; Qiyan, Zhang; Yufen, Chen; Kusuoka, Hideo; Matsuoka, Masaki

    2004-03-31

    To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.

  12. Demonstration of Advanced Technologies for Multi-Load Washers in Hospitality and Healthcare -- Ozone Based Laundry Systems

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Brian K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Parker, Graham B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Petersen, Joseph M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sullivan, Greg [Efficiency Solutions, LLC (United States); Goetzler, W. [Navigant Consulting, Inc. (United States); Sutherland, T. A. [Navigant Consulting, Inc. (United States); Foley, K. J. [Navigant Consulting, Inc. (United States)

    2014-08-14

    The objective of this demonstration project was to evaluate market-ready retrofit technologies for reducing the energy and water use of multi-load washers in healthcare and hospitality facilities. Specifically, this project evaluated laundry wastewater recycling technology in the hospitality sector and ozone laundry technology in both the healthcare and hospitality sectors. This report documents the demonstration of ozone laundry system installations at the Charleston Place Hotel in Charleston, South Carolina, and the Rogerson House assisted living facility in Boston, Massachusetts.

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

    OpenAIRE

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

    2015-01-01

    Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients’ demands and expectations towards better medical care are exerting pressure on the sustainabi...

  14. A Wearable Healthcare System With a 13.7 μA Noise Tolerant ECG Processor.

    Science.gov (United States)

    Izumi, Shintaro; Yamashita, Ken; Nakano, Masanao; Kawaguchi, Hiroshi; Kimura, Hiromitsu; Marumoto, Kyoji; Fuchikami, Takaaki; Fujimori, Yoshikazu; Nakajima, Hiroshi; Shiga, Toshikazu; Yoshimoto, Masahiko

    2015-10-01

    To prevent lifestyle diseases, wearable bio-signal monitoring systems for daily life monitoring have attracted attention. Wearable systems have strict size and weight constraints, which impose significant limitations of the battery capacity and the signal-to-noise ratio of bio-signals. This report describes an electrocardiograph (ECG) processor for use with a wearable healthcare system. It comprises an analog front end, a 12-bit ADC, a robust Instantaneous Heart Rate (IHR) monitor, a 32-bit Cortex-M0 core, and 64 Kbyte Ferroelectric Random Access Memory (FeRAM). The IHR monitor uses a short-term autocorrelation (STAC) algorithm to improve the heart-rate detection accuracy despite its use in noisy conditions. The ECG processor chip consumes 13.7 μA for heart rate logging application.

  15. Multiple bio-monitoring system using visible light for electromagnetic-wave free indoor healthcare

    Science.gov (United States)

    An, Jinyoung; Pham, Ngoc Quan; Chung, Wan-Young

    2017-12-01

    In this paper, a multiple biomedical data transmission system with visible light communication (VLC) is proposed for an electromagnetic-wave-free indoor healthcare. VLC technology has emerged as an alternative solution to radio-frequency (RF) wireless systems, due to its various merits, e.g., ubiquity, power efficiency, no RF radiation, and security. With VLC, critical bio-medical signals, including electrocardiography (ECG), can be transmitted in places where RF radiation is restricted. This potential advantage of VLC could save more lives in emergency situations. A time hopping (TH) scheme is employed to transfer multiple medical-data streams in real time with a simple system design. Multiple data streams are transmitted using identical color LEDs and go into an optical detector. The received multiple data streams are demodulated and rearranged using a TH-based demodulator. The medical data is then monitored and managed to provide the necessary medical care for each patient.

  16. Redefining ethical leadership in a 21st-century healthcare system.

    Science.gov (United States)

    Ho, Anita; Pinney, Stephen

    2016-01-01

    Traditional ethical leadership in healthcare concentrated on the oversight of the individual provider-patient relationship. However, as care delivery becomes predominantly team-based and integrated across provider organizations, these ethical frameworks also need to consider meso- and macro-factors within the system. These broader issues require managers and administrative leaders to augment their ethical perspectives beyond current and prospective patients with those of the team, organization, and broader system, where high levels of coordination and oversight are essential. Administrators are increasingly ethically accountable not only for how individual care encounters are conducted (micro level) but also for how the system is organized to deliver and ensure quality care for patients receiving care (meso level) and service populations who turn to them for care when needed (macro level). © 2015 The Canadian College of Health Leaders.

  17. Evaluation and implementation of QR Code Identity Tag system for Healthcare in Turkey.

    Science.gov (United States)

    Uzun, Vassilya; Bilgin, Sami

    2016-01-01

    For this study, we designed a QR Code Identity Tag system to integrate into the Turkish healthcare system. This system provides QR code-based medical identification alerts and an in-hospital patient identification system. Every member of the medical system is assigned a unique QR Code Tag; to facilitate medical identification alerts, the QR Code Identity Tag can be worn as a bracelet or necklace or carried as an ID card. Patients must always possess the QR Code Identity bracelets within hospital grounds. These QR code bracelets link to the QR Code Identity website, where detailed information is stored; a smartphone or standalone QR code scanner can be used to scan the code. The design of this system allows authorized personnel (e.g., paramedics, firefighters, or police) to access more detailed patient information than the average smartphone user: emergency service professionals are authorized to access patient medical histories to improve the accuracy of medical treatment. In Istanbul, we tested the self-designed system with 174 participants. To analyze the QR Code Identity Tag system's usability, the participants completed the System Usability Scale questionnaire after using the system.

  18. Evaluating the Life Cycle Environmental Benefits and Trade-Offs of Water Reuse Systems for Net-Zero Buildings.

    Science.gov (United States)

    Hasik, Vaclav; Anderson, Naomi E; Collinge, William O; Thiel, Cassandra L; Khanna, Vikas; Wirick, Jason; Piacentini, Richard; Landis, Amy E; Bilec, Melissa M

    2017-02-07

    Aging water infrastructure and increased water scarcity have resulted in higher interest in water reuse and decentralization. Rating systems for high-performance buildings implicitly promote the use of building-scale, decentralized water supply and treatment technologies. It is important to recognize the potential benefits and trade-offs of decentralized and centralized water systems in the context of high-performance buildings. For this reason and to fill a gap in the current literature, we completed a life cycle assessment (LCA) of the decentralized water system of a high-performance, net-zero energy, net-zero water building (NZB) that received multiple green building certifications and compared the results with two modeled buildings (conventional and water efficient) using centralized water systems. We investigated the NZB's impacts over varying lifetimes, conducted a break-even analysis, and included Monte Carlo uncertainty analysis. The results show that, although the NZB performs better in most categories than the conventional building, the water efficient building generally outperforms the NZB. The lifetime of the NZB, septic tank aeration, and use of solar energy have been found to be important factors in the NZB's impacts. While these findings are specific to the case study building, location, and treatment technologies, the framework for comparison of water and wastewater impacts of various buildings can be applied during building design to aid decision making. As we design and operate high-performance buildings, the potential trade-offs of advanced decentralized water treatment systems should be considered.

  19. A wireless multi-channel bioimpedance measurement system for personalized healthcare and lifestyle.

    Science.gov (United States)

    Ramos, Javier; Ausín, José Luis; Lorido, Antonio Manuel; Redondo, Francisco; Duque-Carrillo, Juan Francisco

    2013-01-01

    Miniaturized, noninvasive, wearable sensors constitute a fundamental prerequisite for pervasive, predictive, and preventive healthcare systems. In this sense, this paper presents the design, realization, and evaluation of a wireless multi-channel measurement system based on a cost-effective high-performance integrated circuit for electrical bioimpedance (EBI) measurements in the frequency range from 1 kHz to 1 MHz. The resulting on-chip spectrometer provides high measuring EBI capabilities and together with a low-cost, commercially available radio frequency transceiver device. It provides reliable wireless communication, constitutes the basic node to build EBI wireless sensor networks (EBI-WSNs). The proposed EBI-WSN behaves as a high-performance wireless multi-channel EBI spectrometer, where the number of channels is completely scalable and independently configurable to satisfy specific measurement requirements of each individual. A prototype of the EBI node leads to a very small printed circuit board of approximately 8 cm2 including chip-antenna, which can operate several years on one 3-V coin cell battery and make it suitable for long-term preventive healthcare monitoring.

  20. Pharmacy Benefit Management Companies: Do They Create Value in the US Healthcare System?

    Science.gov (United States)

    Lyles, Alan

    2017-05-01

    Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing. Whether these potential outcomes are realized within the relevant budget is a function of the healthcare system and the interaction of benefit design and clinical processes-not just individually vetted components. Efficiencies and values achieved in price discounts and cost sharing can be nullified if there is irrational prescribing (over-utilization, under-utilization and mis-utilization), variable patient adherence to medication regimens, ineffective formulary processes, or fraud, waste and abuse. Rising prescription drug costs and the increasing prevalence of 'high deductible health plans', which require much greater patient out-of-pocket costs, is creating a crisis for PBM efforts towards an affordable pharmacy benefit. Since PBM rebate and incentive contracts are opaque to the public, whether they add value by restraining higher drug prices or benefit from them is debatable.