WorldWideScience

Sample records for swedish healthcare system

  1. Factors for successful improvement of Swedish healthcare

    OpenAIRE

    Olsson, Jesper

    2005-01-01

    The Swedish OCM, developed by an Integrative Group Process, was found to be a valid model able to distinguish successful from unsuccessful organizations in terms of improvement. A majority of healthcare organizations applied the Internal Collaborative strategy which lacks the patient centered task alignment characterizing those organizations predicted to be successful by their relatively superior Swedish OCM score. Managers tend to overestimate the prospects of organizationa...

  2. Burnout and physical and mental health among Swedish healthcare workers

    NARCIS (Netherlands)

    Peterson, U.; Demerouti, E.; Bergström, G.; Samuelsson, M.; Asberg, M.; Nygren, A.

    2008-01-01

    Title. Burnout and physical and mental health among Swedish healthcare workers Aim. This paper is a report of a study to investigate how burnout relates to self-reported physical and mental health, sleep disturbance, memory and lifestyle factors. Background. Previous research on the possible

  3. Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare

    Directory of Open Access Journals (Sweden)

    Andersson Ann-Christine

    2013-02-01

    Full Text Available Abstract Background Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods A questionnaire, founded on the Minnesota Innovation Survey (MIS, was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

  4. Swedish healthcare providers' perceptions of preconception expanded carrier screening (ECS)-a qualitative study.

    Science.gov (United States)

    Matar, A; Kihlbom, U; Höglund, A T

    2016-07-01

    Reproductive autonomy, medicalization, and discrimination against disabled and parental responsibility are the main ongoing ethical debates concerning reproductive genetic screening. To examine Swedish healthcare professionals' views on preconception expanded carrier screening (ECS), a qualitative study involving academic and clinical institutions in Sweden was conducted in September 2014 to February 2015. Eleven healthcare professionals including clinicians, geneticists, a midwife, and a genetic counselor were interviewed in depth using a semi-structured interview guide. The questionnaire was constructed after reviewing the main literature and meetings with relevant healthcare providers. The interviews were recorded, transcribed verbatim, and content analyzed for categories and subcategories. Participants nurtured many ethical and non-ethical concerns regarding preconception ECS. Among the ethical concerns were the potential for discrimination, medicalization, concerns with prioritization of healthcare resources, and effects on reproductive freedom. The effects of implementation of preconception ECS, its stakeholders, regulations, and motivation are some of non-ethical concerns. These concerns, if not addressed, may affect the uptake and usage of carrier screening within Swedish healthcare system. As this is a qualitative study with a small non-random sample size, the findings cannot be generalized. The participants had little to no working experience with expanded screening panels. Moreover, the interviews were conducted in English, a second language for the participants, which might have limited the expression of their views. However, the authors claim that the findings may be pertinent to similar settings in other Scandinavian countries.

  5. Nurses' Use and Perception of an Information and Communication Technology System for Improving Coordination During Hospital Discharges: A Survey in Swedish Primary Healthcare.

    Science.gov (United States)

    Christiansen, Line; Fagerström, Cecilia; Nilsson, Lina

    2017-07-01

    To facilitate communications between care levels and improve coordination during hospital discharges, there is great potential in using information and communication technology systems, because they can significantly help to deter unnecessary readmissions. However, there is still a lack of knowledge about how often nurses use information and communication technology and the indicators related to its use. The aims of this study were to describe the indicators related to nurses' use of an information and communication technology system for collaboration between care levels and to estimate whether the level of use can be related to nurses' perceptions of the information and communication technology system's contribution to improve coordination during hospital discharges. A quantitative survey of 37 nurses from 11 primary healthcare centers was performed in a county in southern Sweden. The data were analyzed using descriptive and comparative analyses. The results showed that perceptions concerning the information and communication technology system's usability and time consumption differed between nurses who used the system and those who did not. Simultaneously, the nurses were rather unaware of the ability of the information and communication technology system to improve coordination during patient discharges.

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

    Science.gov (United States)

    Rosenälv, Jessica; Lundell, Karl-Henrik

    2012-01-01

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

  7. Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management.

    Science.gov (United States)

    Öberg, Ulrika; Orre, Carl Johan; Isaksson, Ulf; Schimmer, Robyn; Larsson, Håkan; Hörnsten, Åsa

    2017-09-28

    Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self-management for people with chronic conditions, it is important to highlight nurses' experiences. This study is part of a larger project aimed at implementing person-centred interactive self-management support (iSMS) in primary health care. The aim of this study was to describe Swedish primary healthcare nurses' perceptions of using digital eHealth systems and services to support patient self-management. Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis. Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes. The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self-management support as well as giving the primary healthcare nurses adequate resources to support patients' self-management while still maintaining the values associated with person-centred care. © 2017 Nordic College of Caring Science.

  8. Experiences from implementing value-based healthcare at a Swedish University Hospital - an longitudinal interview study.

    Science.gov (United States)

    Nilsson, Kerstin; Bååthe, Fredrik; Andersson, Annette Erichsen; Wikström, Ewa; Sandoff, Mette

    2017-02-28

    Implementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The aim of this study is to explore how representatives of four pilot project teams experienced implementing VBHC in a large Swedish University Hospital over a period of 2 years. The project teams started their work in October 2013. An explorative and qualitative design was used, with interviews as the data collection method. All the participants in the four pilot project teams were individually interviewed three times, with interviews starting in March 2014 and ending in November 2015. All the interviews were transcribed and analyzed using qualitative analysis. Value for the patients was experienced as the fundamental drive for implementing VBHC. However, multiple understandings of what value for patients' means existed in parallel. The teams received guidance from consultants during the first 3 months. There were pros and cons to the consultant's guidance. This period included intensive work identifying outcome measurements based on patients' and professionals' perspectives, with less interest devoted to measuring costs. The implementation process, which both gave and took energy, developed over time and included interventions. In due course it provided insights to the teams about the complexity of healthcare. The necessity of coordination, cooperation and working together inter-departmentally was critical. Healthcare organizations implementing VBHC will benefit from emphasizing value for patients, in line with the intrinsic drive in healthcare, as well as managing the process of implementation on the basis of understanding the complexities of healthcare. Paying attention to the patients' voice is a most important concern and is also a key towards increased engagement from physicians and care providers for improvement work.

  9. Digital Components in Swedish NPP Power Systems

    International Nuclear Information System (INIS)

    Karlsson, Mattias; Eriksson, Tage

    2015-01-01

    Swedish nuclear power plants have over the last 20 years of operation modernised or exchanged several systems and components of the electrical power system. Within these works, new components based on digital technology have been employed in order to realize functionality that was previously achieved by using electro-mechanical or analogue technology. Components and systems such as relay protection, rectifiers, inverters, variable speed drives and diesel-generator sets are today equipped with digital components. Several of the systems and components fulfil functions with a safety-role in the NPP. Recently, however, a number of incidents have occurred which highlight deficiencies in the design or HMI of the equipment, which warrants questions whether there are generic problems with some applications of digital components that needs to be addressed. The use of digital components has presented cost effective solutions, or even the only available solution on the market enabling a modernisation. The vast majority of systems using digital components have been operating without problems and often contribute to improved safety but the challenge of non-detectable, or non-identifiable, failure modes remain. In this paper, the extent to which digital components are used in Swedish NPP power systems will be presented including a description of typical applications. Based on data from maintenance records and fault reports, as well as interviews with designers and maintenance personnel, the main areas where problems have been encountered and where possible risks have been identified will be described. The paper intends to investigate any 'tell-tales' that could give signals of unwanted behaviour. Furthermore, particular benefits experienced by using digital components will be highlighted. The paper will also discuss the safety relevance of these findings and suggest measures to improve safety in the application of digital components in power systems. (authors)

  10. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

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

  11. 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.

  12. The Nigerian, Swedish and Chilean Pension Systems: A ...

    African Journals Online (AJOL)

    The Nigerian, Swedish and Chilean Pension Systems: A Comparative Analysis of Schemes and Reforms. ... Ethiopian Journal of Economics ... While Chile and Nigeria completely moved from a defined benefit system to a defined contribution system, Sweden chose a “hybrid”, a model which has received wide acclaim by ...

  13. Income disparities in healthcare use remain after controlling for healthcare need: evidence from Swedish register data on psoriasis and psoriatic arthritis.

    Science.gov (United States)

    Löfvendahl, Sofia; Jöud, Anna; Petersson, Ingemar F; Theander, Elke; Svensson, Åke; Carlsson, Katarina Steen

    2018-04-01

    We used a southern Swedish cohort of psoriasis (PSO) and psoriatic arthritis (PsA) patients and population-based referents (N = 57,800) to investigate the influence of socioeconomic and demographic factors on the probability of healthcare use and on healthcare costs when controlling for need as measured by PSO/PsA and common additional morbidities such as diabetes, depression and myocardial infarction. People with PSO/PsA were identified by ICD-10 codes in the Skåne Healthcare Register 1998-2007. Resource use and costs for years 2008-2011 were retrieved from the Skåne Healthcare Register and the Swedish Prescribed Drug Register, and socioeconomic data were retrieved from Statistics Sweden. After controlling for PSO/PsA and common additional morbidities, income, and to some extent education, had significant effects on the probability of five types of healthcare use. Overall, income showed a bell-shaped relationship to healthcare costs, with patients in income quintiles 2 and 3 having the highest mean annualized cost irrespective of model specification. Education did not have a significant effect in most specifications. Analyses including interaction effects indicated similarly higher costs across income quintiles in the PSO and PsA subgroups, though these cost differences were lower in magnitude for patients with PSO in quintile 5 and with PsA in quintile 1. In conclusion, our results show persistent socioeconomic disparities in healthcare use among a cohort of chronically ill patients and referents, even after controlling for the presence of PSO/PsA and common additional morbidities. These disparities persist even in a country with general healthcare coverage and low out-of-pocket payments.

  14. Architecture of personal healthcare information system in ubiquitous healthcare

    NARCIS (Netherlands)

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

    2009-01-01

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

  15. Mentally disordered criminal offenders in the Swedish criminal system.

    Science.gov (United States)

    Svennerlind, Christer; Nilsson, Thomas; Kerekes, Nóra; Andiné, Peter; Lagerkvist, Margareta; Forsman, Anders; Anckarsäter, Henrik; Malmgren, Helge

    2010-01-01

    Historically, the Swedish criminal justice system conformed to other Western penal law systems, exempting severely mentally disordered offenders considered to be unaccountable. However, in 1965 Sweden enforced a radical penal law abolishing exceptions based on unaccountability. Mentally disordered offenders have since then been subjected to various forms of sanctions motivated by the offender's need for care and aimed at general prevention. Until 2008, a prison sentence was not allowed for offenders found to have committed a crime under the influence of a severe mental disorder, leaving forensic psychiatric care the most common sanction in this group. Such offenders are nevertheless held criminally responsible, liable for damages, and encumbered with a criminal record. In most cases, such offenders must not be discharged without the approval of an administrative court. Two essentially modern principles may be discerned behind the "Swedish model": first, an attempted abolishment of moral responsibility, omitting concepts such as guilt, accountability, atonement, and retribution, and, second, the integration of psychiatric care into the societal reaction and control systems. The model has been much criticized, and several governmental committees have suggested a re-introduction of a system involving the concept of accountability. This review describes the Swedish special criminal justice provisions on mentally disordered offenders including the legislative changes in 1965 along with current proposals to return to a pre-1965 system, presents current Swedish forensic psychiatric practice and research, and discusses some of the ethical, political, and metaphysical presumptions that underlie the current system. Copyright 2010 Elsevier Ltd. All rights reserved.

  16. 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...

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

    Science.gov (United States)

    Pedroso, Marcelo Caldeira; Malik, Ana Maria

    2012-10-01

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

  18. Swedish spent fuel management systems, facilities and operating experiences

    International Nuclear Information System (INIS)

    Vogt, J.

    1998-01-01

    About 50% of the electricity in Sweden is generated by means of nuclear power from 12 LWR reactors located at four sites and with a total capacity of 10,000 MW. The four utilities have jointly created SKB, the Swedish Nuclear Fuel and Waste Management Company, which has been given the mandate to manage the spent fuel and radioactive waste from its origin at the reactors to the final disposal. SKB has developed a system for the safe handling of all kinds of radioactive waste from the Swedish nuclear power plants. The keystones now in operation of this system are a transport system, a central interim storage facility for spent nuclear fuel (CLAB), a final repository for short-lived, low and intermediate level waste (SFR). The remaining, system components being planned are an encapsulation plant for spent nuclear fuel and a deep repository for encapsulated spent fuel and other long-lived radioactive wastes. (author)

  19. What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management.

    Science.gov (United States)

    Gustavsson, Catharina; Nordqvist, Maria; Bröms, Kristina; Jerdén, Lars; Kallings, Lena V; Wallin, Lars

    2018-03-21

    The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare. Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis. We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling. The study provides knowledge

  20. Healthcare system simulation using Witness

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  1. Strategies for healthcare information systems

    NARCIS (Netherlands)

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

    2001-01-01

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

  2. Political strategies in difficult times - The "backstage" experience of Swedish politicians on formal priority setting in healthcare.

    Science.gov (United States)

    Garpenby, Peter; Nedlund, Ann-Charlotte

    2016-08-01

    This paper contributes to the knowledge on the governing of healthcare in a democratic context in times of austerity. Resource allocation in healthcare is a highly political issue but the political nature of healthcare is not always made clear and the role of politicians is often obscure. The absence of politicians in rationing/disinvestment arrangements is usually explained with blame-shifting arguments; they prefer to delegate "the burden of responsibility" to administrative agencies or professionals. Drawing on a case where Swedish regional politicians involved themselves in setting priorities at a more detailed level than previously, the findings suggest that the subject of "blame avoidance" is more complicated than usually assumed. A qualitative case study was designed, involving semi-structured interviews with 14 regionally elected politicians in one Swedish health authority, conducted in June 2011. The interviews were analysed through a thematic analysis in accordance with the "framework approach" by Ritchie and Lewis. Findings show that an overarching strategy among the politicians was to appear united and to suppress conflict, which served to underpin the vital strategy of bringing the medical profession into the process. A key finding is the importance that politicians, when appearing "backstage", attach to the prevention of blame from the medical profession. This case illustrates that one has to take into account that priority settings requires various types of skills and knowledges - not only technical but also political and social. Another important lesson points toward the need to broaden the political leadership repertoire, as leadership in the case of priority setting is not about politicians being all in or all out. The results suggest that in a priority-setting process it is of importance to have politics on-board at an early stage to secure loyalty to the process, although not necessarily being involved in all details. Copyright © 2016 Elsevier

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

    Science.gov (United States)

    Cassatly, Hannah; Cassatly, Michael

    2015-01-01

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

  4. Influencing Swedish homeowners to adopt district heating system

    Energy Technology Data Exchange (ETDEWEB)

    Mahapatra, Krushna; Gustavsson, Leif [Ecotechnology, Mid Sweden University, Akademigatan 1, 831 25 Oestersund (Sweden)

    2009-02-15

    Improved energy efficiency and greenhouse gas mitigation could be achieved by replacing resistance heaters with district heating system. In 2005, only about 8% of the Swedish detached houses had district heating system. The expansion of such systems largely depends on homeowners' adoption decisions. And, to motivate homeowners to adopt district heating, it is essential to understand their decision-making process. In this context, in June 2005 we carried out a questionnaire survey of about 700 homeowners who lived in the city of Oestersund in houses with resistance heaters (baseline survey). About 84% of the respondents did not intend to install a new heating system. Since then these homeowners were influenced by (a) an investment subsidy by the Swedish government to replace resistance heaters with district heating, a brine/water-based heat pump, or a biomass-based heating system and (b) a marketing campaign by the municipality-owned district heating company. This paper analyses how these two measures influenced about 78% of the homeowners to adopt the district heating system. For this purpose we carried out a follow-up survey of the same homeowners in December 2006 (resurvey). Results showed that the investment subsidy and the marketing campaign created a need among the homeowners to adopt a new heating system. The marketing campaign was successful in motivating them to adopt the district heating system. The marketing strategy by the district heating company corresponds to the results obtained in the baseline survey. (author)

  5. Influencing Swedish homeowners to adopt district heating system

    Energy Technology Data Exchange (ETDEWEB)

    Mahapatra, Krushna; Gustavsson, Leif [Ecotechnology, Mid Sweden University, Akademigatan 1, 831 25 Oestersund (Sweden)

    2009-02-15

    Improved energy efficiency and greenhouse gas mitigation could be achieved by replacing resistance heaters with district heating system. In 2005, only about 8% of the Swedish detached houses had district heating system. The expansion of such systems largely depends on homeowners' adoption decisions. And, to motivate homeowners to adopt district heating, it is essential to understand their decision-making process. In this context, in June 2005 we carried out a questionnaire survey of about 700 homeowners who lived in the city of Oestersund in houses with resistance heaters (baseline survey). About 84% of the respondents did not intend to install a new heating system. Since then these homeowners were influenced by (a) an investment subsidy by the Swedish government to replace resistance heaters with district heating, a brine/water-based heat pump, or a biomass-based heating system and (b) a marketing campaign by the municipality-owned district heating company. This paper analyses how these two measures influenced about 78% of the homeowners to adopt the district heating system. For this purpose we carried out a follow-up survey of the same homeowners in December 2006 (resurvey). Results showed that the investment subsidy and the marketing campaign created a need among the homeowners to adopt a new heating system. The marketing campaign was successful in motivating them to adopt the district heating system. The marketing strategy by the district heating company corresponds to the results obtained in the baseline survey. (author)

  6. Influencing Swedish homeowners to adopt district heating system

    International Nuclear Information System (INIS)

    Mahapatra, Krushna; Gustavsson, Leif

    2009-01-01

    Improved energy efficiency and greenhouse gas mitigation could be achieved by replacing resistance heaters with district heating system. In 2005, only about 8% of the Swedish detached houses had district heating system. The expansion of such systems largely depends on homeowners' adoption decisions. And, to motivate homeowners to adopt district heating, it is essential to understand their decision-making process. In this context, in June 2005 we carried out a questionnaire survey of about 700 homeowners who lived in the city of Ostersund in houses with resistance heaters (baseline survey). About 84% of the respondents did not intend to install a new heating system. Since then these homeowners were influenced by (a) an investment subsidy by the Swedish government to replace resistance heaters with district heating, a brine/water-based heat pump, or a biomass-based heating system and (b) a marketing campaign by the municipality-owned district heating company. This paper analyses how these two measures influenced about 78% of the homeowners to adopt the district heating system. For this purpose we carried out a follow-up survey of the same homeowners in December 2006 (resurvey). Results showed that the investment subsidy and the marketing campaign created a need among the homeowners to adopt a new heating system. The marketing campaign was successful in motivating them to adopt the district heating system. The marketing strategy by the district heating company corresponds to the results obtained in the baseline survey

  7. Swedish Homeowners' Attitude towards Water-Based Heating Systems

    Energy Technology Data Exchange (ETDEWEB)

    Gustavsson, L; Mahapatra, K [Mid Sweden Univ., Ecotechnology, SE-831 25 Oestersund (Sweden)

    2008-10-15

    In 2004 and 2007, we conducted questionnaire surveys of 1,500 randomly selected Swedish homeowners of detached houses to understand their attitude towards adopting an innovative heating system (IHS). The results showed that there was no substantial change in homeowners' attitude towards IHSs. More than 80% of the respondents did not intend to install a new heating system. Economic aspects and functional reliability were the most important factors in the respondents' choice of heating system while environmental factors were of less importance. Installers were the most frequently consulted source of information on heating systems. Respondents perceived the relative advantage of pellet boilers over oil or electricity-based heating systems, but bedrock heat pump system was ranked higher than pellet heating system in every aspect except for investment cost. Pellet heating system has advantages with respect to investment cost. District heating system was considered as most functionally reliable and automatic. Keywords: Heat sector, socio-economic aspects, market implementation

  8. Technical description of the Swedish natural gas distribution system

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, Ronny [KM Miljoeteknik AB (Sweden)

    1997-06-01

    This description of the Swedish distribution network has been produced to provide information for distribution companies, trade organisations, etc., who have an interest in getting a clear understanding of the technical design and standards, technical directives, etc., which have served as guidance in the development. The technical description covers the piping system from a measuring and regulating station (MR station) up to the consumer`s substation, however, only sections with a maximum operating pressure of 4 bar. By way of introduction, the description contains introductory information on supply channels, consumption patterns and the principal design of the high pressure network in Sweden 10 refs, 10 figs, 1 tab

  9. Margins in Swedish district heating systems; Marginaler i Fjaerrvaermesystem

    Energy Technology Data Exchange (ETDEWEB)

    Selinder, Patrik; Zinko, Heimo [ZW Energiteknik AB, Nykoeping (Sweden)

    2003-03-01

    It can be assumed on good reasons that the Swedish district heating nets are designed with relatively large margins concerning the transportable power. This is done historically to be able to transport the necessary power that can be called for on the coldest winter days but which occur rarely and also due to the former (until 2001) applied recommendations for the dimensioning of hot water flows. The aim of this project was to investigate the possibilities of reducing the connecting power to customers, both from a technical and from the customer point of view. The heating system of a building in Sweden is normally dimensioned according to a certain outdoor air temperature (DUT in Swedish). According to the Swedish Building Code, DUT20 is defined for a given location in such a way that if the heating system is designed for this temperature, the room temperature is allowed to decrease by 3 deg C in the average once in 20 years. That means that for economical reasons, a power deficiency is accounted for in the case of strong cold. The value of DUT is depending on the thermal inertia of the building. Buildings with high thermal inertia can have a higher DUT and vice versa. A reduced system size can in principle mean smaller size of pipes and consumer substations and more power available for additional customers to be connected. In principle, that means a more profitable district heating operation. Besides costs, another problem with oversized capacities are possible operational problems due to slow dynamic system responses, for instance at restarting occasions after a pump stop. A smaller valve size will result in a better system dynamic and may result in a more compliant system operation and increased delivery quality. By choosing just right DUT for every building and abandoning safety margins, it is shown in the report that the connecting power can be reduced in especially medium light to heavy buildings with larger time constants. However, this also means that the

  10. 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.

  11. 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

  12. 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.

  13. The Swedish sea transportation system for safety reasons

    International Nuclear Information System (INIS)

    Dybeck, P.

    1993-01-01

    Sweden began to design and build a sea transportation system. The ship M/S SIGYN is specially designed for transports of radioactive waste. It is a combined roll-on/roll-off and lift-on/lift-off vessel. It is built for world wide operation and with the highest requirements of two independent classification societies, Lloyds Register of Shipping and Bureau Veritas. The ship is also designed to conform to the Swedish/Finish ice class 1A. The transport cask for spent fuel, TN 17/2, and core component TN 17-CC are designed as type (B) casks and manufactured to comply with the IAEA Regulations for the Safe Transport of Radioactive Materials, 1973. (J.P.N.)

  14. Infrastructuring Multicultural Healthcare Information Systems

    DEFF Research Database (Denmark)

    Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik

    2017-01-01

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

  15. 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...

  16. Fiery Spirits in the context of institutional entrepreneurship in Swedish healthcare.

    Science.gov (United States)

    Eriksson, Nomie; Ujvari, Sandor

    2015-01-01

    Clinical governance and leadership concepts can lead to more or less successful implementations of new clinical practice. The purpose of this paper is to examine how Fiery Spirits, as institutional entrepreneurs can, working in a team, implement sustained change in hospital clinical practice. This paper describes two case studies, conducted at two Swedish hospitals over a period of two years, in which changes in clinical practice were implemented. In both cases, key-actors, termed Fiery Spirits, played critical roles in these changes. The authors use a qualitative approach and take an intra-organizational perspective with semi-structured in-depth interviews and document analysis. The new clinical practices were successfully implemented with a considerable influence of the Fiery Spirits who played a pivotal role in the change efforts. The Fiery Spirits persuasively, based on their structural and normative legitimacy and the adoption of learning processes, advocated, and supported change. Fiery Spirits, given flexibility and opportunity, can be powerful forces for change outside the trajectory of management-inspired and management-directed change. Team members, when inspired and encouraged by Fiery Spirits, are less resistant to change and more willing to test new clinical practices. The paper complements literature on how the Fiery Spirit concept aligns with concepts of clinical governance and leadership and how change can be achieved. Additionally, the findings show the effects of legitimacy and learning processes on change in clinical practice.

  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. 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...

  19. Parents' experiences of parental groups in Swedish child health-care: Do they get what they want?

    Science.gov (United States)

    Lefèvre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger

    2016-03-01

    Almost all parents in Sweden are invited to parental groups organized by the child health service (CHS) during their child's first year, but only 40% chose to attend. The aim of this study was to describe parents' experiences of participating in these parental groups. A total of 143 parents from 71 different parental groups at 27 child health-care (CHC) centres in one Swedish county completed an online questionnaire. A majority of the parents found the parental groups to be meaningful and more than 60% met someone in the group who they socialized with outside the meetings. Parents wanted a greater focus on child-related community information, existential questions, relationships and parenting in general. Group leadership seems to be of significance to how parents in a group connect and whether the parental role is affected. Making CHC nurses more aware of the topics parents desire could help them meet parents' needs. Education and training in group dynamics and group leadership could be of value in further improving the high-quality service CHC nurses already offer parents. More knowledge is needed about what would attract those parents who do not participate. © The Author(s) 2014.

  20. 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

  1. 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.

  2. Infrastructuring Multicultural Healthcare Information Systems.

    Science.gov (United States)

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

    2017-01-01

    This paper stresses the need for more research in the field of Participatory Design (PD) and in particular into how to design Health Information Technology (HIT) together with care providers and -receivers in multicultural settings. We contribute to this research by describing a case study, the 'Health-Cultures' project, in which we designed HIT for the context of home care of older people with a migration background. The Health-Cultures project is located in the city of Genk, Belgium, which is known for its multicultural population, formed by three historical migration waves of people coming to work in the nowadays closed coal mines. Via a PD approach, we studied existing means of dialogue and designed HIT that both care receivers and care providers in Genk can use in their daily exchanges between cultures in home care contexts. In discussing relevant literature as well as the results of this study, we point to the need and the ways of taking spatio-historical aspects of a specific healthcare situation into account in the PD of HIT to support multicultural perspectives on healthcare.

  3. Healthcare resource use, comorbidity, treatment and clinical outcomes for patients with primary intracranial tumors: a Swedish population-based register study.

    Science.gov (United States)

    Bergqvist, Jenny; Iderberg, Hanna; Mesterton, Johan; Bengtsson, Nils; Wettermark, Björn; Henriksson, Roger

    2017-03-01

    Primary intracranial tumors are relatively uncommon and heterogeneous, which make them challenging to study. We coupled data from unique Swedish population-based registries in order to deeper analyze the most common intracranical tumor types. Patient characteristics (e.g. comorbidities), care process measures like adherence to national guidelines, healthcare resource use and clinical outcome was evaluated. A register-based study including several population-based registries for all patients living in Stockholm-Gotland, diagnosed with primary intracranial tumor between 2001 and 2013 was performed. Patient characteristics were captured and investigated in relation to survival, healthcare resource use (inpatient-, outpatient- and primary care) and treatment process. High-grade glioma and meningioma were the most common tumor types and most patients (76%) were above the age of 40 in the patient population (n = 3664). Older age, comorbidity (Elixhauser comorbidity index) and type of tumor (high-grade glioma) were associated with lower survival rate and increased use of healthcare resources, analyzed for patients living in Stockholm (n = 3031). The analyses of healthcare use and survival showed no differences between males and females, when stratifying by tumor types. Healthcare processes were not always consistent with existing national treatment recommendations for patients with high-grade gliomas (n = 474) with regard to specified lead times, analyzed in the Swedish Brain Tumor Registry, as also observed at the national level. Age, comorbidity and high-grade gliomas, but not sex, were associated with decreased survival and increased use of healthcare resources. Fewer patients than aimed for in national guidelines received care according to specified lead times. The analysis of comprehensive population-based register data can be used to improve future care processes and outcomes.

  4. The Nigerian, Swedish and Chilean Pension Systems: A ...

    African Journals Online (AJOL)

    preferred customer

    the concern for the long-term financial viability of existing government operated pension ... Thus, this study comparatively evaluates the Nigerian, Swedish and Chilean pension ... Keywords: Demographic crisis, Pension reform, Public policy .... care which employers owe their employees on retirement or in case of death.

  5. Managers' perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare

    Directory of Open Access Journals (Sweden)

    de Rijk Angelique

    2010-09-01

    Full Text Available Abstract Background This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Methods Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs in Sweden were subjected to qualitative analysis. Results The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1 they have high status and expertise; 2 they lack knowledge of the system; 3 they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Conclusions Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others in relation to the physician role. Further research is needed to elucidate how managers in healthcare

  6. Managers' perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare.

    Science.gov (United States)

    von Knorring, Mia; de Rijk, Angelique; Alexanderson, Kristina

    2010-09-17

    This study focused on the manager role in the manager-physician relationship, considered from the manager perspective. The aim was to understand how top executives in Swedish healthcare regard management of physicians in their organisations, and what this implies for the manager role in relation to the medical profession. Abbott's theory of professional jurisdiction was used to inform thinking about managerial control and legitimacy in relation to physicians. Data from semi-structured individual interviews with 18 of the 20 county council chief executive officers (CEOs) in Sweden were subjected to qualitative analysis. The results show that, when asked about their views on management of physicians, the CEOs talked about "how physicians are" rather than describing their own or their subordinate managers' managerial behaviour or strategies. Three types of descriptions of physicians were identified: 1) they have high status and expertise; 2) they lack knowledge of the system; 3) they do what they want in the organisation. The CEOs seldom reported that general management strategies were used to manage physicians. Instead, they described four types of physician-specific management strategies that were used in their organisations: organisational separation of physicians; "nagging and arguing"; compensations; relying on the physician role. These strategies seemed to reflect pragmatic behaviour on behalf of the managers that helped them to maintain control over physicians in daily work. However, in a longer perspective, they seemed to decrease the legitimacy of the manager role and also contribute to weakening of that role in the organisation. Many CEOs seemed to regard the manager role in their organisations as weak and described difficulties in both taking and defining that role (for themselves or others) in relation to the physician role. Further research is needed to elucidate how managers in healthcare organisations assume the manager role in relation to the medical

  7. The orthopaedist's role in healthcare system governance.

    Science.gov (United States)

    Probe, Robert A

    2013-06-01

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

  8. The Swedish system for funding of nuclear waste management

    International Nuclear Information System (INIS)

    Hedman, Tommy; Westerlind, Magnus

    2003-01-01

    Nuclear activities in Sweden goes back to early 1950's. Research and development on spent fuel disposal in Sweden started in earnest with the report of the AKA-commission 1976, which outlined a complete system for the management of spent fuel and associated waste, including how to handle the costs. Components of the system, mentioned in the AKA-report, such as a sea transportation (MS Sigyn), a central spent fuel storage facility (CLAB) and a final repository for operational waste (SFR) have since been constructed and taken in operation. The research and planning for the additional facilities needed for a complete system is in an advanced stage. A nuclear waste fund has also been created, based on a special fee on nuclear power production. During the 1970's the nuclear power utilities established their own internal funds for future waste management expenses. These funds were transferred to the government-run financing system established in 1981 when the Swedish parliament passed the Act on the Financing of Future Expenses for Spent Nuclear Fuel etc. The fees to be paid into the Fund are to be based on the assumption that each reactor generates electricity for 25 years. These fees, plus the interest on the money already deposited in the Fund, must meet all expenses for handling spent fuel, dismantling facilities and for dealing with radioactive decommissioning waste. A guarantee shall compensate for the eventuality of a nuclear power plant being closed before the end of the 25-year earning period. The type of guarantee must be available until all nuclear waste has been placed in a repository and must cover contingencies for the waste programme. This guarantee will be used if expenses for future nuclear waste management become higher than expected, if these expenses have to be met earlier than expected, or if the actual amount in the Fund is lower than was estimated. The process of yearly cost calculations, review and determination of fees and guarantees is well

  9. Army Healthcare Enterprise Management System

    National Research Council Canada - National Science Library

    2001-01-01

    ... to buy the Enterprise Management System. The Information Technology Business Center provides information technology services to Fort Sam Houston tenants which include the Army Medical Command and the Army Medical Department Center and School...

  10. Activity System Theory Approach to Healthcare Information System

    OpenAIRE

    Bai, Guohua

    2004-01-01

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

  11. Systems healthcare: a holistic paradigm for tomorrow.

    Science.gov (United States)

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

    2017-12-19

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

  12. Development, implementation, and experiences of the Swedish spent fuel and waste sea transportation system

    International Nuclear Information System (INIS)

    Gustafsson, B.; Dybeck, P.; Pettersson, S.

    1989-01-01

    In Sweden, electrical production from the first commercial nuclear plant commenced in 1972, i.e. 17 years ago. There are now 12 nuclear reactors in operation, the last two were connected to the grid in fall 1985. These 12 reactors produced about 50% of the present electrical demand in Sweden. The remaining 50% are mainly covered by hydro power stations. The operating record for the Swedish reactors has generally been very good. Nevertheles, the Swedish parliament has taken a decision, that nuclear power shall be phased out from the Swedish system not later than the year 2010. Many of them - to use a mild expression-question the wisdom of this decision. The efforts in the waste management area will, however, be given a continued high priority. The primary responsibility for the management of nuclear waste lies with the waste producer. In order to achieve a good coordination and an effective management the four Swedish nuclear power utilities have delegated these responsibilities to the jointly owned Swedish Nuclear Fuel and Waste Management Co., SKB. This means that SKB is responsible for measures required for the implementation of the national nuclear waste management program such as planning, design, construction and operation of waste facilities including the necessary R and D work. The responsibility of the nuclear power utilities also includes the financing of the waste management program. A special funding system, controlled by the authorities, has been established for this purpose

  13. Design of alarm systems in Swedish nuclear power plants

    International Nuclear Information System (INIS)

    Thunberg, Anna; Osvalder, Anna-Lisa

    2008-04-01

    Research within the area of improving alarm system design and performance has mainly focused on new alarm systems. However, smaller modernisations of legacy systems are more common in the Swedish nuclear industry than design of totally new systems. This imposes problems when the new system should function together with the old system. This project deals with the special concerns raised by modernisation projects. The objective of the project has been to increase the understanding of the relationship between the operator's performance and the design of the alarm system. Of major concern has been to consider the cognitive abilities of the operator, different operator roles and work situations, and varying need of information. The aim of the project has been to complement existing alarm design guidance and to develop user-centred alarm design concepts. Different case studies have been performed in several industry sectors (nuclear, oil refining, pulp and paper, aviation and medical care) to identify best practice. Several empirical studies have been performed within the nuclear area to investigate the operator's need of information, performance and workload in different operating modes. The aspect of teamwork has also been considered. The analyses show that the operator has different roles in different work situations which affect both the type of information needed and how the information is processed. In full power operation, the interaction between the operator and the alarm system is driven by internal factors and the operator tries to maintain high situation awareness by actively searching for information. The operator wants to optimise the process and need detailed information with possibilities to follow-up and get historical data. In disturbance management, the operator is more dependent on external information presented by the alarm system. The new compilation of alarm guidance is based on the operator's varying needs in different working situations and is

  14. Ensuring healthcare system integrity with blockchain

    OpenAIRE

    I. L?hmus

    2016-01-01

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

  15. Flexible solution for interoperable cloud healthcare systems.

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

    Juhnke, Christin; Mühlbacher, Axel C

    2013-01-01

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

  17. Dynamic modelling of nitrous oxide emissions from three Swedish sludge liquor treatment systems

    DEFF Research Database (Denmark)

    Lindblom, E.; Arnell, M.; Flores-Alsina, X.

    2016-01-01

    The objective of this paper is to model the dynamics and validate the results of nitrous oxide (N2O)emissions from three Swedish nitrifying/denitrifying, nitritation and anammox systems treating real anaerobic digester sludge liquor. The Activated Sludge Model No. 1 is extended to describe N2O...

  18. Swedish Technology Teachers' Views on Assessing Student Understandings of Technological Systems

    Science.gov (United States)

    Schooner, Patrick; Klasander, Claes; Hallström, Jonas

    2018-01-01

    Technology education is a new school subject in comparison with other subjects within the Swedish compulsory school system. Research in technology education shows that technology teachers lack experience of and support for assessment in comparison with the long-term experiences that other teachers use in their subjects. This becomes especially…

  19. The Effects of Swedish Knife Model on Students' Understanding of the Digestive System

    Science.gov (United States)

    Cerrah Ozsevgec, Lale; Artun, Huseyin; Unal, Melike

    2012-01-01

    This study was designed to examine the effect of Swedish Knife Model on students' understanding of digestive system. A simple experimental design (pretest-treatment-posttest) was used in the study and internal comparison of the results of the one group was made. The sample consisted of 40 7th grade Turkish students whose ages range from 13 to 15.…

  20. Service models for remote healthcare monitoring systems.

    Science.gov (United States)

    Moorman, Bridget A

    2010-01-01

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

  1. Resolving the dilemma between equality and liberty: the Swedish political system

    Directory of Open Access Journals (Sweden)

    Nathalie BLANC-NOEL

    2013-06-01

    Full Text Available Swedish democracy ranks very high in international democracy indexes. It fascinates political scientists from all over the world because it seems to have resolved a fundamental political dilemma: the choice between equality and liberty, without the historical inconvenient of regimes which favoured too much equality - but killed liberty, or regimes which favoured liberty - but failed to make citizens equal... The "'egalitarian pluralism" practiced in Swedish political system is rooted in a specific political culture. This culture has opted for popular sovereignty and comes from the ancient peasant society. Lutheran values and the absence of feudalism paved the way to the search for equality and the edification of a strong State. In the 20th century, the Social-democrats endorsed the traditional Swedish values and prolonged them in the so-called Swedish model, with social policies allowing more equality along with more individual autonomy. Nowadays, the model is evolving, coping with globalization, and the definition of equality is under discussion.

  2. Healthcare system information at language schools for newly arrived immigrants

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  3. 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.

  4. 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.

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

    Science.gov (United States)

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

    2016-03-11

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

  6. Yoga Therapy in the German Healthcare System.

    Science.gov (United States)

    Cramer, Holger

    2018-05-09

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

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

    DEFF Research Database (Denmark)

    Patou, François; Maier, Anja

    2017-01-01

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

  8. 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.

  9. HIV-positive migrants’ encounters with the Swedish health care system

    DEFF Research Database (Denmark)

    Mehdiyar, Manijeh; Andersson, Rune; Hjelm, Katarina

    2016-01-01

    of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated......Background: There is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients....... Objective: The aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden. Design: This is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years. Results: ‘A hybrid...

  10. System integrational and migrational concepts and methods within healthcare

    DEFF Research Database (Denmark)

    Endsleff, F; Loubjerg, P

    1997-01-01

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

  11. TRIUMF - The Swedish data base system for radioactive waste in SFR

    International Nuclear Information System (INIS)

    Skogsberg, Marie; Andersson, Per-Anders

    2006-01-01

    All short lived LLW/ILW from the operation and maintenance of all Swedish Nuclear Power Plants are disposed in SFR, the Swedish final repository for radioactive operational waste. It is important to save all the information about radioactive waste that is needed now and in the future. To be secure that, we have developed a database system in Sweden called Triumf, consisting information about all the waste packages that are disposed in SFR. The waste producers register data concerning individual waste package during production. Before transport to SFR a data file with all information about the individual waste packages is transferred to Triumf. When transferred, the data are checked against accepted limitations before the waste can be loaded on the ship for transport to SFR. After disposal at SFR the deposition location in the repository is added to the database for each waste package. (author)

  12. Prescribing during pregnancy and lactation with reference to the Swedish classification system

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Sørensen, Henrik Toft; Berg, Lolkje de Jong-van den

    1999-01-01

    retail pharmacies, made it possible to identify prescriptions by individual use. All 34,334 prescriptions were set against the Swedish classification of risk of drug use in pregnancy and lactation. RESULTS: During pregnancy, safe (group A), potentially harmful (group B3, C, and D), and non...... and II), drugs with possible harmful neonatal effects (group III), and non-classifiable drugs accounted for 43.5%, 4.8%, and 35.8% of the prescriptions, respectively. CONCLUSION: According to the Swedish classification system, we found that during pregnancy and lactation a high proportion of Danish women...... were exposed to one or more drugs in high risk groups; furthermore, knowledge regarding their safety for the fetus and neonate was limited for a large proportion of the prescriptions. Current evidence about long-term effects of prenatal exposure stresses the need for long-term follow-up of health...

  13. The transformation of the Swedish political party system in the late 20th/early 21st century

    Directory of Open Access Journals (Sweden)

    Ryabichenko Arkady

    2013-09-01

    Full Text Available This article studies the process of transformation of the Swedish political party system in the 1980s. The study aims to develop a typology of the Swedish political party system before and after the transformation processes commenced. The article identifies the key prerequisites for such transformation: the crisis of social democracy and an increase in the nationalist attitudes in the society caused by the negative repercussions of the system of integration of migrants into the society based on the multiculturalism principles. The interethnic tension manifested itself in the wide support for the Swedish Democrats Party in the 2010 parliamentary election. From a political party system dominated by social democrats, the Swedish political party system turned into one with two leading parties – the centre-left Swedish Social Democratic Labour Party and the centre-right Moderate Party. The Swedish Democrats position themselves as an alternative to the two party blocs headed by the dominating parties (the Alliance and the Red-Green. The study employs an interdisciplinary approach in the framework of science synthesis. Its results can be of practical significance for politicians, social activists, and academicians.

  14. 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.

  15. 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.

  16. With or without the group: Swedish midwives' and child healthcare nurses' experiences in leading parent education groups.

    Science.gov (United States)

    Forslund Frykedal, Karin; Rosander, Michael; Berlin, Anita; Barimani, Mia

    2016-12-01

    The aim of the study was to describe and to understand midwives' and child healthcare nurses' experiences of working with parent education groups through their descriptions of the role and what they find rewarding and challenging in that work. Data were collected through three open-ended questions from a web survey: 'How do you refer to your role when working in parent education?', 'What is the biggest challenge or difficulty for you when working in parent education?' and 'What is most rewarding when working in parent education?' The answers were analysed by using qualitative content analysis and correlation analysis. The results show that the midwives and child healthcare nurses either included or excluded the group when describing their role as leaders and their influence on parents. The same applies to what they found rewarding and what was difficult and challenging for them in working with the groups. Primarily, the leaders who excluded the group expressed a lack of competence on a professional level in managing groups and using the right teaching methods to process the knowledge content. One important question to deal with is how to best support midwives and nurses in child healthcare to be prepared for working with parent education groups. One obvious thing is to provide specialized training in an educational sense. An important aspect could also be providing supervision, individually or in groups. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Performance Measurement Systems in Swedish Health Care Services

    OpenAIRE

    Kollberg, Beata

    2007-01-01

    In the quality management literature, measurements are attributed great importance in improving products and processes. Systems for performance measurement assessing financial and non-financial measurements were developed in the late 1980s and early 1990s. The research on performance measurement systems has mainly been focused on the design of different performance measurement systems. Many authors are occupied with the study of the constructs of measures and developing prescriptive models of...

  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. Consumer response to a report card comparing healthcare systems.

    Science.gov (United States)

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

    2002-06-01

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

  20. An evolving systems-based methodology for healthcare planning.

    Science.gov (United States)

    Warwick, Jon; Bell, Gary

    2007-01-01

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

  1. Swedish Energy Research 2009

    Energy Technology Data Exchange (ETDEWEB)

    2009-07-01

    Swedish Energy Research 2009 provides a brief, easily accessible overview of the Swedish energy research programme. The aims of the programme are to create knowledge and skills, as needed in order to commercialise the results and contribute to development of the energy system. Much of the work is carried out through about 40 research programmes in six thematic areas: energy system analysis, the building as an energy system, the transport sector, energy-intensive industries, biomass in energy systems and the power system. Swedish Energy Research 2009 describes the overall direction of research, with examples of current research, and results to date within various thematic areas and highlights

  2. Efficiency vs Effectiveness: a Benchmarking Study on European Healthcare Systems

    Directory of Open Access Journals (Sweden)

    Corrado lo Storto

    2017-10-01

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

  3. Measuring healthcare productivity - from unit to system level.

    Science.gov (United States)

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

    2016-04-18

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

  4. Dynamic modelling of nitrous oxide emissions from three Swedish sludge liquor treatment systems

    DEFF Research Database (Denmark)

    Lindblom, E.; Arnell, M.; Flores-Alsina, X.

    2014-01-01

    The objective of this paper is to model the dynamics and validate the results of nitrous oxide (N2O)emissions from three Swedish nitrifying/denitrifying, nitritation and anammox systems treating real anaerobic digester sludge liquor. The Activated Sludge Model No. 1 is extended to describe N2O...... production by both heterotrophic and autotrophic denitrification. In addition, mass transfer equations are implemented to characterize the dynamics of N2O in the water and the gas phases.The biochemical model is simulated and validated for two hydraulic patterns: (1) a sequencing batch reactor; and, (2...

  5. Coherence in the Danish Healthcare System

    DEFF Research Database (Denmark)

    Frederiksen, Jesper; Olivares Bøgeskov, Benjamin Miguel

    2017-01-01

    In this article, we investigate ‘coherence in healthcare’ as a strategy of welfare policy. We conduct our investigation within the theoretical and methodological framework of Scandinavian praxeology, and we construct our empirical data from Danish administrative documents. The tools and terms...... 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...... the stated aim in policy is to improve coherence in healthcare for the benefit of the patients, various ambiguities within the institutions producing policy tend to maintain a certain order rather than introducing changes. Furthermore, we discuss how this section of the welfare state, examined in relation...

  6. 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.

  7. 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 ...

  8. 'Organisation of contraceptive care' and attitudes among healthcare providers in two Swedish cities with different socio-demographic profiles.

    Science.gov (United States)

    Palmquist, Moa; Brynhildsen, Jan; Falk, Gabriella

    2015-06-01

    OBJECTIVE To compare contraceptive services provided by family planning clinics in Linköping and Norrköping in Östergötland County, Sweden. The two cities are of similar size but have different socio-demographic profiles. The abortion rate in Linköping (15.3 per 1000) is substantially lower than in Norrköping (21.1 per 1000). METHODS The study was performed in two steps. First, the clinics providing contraceptive services in the two cities were studied using ten pre-defined quality indicators. Thereafter, 11 healthcare providers were interviewed: six in Linköping and five in Norrköping. The interviews were analysed using qualitative content analysis. RESULTS No differences were found in the organisation of contraceptive care in the two cities. Neither city met the criteria for five of the ten quality indicators. The analysis of the interviews generated four themes: 'Guidelines and electronic record template', 'Criteria for good contraceptive counselling', 'Availability of contraception', and 'Sexual health'. The interviews revealed that the clinical leadership in Norrköping was insufficient. CONCLUSION Clinics in the two cities are organised in the same way so that differences in abortion rates cannot be related to differences in organisation. The reasons for the differences in abortion rates in the two cities have yet to be determined.

  9. 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

  10. Building a Healthcare System's Innovation Program.

    Science.gov (United States)

    Conger, Michelle D

    2016-01-01

    OSF HealthCare, based in Peoria, Illinois, has developed an innovative strategy to adapt to the changes and forces disrupting the healthcare environment. This strategy evolved organically from the performance improvement efforts we began more than 15 years ago, as well as from the lessons we learned from years of research into the innovative practices and platforms of other healthcare institutions and of companies in other industries. More important, the strategy reflects our mission "to serve persons with the greatest care and love."The OSF innovation model has three components: internal innovations, partnering with external entities, and validating innovations through simulation. OSF has an ongoing and comprehensive commitment to innovation. Examples include our initiative to transform our model of care in primary care clinics by expanding access, reducing costs, and increasing efficiency; our partnerships with outside entities to find revolutionary solutions and products in which we can invest; and our establishment of a world-class simulation and education center.OSF HealthCare could not do any of this if it lacked the support of its people. To that end, we continue to work on embedding a culture of innovation across all of our facilities. Ours is a culture in which everyone is encouraged to voice creative ideas and no one is afraid to fail-all for the betterment of our organization and the patients we serve.

  11. Environmental impact assessment of the Swedish high-level radioactive waste disposal system - examples of likely considerations

    International Nuclear Information System (INIS)

    1994-01-01

    Sweden is investigating the feasibility of establishing a high-level radioactive waste (HLW) disposal system consisting of three components as follows: (1) Encapsulation facility, (2) system for transporting waste and (3) geologic repository. Swedish law requires that an Environmental Impact Assessment (EIA) be written for any planned action expected to have a significant impact on the environment. Before embarking on construction and operation of a HLW disposal system, the Swedish government will evaluate the expected environmental impacts to assure that the Swedish people and environmental will not be unduly affected by the disposal system. The EIA process requires that reasonable alternatives to the proposed action, including the 'zero' or 'no action' alternative, be considered so that the final approved plan for disposal will have undergone scrutiny and comparison of alternatives to arrive at a plan which is the best achievable given reasonable physical and monetary constraints. This report has been prepared by the Center for Nuclear Waste Regulatory Analyses (CNWRA) for use by the Swedish Radiation Protection Institute (SSI). The purpose of this report is to establish a document which outlines the types of information which would be in an EIA for a three part disposal system like that envisioned by the Swedish Nuclear Fuel and Waste Management Company (SKB) for the disposal of Sweden's HLW. Technical information that would normally be included in an EIA is outlined in this document. The SSI's primary interest is in radiological impacts. However, for the sake of completeness and also to evaluate all environmental impacts in a single document, non-radiological impacts are also included. Swedish authorities other than the SSI may have interest in the non-radiological parts of the document. 26 refs

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

    Science.gov (United States)

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

    1997-01-01

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

  13. Swedish projects

    International Nuclear Information System (INIS)

    Thunell, J.

    1992-01-01

    A description is given of research activities, concerning heating systems, which were carried out in Sweden during 1991. The main subject areas dealt with under the gas technology group within the area of heating systems were catalytic combustion, polyethylene materials, and gas applications within the paper and pulp industries. A list is given of the titles of project reports published during 1991 and of those begun during that year. Under the Swedish Centre for Gas Technology (SGC), the main areas of research regarding gas applications were polyethylene materials, industrial applications and the reduction of pollutant emissions. A detailed list is given of research projects which were in progress or proposed by March 1992 under the heating system gas technology research group in Sweden. This list also presents the aims and descriptions of the methods, etc. (AB)

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

    Science.gov (United States)

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

    2015-09-01

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

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

    African Journals Online (AJOL)

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

  16. Ethnic Swedish parents' experiences of minority ethnic nurses' cultural competence in Swedish paediatric care.

    Science.gov (United States)

    Tavallali, Azar G; Kabir, Zarina Nahar; Jirwe, Maria

    2014-06-01

    Sweden has a population of a little more than 9.4 million. The rapid growth of immigration in Sweden has resulted in an increased number of minority ethnic patients and minority ethnic nurses in the Swedish healthcare system. This also applies to paediatric care. The purpose of this study was to explore how parents with ethnic Swedish backgrounds experience minority ethnic nurses' cultural competence and the care the nurses provide in a Swedish paediatric care context. This exploratory qualitative study is of 14 parents with an ethnic Swedish background whose child was in a ward at a children's hospital in Stockholm County Council. Data were collected using semi-structured interviews to identify parents' perceptions and experiences of minority ethnic nurses' cultural competence. The interviews were analysed by qualitative content analysis. The analyses of the interviews led to four main categories: influence of nurses' ethnicity; significance of cross-cultural communication; cross-cultural skills; and the importance of nursing education. Nurses' ethnicity did not have much impact on parents' satisfaction with their child's care. The parents attached importance to nurses' language skills and to their adaptation and awareness of Swedish culture. They also attached weight to nurses' professional knowledge and personal attributes. The role of nursing education to increase nurses' cultural awareness was highlighted too. © 2013 Nordic College of Caring Science.

  17. 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.

  18. Development of Wearable Systems for Ubiquitous Healthcare Service Provisioning

    OpenAIRE

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

    2013-01-01

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

  19. Some perspectives on affordable healthcare systems in China.

    Science.gov (United States)

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

    2007-01-01

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

  20. Design principles for achieving integrated healthcare information systems.

    Science.gov (United States)

    Jensen, Tina Blegind

    2013-03-01

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

  1. A review of the Australian healthcare system: A policy perspective

    Science.gov (United States)

    Sambasivan, Murali

    2018-01-01

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

  2. The ability of criminal law to produce gender equality: judicial discourses in the Swedish criminal legal system.

    Science.gov (United States)

    Burman, Monica

    2010-02-01

    The main aim of the Swedish Women's Peace reform in 1998 was to enhance criminal legal protection for women exposed to violence in heterosexual relationships and to promote gender equality. However, these ambitions risk being contravened in a masculinist criminal legal system. One problem concerns how the victim is constructed in criminal legal cases. The author argues that moral balancing and discourses of responsibility and guilt in Swedish cases constrain the agency possible for women and suggest that a more comprehensive policy in Sweden must be developed to include violent men, their agency, and their responsibility for the violence.

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

    CSIR Research Space (South Africa)

    Adebesin, F

    2014-05-01

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

  4. 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.

  5. Process-driven selection of information systems for healthcare

    Science.gov (United States)

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

    1995-05-01

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

  6. Using HFACS-Healthcare to Identify Systemic Vulnerabilities During Surgery.

    Science.gov (United States)

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

    2018-03-01

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

  7. Sustainability of midwifery practice within the South African healthcare system

    OpenAIRE

    2012-01-01

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

  8. [Connecting the Baltic area : the Swedish postal System in the seventeenth century] / Kaarel Vanamölder

    Index Scriptorium Estoniae

    Vanamölder, Kaarel, 1981-

    2011-01-01

    Arvustus: Connecting the Baltic area : the Swedish postal System in the seventeenth century. Ed. by Heiko Droste. Södertörn Studies in History, 9, Södertörn Academic Studies, 42 (Huddinge: Södertörns högskola, 2011)

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

    OpenAIRE

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  11. 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.

  12. Virtual Video Prototyping of Pervasive Healthcare Systems

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bossen, Claus; Madsen, Kim Halskov

    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...... issues, since one cannot avoid paying attention to the physical, real-world constraints and to details in the usage-interaction between users and technology. From the users' perspective, during our evaluation of the virtual video prototype, we experienced how it enabled users to relate...

  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...... issues, since one cannot avoid paying attention to the physical, real-world constraints and to details in the usage-interaction between users and technology. From the users' perspective, during our evaluation of the virtual video prototype, we experienced how it enabled users to relate...

  14. 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.

  15. System theory and safety models in Swedish, UK, Dutch and Australian road safety strategies.

    Science.gov (United States)

    Hughes, B P; Anund, A; Falkmer, T

    2015-01-01

    Road safety strategies represent interventions on a complex social technical system level. An understanding of a theoretical basis and description is required for strategies to be structured and developed. Road safety strategies are described as systems, but have not been related to the theory, principles and basis by which systems have been developed and analysed. Recently, road safety strategies, which have been employed for many years in different countries, have moved to a 'vision zero', or 'safe system' style. The aim of this study was to analyse the successful Swedish, United Kingdom and Dutch road safety strategies against the older, and newer, Australian road safety strategies, with respect to their foundations in system theory and safety models. Analysis of the strategies against these foundations could indicate potential improvements. The content of four modern cases of road safety strategy was compared against each other, reviewed against scientific systems theory and reviewed against types of safety model. The strategies contained substantial similarities, but were different in terms of fundamental constructs and principles, with limited theoretical basis. The results indicate that the modern strategies do not include essential aspects of systems theory that describe relationships and interdependencies between key components. The description of these strategies as systems is therefore not well founded and deserves further development. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. System aspects on safeguards for the back-end of the Swedish nuclear fuel cycle

    Energy Technology Data Exchange (ETDEWEB)

    Fritzell, Anni (Dept. of Physics and Astronomy, Uppsala Univ., Uppsala (Sweden))

    2008-03-15

    This thesis has investigated system aspects of safeguarding the back-end of the Swedish nuclear fuel cycle. These aspects include the important notion of continuity of knowledge, the philosophy of verifying measurements and the need to consider the safeguards system as a whole when expanding it to include the encapsulation facility and the geological repository. The research has been analytical in method both in the identification of concrete challenges for the safeguards community in Paper 1, and in the diversion path analysis performed in Paper 2. This method of work is beneficial for example when abstract notions are treated. However, as a suggestion for further work along these lines, a formal systems analysis would be advantageous, and may even reveal properties of the safeguards system that the human mind so far has been to narrow to consider. A systems analysis could be used to model a proposed safeguards approach with the purpose of finding vulnerabilities in its detection probabilities. From the results, capabilities needed to overcome these vulnerabilities could be deduced, thereby formulating formal boundary conditions. These could include: The necessary partial defect level for the NDA measurement; The level of redundancy required in the C/S system to minimize the risk of inconclusive results due to equipment failure; and, Requirements on the capabilities of seismic methods, etc. The field of vulnerability assessment as a tool for systems analysis should be of interest for the safeguards community, as a formal approach could give a new dimension to the credibility of safeguards systems

  17. System aspects on safeguards for the back-end of the Swedish nuclear fuel cycle

    International Nuclear Information System (INIS)

    Fritzell, Anni

    2008-03-01

    This thesis has investigated system aspects of safeguarding the back-end of the Swedish nuclear fuel cycle. These aspects include the important notion of continuity of knowledge, the philosophy of verifying measurements and the need to consider the safeguards system as a whole when expanding it to include the encapsulation facility and the geological repository. The research has been analytical in method both in the identification of concrete challenges for the safeguards community in Paper 1, and in the diversion path analysis performed in Paper 2. This method of work is beneficial for example when abstract notions are treated. However, as a suggestion for further work along these lines, a formal systems analysis would be advantageous, and may even reveal properties of the safeguards system that the human mind so far has been to narrow to consider. A systems analysis could be used to model a proposed safeguards approach with the purpose of finding vulnerabilities in its detection probabilities. From the results, capabilities needed to overcome these vulnerabilities could be deduced, thereby formulating formal boundary conditions. These could include: The necessary partial defect level for the NDA measurement; The level of redundancy required in the C/S system to minimize the risk of inconclusive results due to equipment failure; and, Requirements on the capabilities of seismic methods, etc. The field of vulnerability assessment as a tool for systems analysis should be of interest for the safeguards community, as a formal approach could give a new dimension to the credibility of safeguards systems

  18. 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.

  19. 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.

  20. Secure Wireless Military Healthcare Telemedicine Enterprise System

    National Research Council Canada - National Science Library

    Lucas, Kenneth

    2006-01-01

    .... In theory clinicians should be able to select and use the information modalities and electronic medical record systems they prefer, with the technical systems integration issues of information...

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

    Directory of Open Access Journals (Sweden)

    Kristina D. Wood

    2013-01-01

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

  2. 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.

  3. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. How can fossil fuel based public bus transport systems become a sustainable solution for Swedish medium-sized cities?

    OpenAIRE

    Borén, Sven; Nurhadi, Lisiana; Ny, Henrik

    2013-01-01

    Vehicles, infrastructure, fuel systems and other energy-driven systems that serve public transport are complex with many resource inputs and outputs, and involve many processes. Life Cycle Assessment (LCA) and Life Cycle Costing (LCC) helps analyzing those by quantifying environmental and economic effects, but will not in themselves provide a full systems perspective. Swedish authorities have set ambitious national goals, and many regions targets a 100% increase in public transport by 2020. T...

  6. The Swedish police as a part of the security systems of nuclear material and other radioactive materials

    International Nuclear Information System (INIS)

    Nylen, L.

    2001-01-01

    Full text: In Sweden a special transport system has been developed for transport of nuclear substances and nuclear waste. This system in itself includes a high security level. Extraordinary circumstances can give cause for protective police measures and intervention. In concerned provinces an incident and emergency response planning take place of the police actions that may be needed at the following types of event: a) bomb threat; b) attack or threat of attack on transport vehicle; c) demonstrations. If a Swedish nuclear power plant is the subject of a bomb threat or other criminal assault, it is in Sweden, according to the Police Act, the task of the police to intervene, interrupt criminal acts and to restore order and security. The role of the Swedish police as regards the physical protection is, among other things, to carry out a certain control within protected area by special trained police personnel before a reactor is put into operation or restarted after revision or repair. Police authorities that have a nuclear power station within its jurisdiction should establish a plan for police actions at the nuclear power station in consultation with legal owner or management of the plant, the Swedish Nuclear Power Administration and the county administration. Special training and frequent practice of response personnel is crucial as well as co-training with key personnel at nuclear power stations. The National Criminal Investigation Department coordinates and commands police measures concerning different types of nuclear transports. Close co-operation with security and operational personnel at the nuclear power stations, operators of the transport system, the Swedish Nuclear Power Administration and the Swedish Radiation Protection Institute is very important. (author)

  7. 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.

  8. Executable Design Models for a Pervasive Healthcare Middleware System

    DEFF Research Database (Denmark)

    Jørgensen, Jens Bæk; Christensen, Søren

    2002-01-01

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

  9. Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care

    Directory of Open Access Journals (Sweden)

    Fridh Gerd

    2006-06-01

    Full Text Available Abstract Background Individualbased measures for comorbidity are of increasing importance for planning and funding health care services. No measurement for individualbased healthcare costs exist in Sweden. The aim of this study was to validate the Johns Hopkins ACG Case-Mix System's predictive value of polypharmacy (regular use of 4 or more prescription medicines used as a proxy for health care costs in an elderly population and to study if the prediction could be improved by adding variables from a population based study i.e. level of education, functional status indicators and health perception. Methods The Johns Hopkins ACG Case-Mix System was applied to primary health care diagnoses of 1402 participants (60–96 years in a cross-sectional community based study in Karlskrona, Sweden (the Swedish National study on Ageing and Care during a period of two years before they took part in the study. The predictive value of the Johns Hopkins ACG Case-Mix System was modeled against the regular use of 4 or more prescription medicines, also using age, sex, level of education, instrumental activity of daily living- and measures of health perception as covariates. Results In an exploratory biplot analysis the Johns Hopkins ACG Case-Mix System, was shown to explain a large part of the variance for regular use of 4 or more prescription medicines. The sensitivity of the prediction was 31.9%, whereas the specificity was 88.5%, when the Johns Hopkins ACG Case-Mix System was adjusted for age. By adding covariates to the model the sensitivity was increased to 46.3%, with a specificity of 90.1%. This increased the number of correctly classified by 5.6% and the area under the curve by 11.1%. Conclusion The Johns Hopkins ACG Case-Mix System is an important factor in measuring comorbidity, however it does not reflect an individual's capability to function despite a disease burden, which has importance for prediction of comorbidity. In this study we have shown that

  10. 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...

  11. 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...

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

    Science.gov (United States)

    Elnekave, Eldad; Gross, Revital

    2004-07-01

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

  13. A review of scope and costs for the swedish system for management of nuclear waste

    International Nuclear Information System (INIS)

    1994-01-01

    From a financial analysis of the swedish nuclear waste management program it is deduced that a 25 year long operation of the swedish reactors will not create funds large enough to finance the program at the present fee level (0.019 SEK/kWh). The real interest rate is of great importance for the return from the fees. The cost estimates for decommissioning are much lower than that for comparable reactors in other countries (e.g. Trojan, USA vs Ringhals 2), possibly totaling up to 20 GSEK for all twelve swedish reactors. 3 figs., 12 tabs

  14. 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.

  15. [Interpretation in the Danish health-care system].

    Science.gov (United States)

    Lund Hansen, Marianne Taulo; Nielsen, Signe Smith

    2013-03-04

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

  16. [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.

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

    OpenAIRE

    Talpur, Mir Sajjad Hussain

    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,...

  18. CMOS Enabled Microfluidic Systems for Healthcare Based Applications.

    Science.gov (United States)

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

    2018-04-01

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

  19. CMOS Enabled Microfluidic Systems for Healthcare Based Applications

    KAUST Repository

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

    2018-01-01

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

  20. 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.

  1. 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.

  2. Adoption of innovative heating systems. Needs and attitudes of Swedish homeowners

    Energy Technology Data Exchange (ETDEWEB)

    Mahapatra, K; Gustavsson, L [Ecotechnology, Mid Sweden University, 831 25 Oestersund (Sweden)

    2009-11-15

    Questionnaire surveys of Swedish homeowners of detached houses were carried out in 2004 and 2007 to understand their needs and attitudes towards attributes of innovative heating systems (IHSs) comprised of a bedrock heat pump, district heating, or a wood pellet boiler. In each occasion 1,500 homeowners were randomly selected. The response rate was 42% in 2004 and 48% in 2007. Results showed that the majority of the respondents were satisfied with their existing heating system and did not intend to install new systems. Economic factors and functional reliability were the most important factors in the respondents' choices of heating system, while environmental factors were of lower importance. Among the IHSs, respondents had the most favorable attitude towards bedrock heat pumps followed by district heating and pellet boilers. But the attitude was more favorable towards electric boilers than for pellet boilers. The least favorable attitude was towards oil boilers. Between 2004 and 2007, there was a positive change in respondents' attitude towards IHSs and electric boilers, and a negative change in attitude towards resistance heaters and oil boilers.

  3. 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.

  4. Career management in the healthcare system

    OpenAIRE

    Pusa Tania Tapliga; Roxana Nicoleta Matei

    2014-01-01

    Career management is a specialized activity that provides the relation between HRM and the individual and organizational career planning. The health system is changing, more than any other field. Career Management in the health care system involves a complex process of analysis and human resource planning at both the organizational and the individual level.

  5. A review of the scope and the cost of the Swedish nuclear waste management system

    International Nuclear Information System (INIS)

    1994-03-01

    A Swedish translation of this report appears as an appendix in SOU 1004:108 (ISBN 91-38-13755-0). The report is prepared for the Nuclear Fond Commission and Ministry of Environment and Natural Resources

  6. Swedish industrial and energy supply measures in a European system perspective

    OpenAIRE

    Trygg, Louise

    2006-01-01

    A common electricity market in Europe will in all probability lead to a levelling out of the electricity price, which implies that Swedish consumers will face higher electricity prices with a European structure. This new market situation will force industry and energy suppliers to take new essential measures as actors in a deregulated European electricity market. In this thesis it is shown how over 30 Swedish small and medium-sized industries can reduce their use of electricity by about 50%. ...

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

    African Journals Online (AJOL)

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

  8. 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.

  9. 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.

  10. Future wind power forecast errors, need for regulating power, and costs in the Swedish system

    Energy Technology Data Exchange (ETDEWEB)

    Carlsson, Fredrik [Vattenfall Research and Development AB, Stockholm (Sweden). Power Technology

    2011-07-01

    Wind power is one of the renewable energy sources in the electricity system that grows most rapid in Sweden. There are however two market challenges that need to be addressed with a higher proportion of wind power - that is variability and predictability. Predictability is important since the spot market Nord Pool Spot requires forecasts of production 12 - 36 hours ahead. The forecast errors must be regulated with regulating power, which is expensive for the actors causing the forecast errors. This paper has investigated a number of scenarios with 10 - 55 TWh of wind power installed in the Swedish system. The focus has been on a base scenario with 10 TWh new wind power consisting of 3,5 GW new wind power and 1,5 GW already installed power, which gives 5 GW. The results show that the costs for the forecast errors will increase as more intermittent production is installed. However, the increase can be limited by for instance trading on intraday market or increase quality of forecasts. (orig.)

  11. 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

  12. 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.

  13. Healthcare systems--an international review: an overview.

    Science.gov (United States)

    Lameire, N; Joffe, P; Wiedemann, M

    1999-01-01

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

  14. Photovoltaic Systems for Swedish Prosumers : A technical and economic analysis focused on cooperative multi-family housing

    OpenAIRE

    Sommerfeldt, Nelson; Muyingo, Henry; af Klintberg, Tord

    2016-01-01

    This report is designed to be a comprehensive information resource for Swedish prosumers considering an investment in solar PV systems. The target audience are multi-family cooperative houses, however much of the information is applicable to other building owners and solar energy more broadly. The primary question to be answered; is a rooftop PV investment profitable in Sweden? Naturally there are many variables that can affect the answer; therefore a Monte Carlo methodology is used to conver...

  15. 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.

  16. Information resources assessment of a healthcare integrated delivery system.

    Science.gov (United States)

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

    1999-01-01

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

  17. Information resources assessment of a healthcare integrated delivery system.

    Science.gov (United States)

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

    1999-01-01

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

  18. 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.

  19. Safety Management Characteristics Reflected in Interviews at Swedish Nuclear Power Plants: A System Perspective Approach

    International Nuclear Information System (INIS)

    Salo, Ilkka

    2005-12-01

    The present study investigated safety management characteristics reflected in interviews with participants from two Swedish nuclear power plants. A document analysis regarding the plants' organization, safety policies, and safety culture work was carried out as well. The participants (n=9) were all nuclear power professionals, and the majority managers at different levels with at least 10 years of nuclear power experience. The interview comprised themes relevant for organizational safety and safety management, such as: organizational structures and organizational change, threats to safety, information feedback and knowledge transfer, safety analysis, safety policy, and accident and incident analysis and reporting. The results were in part modeled to important themes derived from a general system theoretical framework suggested by Svenson and developed by Svenson and Salo in relation to studies of 'non-nuclear' safety organizations. A primer to important features of the system theoretical framework is presented in the introductory chapter. The results from the interviews generated interesting descriptions about nuclear safety management in relation to the above themes. Regarding organizational restructuring, mainly centralizations of resources, several examples of reasons for the restructuring and related benefits for this centralization of resources were identified. A number of important reminders that ought to be considered in relation to reorganization were also identified. Regarding threats to the own organization a number of such was interpreted from the interviews. Among them are risks related to generation and competence change-over and risks related to outsourcing of activities. A thorough picture of information management and practical implications related to this was revealed in the interviews. Related to information feedback is the issue of organizational safety indicators and safety indicators in general. The interview answers indicated that the area

  20. Designing an architectural style for Pervasive Healthcare systems.

    Science.gov (United States)

    Rafe, Vahid; Hajvali, Masoumeh

    2013-04-01

    Nowadays, the Pervasive Healthcare (PH) systems are considered as an important research area. These systems have a dynamic structure and configuration. Therefore, an appropriate method for designing such systems is necessary. The Publish/Subscribe Architecture (pub/sub) is one of the convenient architectures to support such systems. PH systems are safety critical; hence, errors can bring disastrous results. To prevent such problems, a powerful analytical tool is required. So using a proper formal language like graph transformation systems for developing of these systems seems necessary. But even if software engineers use such high level methodologies, errors may occur in the system under design. Hence, it should be investigated automatically and formally that whether this model of system satisfies all their requirements or not. In this paper, a dynamic architectural style for developing PH systems is presented. Then, the behavior of these systems is modeled and evaluated using GROOVE toolset. The results of the analysis show its high reliability.

  1. Oral healthcare systems in the extended European union.

    Science.gov (United States)

    Widström, Eeva; Eaton, Kenneth A

    2004-01-01

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

  2. Healthcare delivery systems: designing quality into health information systems.

    Science.gov (United States)

    Joyce, Phil; Green, Rosamund; Winch, Graham

    2007-01-01

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

  3. School Principals' Perceptions of "Basic Values" in the Swedish Compulsory School System in Regard to Bronfenbrenner's Ecological Systems Theory

    Science.gov (United States)

    Drakenberg, Margareth; Malmgren, Therese Vincenti

    2013-01-01

    The purpose of this study is to compare how Swedish school principals understand basic values that are important in fulfilling the Swedish national curriculum, Curriculum 1994 (a new curriculum, Curriculum 2011, which came into operation in autumn 2011, has only minor differences compared to the common text in Curriculum 1994), considering…

  4. 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.

  5. Medical data transmission system for remote healthcare centres

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  6. Transitioning from learning healthcare systems to learning health care communities.

    Science.gov (United States)

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

    2018-02-26

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

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

    DEFF Research Database (Denmark)

    Edwards, Kasper; Nielsen, Anders Paarup

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

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

    OpenAIRE

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

    2014-01-01

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

  9. Swedish projects

    International Nuclear Information System (INIS)

    Thunell, J.

    1993-01-01

    The main sources of the financing of Swedish research on gas technology are listed in addition to names of organizations which carry out this research. The titles and descriptions of the projects carried out are presented in addition to lists of reports published with information on prices. (AB)

  10. 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.

  11. Combining optimisation and simulation in an energy systems analysis of a Swedish iron foundry

    International Nuclear Information System (INIS)

    Mardan, Nawzad; Klahr, Roger

    2012-01-01

    To face global competition, and also reduce environmental and climate impact, industry-wide changes are needed, especially regarding energy use, which is closely related to global warming. Energy efficiency is therefore an essential task for the future as it has a significant impact on both business profits and the environment. For the analysis of possible changes in industrial production processes, and to choose what changes should be made, various modelling tools can be used as a decision support. This paper uses two types of energy analysis tool: Discrete Event Simulation (DES) and Energy Systems Optimisation (ESO). The aim of this study is to describe how a DES and an ESO tool can be combined. A comprehensive five-step approach is proposed for reducing system costs and making a more robust production system. A case study representing a new investment in part of a Swedish iron foundry is also included to illustrate the method's use. The method described in this paper is based on the use of the DES program QUEST and the ESO tool reMIND. The method combination itself is generic, i.e. other similar programs can be used as well with some adjustments and adaptations. The results from the case study show that when different boundary conditions are used the result obtained from the simulation tools is not optimum, in other words, the result shows only a feasible solution and not the best way to run the factory. It is therefore important to use the optimisation tool in such cases in order to obtain the optimum operating strategy. By using the optimisation tool a substantial amount of resources can be saved. The results also show that the combination of optimisation and simulation tools is useful to provide very detailed information about how the system works and to predict system behaviour as well as to minimise the system cost. -- Highlights: ► This study describes how a simulation and an optimisation tool can be combined. ► A case study representing a new

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

    Science.gov (United States)

    Karampelas, Vasilios; Pallikarakis, Nicholas; Mantas, John

    2013-01-01

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

  13. Comprehensive Treatment of Women with Postpartum Psychosis across Health Care Systems from Swedish Psychiatrists' Perspectives

    Science.gov (United States)

    Engqvist, Inger; Ahlin, Arne; Ferszt, Ginette; Nilsson, Kerstin

    2011-01-01

    Studies concerning the psychiatrist's experiences of treating women with postpartum psychosis (PPP) or how they react to these women are limited in the literature. In this study a qualitative design is used. Data collection includes semi-structured interviews with nine Swedish psychiatrists working in psychiatric hospitals. The audio-taped…

  14. Association between medication supplies and healthcare costs in older adults from an urban healthcare system.

    Science.gov (United States)

    Stroupe, K T; Murray, M D; Stump, T E; Callahan, C M

    2000-07-01

    The amount of medication dispensed to older adults for the treatment of chronic disease must be balanced carefully. Insufficient medication supplies lead to inadequate treatment of chronic disease, whereas excessive supplies represent wasted resources and the potential for toxicity. We used an electronic medical record system to determine the distribution of medications supplied to older urban adults and to examine the correlations of these distributions with healthcare costs and use. A cross-sectional study using data acquired over 3 years (1994-1996). A tax-supported urban public healthcare system consisting of a 300-bed hospital, an emergency department, and a network of community-based ambulatory care centers. Patients were >60 years of age and had at least one prescription refill and at least two ambulatory visits or one hospitalization during the 3-year period. Focusing on 12 major categories of drugs used to treat chronic diseases, we determined the amounts and direct costs of these medications dispensed to older adult patients. Amounts of medications that were needed by patients to medicate themselves adequately were compared with the medication supply actually dispensed considering all sources of care (primary, emergency, and inpatient). We calculated the excess drug costs attributable to oversupply of medication (>120% of the amount needed) and the drug cost reduction caused by undersupply of medication (120% of the supply needed. The total direct cost of targeted medications for 3 years was $1.96 million or, on average, $654,000 annually. During the 3-year period, patients receiving >120% of their needed medications had excess direct medication costs of $279,084 or $144 per patient, whereas patients receiving <80% of drugs needed had reduced medication costs of $423,438 or $634 per patient. Multivariable analyses revealed that both under- and over-supplies of medication were associated with a greater likelihood of emergency department visits and hospital

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

    Science.gov (United States)

    Kolker, Eugene; Kolker, Evelyne

    2014-03-01

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

  16. 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

  17. Safety Management Characteristics Reflected in Interviews at Swedish Nuclear Power Plants: A System Perspective Approach

    Energy Technology Data Exchange (ETDEWEB)

    Salo, Ilkka (Risk Analysis, Social and Decision Research Unit, Dept. of Psychology, Stockholm Univ., Stockholm (Sweden))

    2005-12-15

    The present study investigated safety management characteristics reflected in interviews with participants from two Swedish nuclear power plants. A document analysis regarding the plants' organization, safety policies, and safety culture work was carried out as well. The participants (n=9) were all nuclear power professionals, and the majority managers at different levels with at least 10 years of nuclear power experience. The interview comprised themes relevant for organizational safety and safety management, such as: organizational structures and organizational change, threats to safety, information feedback and knowledge transfer, safety analysis, safety policy, and accident and incident analysis and reporting. The results were in part modeled to important themes derived from a general system theoretical framework suggested by Svenson and developed by Svenson and Salo in relation to studies of 'non-nuclear' safety organizations. A primer to important features of the system theoretical framework is presented in the introductory chapter. The results from the interviews generated interesting descriptions about nuclear safety management in relation to the above themes. Regarding organizational restructuring, mainly centralizations of resources, several examples of reasons for the restructuring and related benefits for this centralization of resources were identified. A number of important reminders that ought to be considered in relation to reorganization were also identified. Regarding threats to the own organization a number of such was interpreted from the interviews. Among them are risks related to generation and competence change-over and risks related to outsourcing of activities. A thorough picture of information management and practical implications related to this was revealed in the interviews. Related to information feedback is the issue of organizational safety indicators and safety indicators in general. The interview answers indicated

  18. PALLIATIVE CARE – ITS ROLE IN HEALTHCARE SYSTEMS

    Directory of Open Access Journals (Sweden)

    Urška Lunder

    2003-11-01

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

  19. 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.

  20. 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.

  1. Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial

    Science.gov (United States)

    Abbott, Allan; Schröder, Karin; Enthoven, Paul; Nilsen, Per; Öberg, Birgitta

    2018-01-01

    Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP. Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context. Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated. Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and

  2. The systemic roles of SKI and SSI in the Swedish nuclear waste management system. Syncho's report for project RISCOM

    International Nuclear Information System (INIS)

    Espejo, R.; Gill, A.

    1998-01-01

    The purpose of this report is to share and summarize our findings about the regulatory roles of SKI/SSI in the context of the Swedish Nuclear System (SNS), with an emphasis on nuclear waste management. The driving force in this review is to make decision processes more transparent. What is reported is based on interviews conducted with employees at SKI/SSI/SKB during early December 1996, the presentation to SKI/SSI in January 1997, discussions during the Shap Wells meeting in Cumbria during March 1997 and RISCOM internal discussions. We offer two hypotheses about the way the Nuclear Waste Management System (NWMS) appears to work. We choose one and derive from it a view about structural issues in SNS and NWMS. The conclusion is a set of systemic roles for the regulators. It is the comparison between these systemic roles and the actual situation that may trigger some adjustments in the system. Our hope is that these findings will make apparent feasible and desirable changes in the system in order to increase the chances for transparent decisions in the Nuclear Waste Management System. In summary, Section 2 includes a general background of the NWMS based on interviews and general information. Section 3 makes a more focused attempt to work out the issues expressed by people in the interviews. Section 4 discusses at a more conceptual level systemic ideas such as the unfolding of complexity. Section 5 is an attempt to organize viewpoints about the NWMS and offers hypotheses to support a preliminary diagnosis of the system in Section 6. We call this section 'A problem of identity'. It is only in Section 7 that basic systemic arguments are unfolded with the intention of supporting an appreciation of SKI/SSI's regulatory roles in the nuclear industry as a whole and nuclear waste management in particular. Section 8 offers a summary of conclusions

  3. 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.

  4. 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

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

    Science.gov (United States)

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

    2011-01-01

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

  6. 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.

  7. Addiction and recovery : perceptions among professionals in the Swedish treatment system

    OpenAIRE

    Samuelsson, Eva; Blomqvist, Jan; Christophs, Irja

    2013-01-01

    AIMS - The objective of the study was to explore perceptions of different addictions among Swedish addiction care personnel. DATA - A survey was conducted with 655 addiction care professionals in the social services, health care and criminal care in Stockholm County. Respondents were asked to rate the severity of nine addictions as societal problems, the individual risk to getting addicted, the possibilities for self-change and the perceived significance of professional treatment in finding a...

  8. The actual status of the development of a Danish/Swedish system concept for a solar combisystem

    DEFF Research Database (Denmark)

    Fiedler, Frank; Bales, Chris; Thür, Alexander

    2005-01-01

    partners a system concept has been developed that is characterized by its high compactness and flexibility. It allows the use of different types of boilers, heating distribution systems and a variable store and collector size. Two prototypes have been built, one for the Danish market with a gas boiler......, and one for the Swedish market with a pellet boiler as auxiliary heater. After intensive testing and eventual further improvements at least two systems will be installed and monitored in demonstration houses. The systems have been modeled in TRNSYS and the simulation results will be used to further...... and Sweden it has been decided to develop a common system concept for both countries, which increases the market potential for the manufacturer. The focus of the development is on systems for the large number of rather well insulated existing single family houses. In close collaboration with the industrial...

  9. 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.

  10. Geographic variation in Medicare and the military healthcare system.

    Science.gov (United States)

    Adesoye, Taiwo; Kimsey, Linda G; Lipsitz, Stuart R; Nguyen, Louis L; Goodney, Philip; Olaiya, Samuel; Weissman, Joel S

    2017-08-01

    To compare geographic variation in healthcare spending and utilization between the Military Health System (MHS) and Medicare across hospital referral regions (HRRs). Retrospective analysis. Data on age-, sex-, and race-adjusted Medicare per capita expenditure and utilization measures by HRR were obtained from the Dartmouth Atlas for 2007 to 2010. Similarly, adjusted data from 2007 and 2010 were obtained from the MHS Data Repository and patients assigned to HRRs. We compared high- and low-spending regions, and computed coefficient of variation (CoV) and correlation coefficients for healthcare spending, hospital inpatient days, hip surgery, and back surgery between MHS and Medicare patients. We found significant variation in spending and utilization across HRRs in both the MHS and Medicare. CoV for spending was higher in the MHS compared with Medicare, (0.24 vs 0.15, respectively) and CoV for inpatient days was 0.36 in the MHS versus 0.19 in Medicare. The CoV for back surgery was also greater in the MHS compared with Medicare (0.47 vs 0.29, respectively). Per capita Medicare spending per HRR was significantly correlated to adjusted MHS spending (r = 0.3; P spending markets in both systems were not comparable; lower spending markets were located mostly in the Midwest. In comparing 2 systems with similar pricing schemes, differences in spending likely reflect variation in utilization and the influence of local provider culture.

  11. The chief nurse executive role in large healthcare systems.

    Science.gov (United States)

    Englebright, Jane; Perlin, Jonathan

    2008-01-01

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

  12. MEDICARE PAYMENTS AND SYSTEM-LEVEL HEALTH-CARE USE

    Science.gov (United States)

    ROBBINS, JACOB A.

    2015-01-01

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

  13. 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.

  14. [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.

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

    Science.gov (United States)

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

    2013-01-01

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

  16. Design of alarm systems in Swedish nuclear power plants; Utformning av larmsystem i svenska kaernkraftverk

    Energy Technology Data Exchange (ETDEWEB)

    Thunberg, Anna; Osvalder, Anna-Lisa (Dept. of Product and Production Development, Chalmers Univ. of Technology, Goeteborg (Sweden))

    2008-04-15

    Research within the area of improving alarm system design and performance has mainly focused on new alarm systems. However, smaller modernisations of legacy systems are more common in the Swedish nuclear industry than design of totally new systems. This imposes problems when the new system should function together with the old system. This project deals with the special concerns raised by modernisation projects. The objective of the project has been to increase the understanding of the relationship between the operator's performance and the design of the alarm system. Of major concern has been to consider the cognitive abilities of the operator, different operator roles and work situations, and varying need of information. The aim of the project has been to complement existing alarm design guidance and to develop user-centred alarm design concepts. Different case studies have been performed in several industry sectors (nuclear, oil refining, pulp and paper, aviation and medical care) to identify best practice. Several empirical studies have been performed within the nuclear area to investigate the operator's need of information, performance and workload in different operating modes. The aspect of teamwork has also been considered. The analyses show that the operator has different roles in different work situations which affect both the type of information needed and how the information is processed. In full power operation, the interaction between the operator and the alarm system is driven by internal factors and the operator tries to maintain high situation awareness by actively searching for information. The operator wants to optimise the process and need detailed information with possibilities to follow-up and get historical data. In disturbance management, the operator is more dependent on external information presented by the alarm system. The new compilation of alarm guidance is based on the operator's varying needs in different working

  17. Distributed Photovoltaics in the Swedish Energy System. Model Development and Simulations

    International Nuclear Information System (INIS)

    Widen, Joakim

    2009-06-01

    that the appearance of daily load profiles, and thus the degree of matching to PV generation, are highly variable. Studies of matching of PV generation to aggregate domestic demand showed that load matching at moderate overproduction levels can be improved by PV panel orientation, demand side management (DSM) and storage. At high overproduction levels, however, the only impacting option is storage. Probabilistic power-flow simulations with the developed models yield a versatile picture of how impacts are distributed among customers and over time, as compared to often-used static simulations. Contrary to the trend towards higher time resolution in international research, hourly resolution was found to be sufficient for determining probability distributions for LV grid voltages. Power-flow simulations of three Swedish LV grids showed that a penetration level of 1 kWp PV systems at every customer was most beneficial in terms of on-site coverage of demand, counteracted voltage drops and decreased network losses. However, much higher penetration levels, up to the highest studied level of 5 kWp per household, can be handled without voltage rise above prescribed limits

  18. Distributed Photovoltaics in the Swedish Energy System. Model Development and Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Widen, Joakim

    2009-06-15

    showed that the appearance of daily load profiles, and thus the degree of matching to PV generation, are highly variable. Studies of matching of PV generation to aggregate domestic demand showed that load matching at moderate overproduction levels can be improved by PV panel orientation, demand side management (DSM) and storage. At high overproduction levels, however, the only impacting option is storage. Probabilistic power-flow simulations with the developed models yield a versatile picture of how impacts are distributed among customers and over time, as compared to often-used static simulations. Contrary to the trend towards higher time resolution in international research, hourly resolution was found to be sufficient for determining probability distributions for LV grid voltages. Power-flow simulations of three Swedish LV grids showed that a penetration level of 1 kWp PV systems at every customer was most beneficial in terms of on-site coverage of demand, counteracted voltage drops and decreased network losses. However, much higher penetration levels, up to the highest studied level of 5 kWp per household, can be handled without voltage rise above prescribed limits

  19. Environmental and Economic Assessment of Swedish Municipal Solid Waste Management in a Systems Perspective

    International Nuclear Information System (INIS)

    Eriksson, Ola

    2003-01-01

    Waste management is something that affects most people. The waste amounts are still increasing, but the waste treatment is changing towards recycling and integrated solutions. In Sweden producers' responsibility for different products, a tax and bans on deposition of waste at landfills implicates a reorganisation of the municipal solid waste management. Plans are made for new incineration plants, which leads to that waste combustion comes to play a role in the reorganisation of the Swedish energy system as well. The energy system is supposed to adapt to governmental decisions on decommission of nuclear plants and decreased use of fossil fuels. Waste from private households consists of hazardous waste, scrap waste, waste electronics and wastes that to a large extent are generated in the kitchen. The latter type has been studied in this thesis, except for newsprint, glass- and metal packages that by source separation haven't ended up in the waste bin. Besides the remaining amount of the above mentioned fractions, the waste consists of food waste, paper, cardboard- and plastic packages and inert material. About 80-90 % of this mixed household waste is combustible, and the major part of that is also possible to recycle. Several systems analyses of municipal solid waste management have been performed. Deposition at landfill has been compared to energy recovery, recycling of material (plastic and cardboard) and recycling of nutrients (in food waste). Environmental impact, fuel consumption and costs are calculated for the entire lifecycle from the households, until the waste is treated and the by-products have been taken care of. To stop deposition at landfills is the most important measure to take as to decrease the environmental impact from landfills, and instead use the waste as a resource, thereby substituting production from virgin resources (avoiding resource extraction and emissions). The best alternative to landfilling is incineration, but also material recycling

  20. Environmental and Economic Assessment of Swedish Municipal Solid Waste Management in a Systems Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Eriksson, Ola

    2003-04-01

    Waste management is something that affects most people. The waste amounts are still increasing, but the waste treatment is changing towards recycling and integrated solutions. In Sweden producers' responsibility for different products, a tax and bans on deposition of waste at landfills implicates a reorganisation of the municipal solid waste management. Plans are made for new incineration plants, which leads to that waste combustion comes to play a role in the reorganisation of the Swedish energy system as well. The energy system is supposed to adapt to governmental decisions on decommission of nuclear plants and decreased use of fossil fuels. Waste from private households consists of hazardous waste, scrap waste, waste electronics and wastes that to a large extent are generated in the kitchen. The latter type has been studied in this thesis, except for newsprint, glass- and metal packages that by source separation haven't ended up in the waste bin. Besides the remaining amount of the above mentioned fractions, the waste consists of food waste, paper, cardboard- and plastic packages and inert material. About 80-90 % of this mixed household waste is combustible, and the major part of that is also possible to recycle. Several systems analyses of municipal solid waste management have been performed. Deposition at landfill has been compared to energy recovery, recycling of material (plastic and cardboard) and recycling of nutrients (in food waste). Environmental impact, fuel consumption and costs are calculated for the entire lifecycle from the households, until the waste is treated and the by-products have been taken care of. To stop deposition at landfills is the most important measure to take as to decrease the environmental impact from landfills, and instead use the waste as a resource, thereby substituting production from virgin resources (avoiding resource extraction and emissions). The best alternative to landfilling is incineration, but also material

  1. 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.

  2. 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.

  3. 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.

  4. Swedish Industry and Kyoto. An Assessment of the Effects of the European CO2 Emission Permit Trading System

    International Nuclear Information System (INIS)

    Braennlund, Runar; Lundgren, Tommy

    2005-01-01

    We assess the effects on Swedish industry input and output demands of different climate policy scenarios connected to energy policy induced by the Kyoto protocol. A unique data set containing firm level data on outputs and inputs during the years 1991-2001 is used to estimate a factor demand model, which is then simulated for different policy scenarios. Sector specific estimation suggests that the proposed quadratic profit function specification exhibit properties and robustness that are consistent with economic theory; that is, all own-price elasticities are negative and all output elasticities are positive. Furthermore, the elasticities show that the input demands are, in most cases, relatively inelastic. Simulation of the model for 6 different policy scenarios reveal that the effects on Swedish base industry of a EU level permit trade system is dependent on (i) removal or no removal of current CO 2 tax, (ii) the established price of permits, and (iii) what will happen to the electricity price. Our analysis show that changes in electricity price may be more important than the price of permits for some sectors

  5. Swedish industry and Kyoto - An assessment of the effects of the European CO2 emission trading system

    International Nuclear Information System (INIS)

    Braennlund, Runar; Lundgren, Tommy

    2007-01-01

    We assess the effects on Swedish industry input demands and output of different climate policy scenarios connected to energy policy induced by the Kyoto protocol. We use a unique dataset containing firm-level data on outputs and inputs between 1991 and 2001 to estimate a factor demand model, which we use to simulate different policy scenarios. Sector-specific estimation suggests that the proposed quadratic profit function specification exhibits properties and robustness that are consistent with economic theory; that is, all own-price elasticities are negative and all output elasticities are positive. Furthermore, the elasticities show that the input demands are, in most cases, relatively inelastic. Simulation of the model for six different policy scenarios reveal that effects on the Swedish base industry of a EU-level permit-trading system depends on (i) the removal or maintenance of the current CO 2 tax, (ii) the price of permits, and (iii) the future price of electricity. Our analysis shows that changes in electricity price may be more important than the price of permits for some sectors. (author)

  6. Lobbying during the revision of the European emissions trading system: Easier for Swedish industrial insiders than for Norwegian outsiders?

    Energy Technology Data Exchange (ETDEWEB)

    Miard, Kadri

    2011-07-01

    This report examines and compares the lobbying routes taken by Swedish and Norwegian energy-intensive industry firms during the revision of the European Emissions Trading System. Two key explanatory factors are in focus here - whether the company has its origin in the EU member state Sweden or in non-member Norway; and the size of the company. Six companies are chosen as cases: Norsk Hydro, Norcem and Norske Skog from Norway; and SSAB, Cementa and Svenska Cellulosa Aktiebolaget from Sweden. A key finding is the extensive use of European associations by all these firms in lobbying EU institutions. Also prevalent is the use of national associations, which would indicate benefits in the form of better institutional response to collective lobbying and resource-sharing aspects. Although Norwegian firms seem to have struggled more than Swedish firms when it comes to lobbying EU institutions, due to lack of access to the EU, not all differences can be explained by the fact of originating in an EU member state Sweden or non-member Norway. While company size has a positive effect on the number of available lobbying routes, this appears to depend on cross-border production and possibly other influences as well.(auth)

  7. Primary care training and the evolving healthcare system.

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

    Xesfingi, Sofia; Vozikis, Athanassios

    2016-03-15

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

  9. Patient Experienced Continuity of Care in the Psychiatric Healthcare System

    DEFF Research Database (Denmark)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne

    2014-01-01

    Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse...... migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry......, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups...

  10. Sensitivity of district heating system operation to heat demand reductions and electricity price variations: A Swedish example

    International Nuclear Information System (INIS)

    Åberg, M.; Widén, J.; Henning, D.

    2012-01-01

    In the future, district heating companies in Sweden must adapt to energy efficiency measures in buildings and variable fuel and electricity prices. Swedish district heating demands are expected to decrease by 1–2% per year and electricity price variations seem to be more unpredictable in the future. A cost-optimisation model of a Swedish local district heating system is constructed using the optimisation modelling tool MODEST. A scenario for heat demand changes due to increased energy efficiency in buildings, combined with the addition of new buildings, is studied along with a sensitivity analysis for electricity price variations. Despite fears that heat demand reductions will decrease co-generation of clean electricity and cause increased global emissions, the results show that anticipated heat demand changes do not increase the studied system's primary energy use or global CO 2 emissions. The results further indicate that the heat production plants and the fuels used within the system have crucial importance for the environmental impact of district heat use. Results also show that low seasonal variations in electricity price levels with relatively low winter prices promote the use of electric heat pumps. High winter prices on the other hand promote co-generation of heat and electricity in CHP plants. -- Highlights: ► A MODEST optimisation model of the Uppsala district heating system is built. ► The impact of heat demand change on heat and electricity production is examined. ► An electricity price level sensitivity analysis for district heating is performed. ► Heat demand changes do not increase the primary energy use or global CO 2 emissions. ► Low winter prices promote use of electric heat pumps for district heating production.

  11. 'It was like I had to fit into a category': Care-seekers' experiences of gender regulation in the Swedish trans-specific healthcare.

    Science.gov (United States)

    Linander, Ida; Alm, Erika; Goicolea, Isabel; Harryson, Lisa

    2017-05-01

    The few previous studies investigating regulation of gender in trans-specific healthcare are mainly based on text material and interviews with care-providers or consist solely of theoretical analyses. There is a lack of studies analysing how the regulation of gender is expressed in the care-seeker's own experiences, especially in a Nordic context. The aim of this study is to analyse narratives of individuals with trans experiences (sometimes called transgender people) to examine how gender performances can be regulated in trans-specific care in Sweden. The conceptual framework is inspired by trans studies, a Foucauldian analysis of power, queer phenomenology and the concept of cisnormativity. Fourteen interviews with people with trans experiences are analysed with constructivist grounded theory. The participants' experiences indicate that gender is constructed as norm-conforming, binary and stable in trans-specific healthcare. This gendered position is resisted, negotiated and embraced by the care-seekers. Norms and discourses both inside and outside trans-specific care contribute to the regulation and limit the room for action for care-users. We conclude that a trans-specific care that has a confirming approach to its care-users, instead of the current focus on gender norm conformity, has the potential to increase the self-determination of gender performance and increase the quality of care.

  12. Wireless biopotential acquisition system for portable healthcare monitoring.

    Science.gov (United States)

    Wang, W-S; Huang, H-Y; Wu, Z-C; Chen, S-C; Wang, W-F; Wu, C-F; Luo, C-H

    2011-07-01

    A complete biopotential acquisition system with an analogue front-end (AFE) chip is proposed for portable healthcare monitoring. A graphical user interface (GUI) is also implemented to display the extracted biopotential signals in real-time on a computer for patients or in a hospital via the internet for doctors. The AFE circuit defines the quality of the acquired biosignals. Thus, an AFE chip with low power consumption and a high common-mode rejection ratio (CMRR) was implemented in the TSMC 0.18-μm CMOS process. The measurement results show that the proposed AFE, with a core area of 0.1 mm(2), has a CMRR of 90 dB, and power consumption of 21.6 μW. Biopotential signals of electroencephalogram (EEG), electrocardiogram (ECG) and electromyogram (EMG) were measured to verify the proposed system. The board size of the proposed system is 6 cm × 2.5 cm and the weight is 30 g. The total power consumption of the proposed system is 66 mW. Copyright © 2011 Informa UK, Ltd.

  13. 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

  14. 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.

  15. UP-report. Energy systems studies. Basis of the Development platform. System to the Swedish Energy Agency's strategy work FOKUS; UP-rapport. Energisystemstudier. Underlag fraan Utvecklingsplattformen. System till Energimyndighetens strategiarbete FOKUS

    Energy Technology Data Exchange (ETDEWEB)

    Ingelstam, Lars; Alm, Maria

    2012-11-01

    The report serves as input to the Swedish Energy Agency's strategies and priorities for research and innovation in the thematic area Energy systems studies for the period 2011 - 2016. The report has been compiled by members of the the Development platform System. This report provides background and circumstances for the energy system studies theme, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and knowledge that enabled the Swedish Energy Agency to then develop a strategy that meets the needs of society and business.

  16. 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...

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

    Science.gov (United States)

    Hercos, Benigno Vicente Santos; Berezovsky, Adriana

    2017-01-01

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

  18. Sectoral agreements and competitive distortions - a Swedish perspective; Effects of EU Emissions Trading System for European industry

    Energy Technology Data Exchange (ETDEWEB)

    Zetterberg, Lars; Holmgren, Kristina

    2009-03-15

    sector approaches to be discussed under the Ad-hoc Working Group on future commitments for Annex I Parties under the Kyoto Protocol (AWG-KP): i) Sector CDM - a CDM crediting mechanism with a previously established baseline ii) Sectoral no-lose mechanism - Sectoral crediting against a previously established no-lose target iii) Sectoral emission trading based on a sector emissions cap Based on these three sectoral models, we have analysed what parameters are important for reducing competition distortion for Swedish industry. We have assumed that these sector agreements are implemented in a developing country (DC). We conclude that if sector agreements are to reduce distortions on competition, it is important that the sector agreements create a real carbon price in the DC, i.e. that emissions of carbon dioxide are associated with a cost for the emitter. All three sector agreement-models suggested by the EU can potentially create a carbon price. The driver for emission reductions are in all three cases the international demand for offsets. As a potentially large buyer of off-sets, the EU demand for off-sets is likely to increase the carbon price in the DC sector. The choice of EU policy with respect to imports of off-set will therefore have great importance. Other buyers, such as other countries, emission trading systems or the voluntary credit market will of course also be important. Moreover, imports of off-sets may reduce the price on EU ETS allowances, thus further narrowing the carbon price gap between the two markets. If an important objective of a sectoral agreement is to reduce competition distortion it should be implemented in sectors where the corresponding Swedish industry has significant carbon related costs and where there is significant trade intensity between Sweden and regions outside the EU. Our preliminary analysis indicates that Swedish sectors with potentially high maximum value at stake are Refineries; Pulp and Paper; Iron and Steel; Cement and Lime; and

  19. 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.

  20. Sociology, systems and (patient) safety: knowledge translations in healthcare policy.

    Science.gov (United States)

    Jensen, Casper Bruun

    2008-03-01

    In 2000 the American Institute of Medicine, adviser to the federal government on policy matters relating to the health of the public, published the report To Err is Human: Building a Safer Health System, which was to become a call to arms for improving patient safety across the Western world. By re-conceiving healthcare as a system, it was argued that it was possible to transform the current culture of blame, which made individuals take defensive precautions against being assigned responsibility for error - notably by not reporting adverse events, into a culture of safety. The IOM report draws on several prominent social scientists in accomplishing this re-conceptualisation. But the analyses of these authors are not immediately relevant for health policy. It requires knowledge translation to make them so. This paper analyses the process of translation. The discussion is especially pertinent due to a certain looping effect between social science research and policy concerns. The case here presented is thus doubly illustrative: exemplifying first how social science is translated into health policy and secondly how the transformation required for this to function is taken as an analytical improvement that can in turn be redeployed in social research.

  1. Ukraine-Japanese-Swedish project: Upgrading of perimeter protection system at Kharkov Institute of Physics and Technology (KIPT)

    International Nuclear Information System (INIS)

    Mikahaylov, V.; Lapshin, V.; Ek, P.; Flyghed, L.; Nilsson, A.; Ooka, N.; Shimizu, K.; Tanuma, K.

    2001-01-01

    Full text: Since the Ukraine voluntarily accepted the status of a non-nuclear-weapons state and concluded a Safeguards Agreement with the IAEA, the Kharkov Institute of Physics and Technology (KIPT) as a nuclear facility using the nuclear material of category 1, has become a Ukrainian priority object for the international community's efforts to ensure nuclear non-proliferation measures and to bring the existing protection systems to the generally accepted security standards. In March 1996, at the meeting held under the auspices of the IAEA in Kiev, the representatives from Japan, Sweden and the USA agreed to provide technical assistance concerning improvement of the nuclear material accountancy and control and physical protection system (MPC and A) available at KIPT. The Technical Secretariat of the Japan-Ukraine Committee for Co-operation on Reducing Nuclear Weapons and Swedish Nuclear Power Inspectorate undertook to solve the most expensive and labour-consuming task namely, the upgrading of the perimeter protection system at KIPT. This included that the current perimeter system, comprising several kilometers, should be completely replaced. Besides the above-mentioned problem, the upgrading should be carried out with the institute in operation. Thus, it was not allowed to replace the existing protection system by a new one unless KIPT was constantly protected. This required the creation of a new protected zone that to a large extent was occupied by the communication equipment, buildings, trees and other objects interfering with the work. All these difficulties required very comprehensive development of the project design as well as a great deal of flexibility during the implementation of the project. These problems were all successfully resolved thanks to a well working project organization, composed of experts from KIPT, JAERI and ANS, involving the highly qualified Swedish technical experts who played a leading role. In the framework of implementation of the

  2. 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.

  3. 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

  4. Bonus systems and their effects on safety: an interview-based pilot study at the Swedish nuclear power plants

    International Nuclear Information System (INIS)

    Torbioern, Ingemar; Mattson, Malin

    2009-03-01

    The aim of this pilot study has been to describe and analyse potential effects on safety-related behaviour and risks associated with the bonus systems currently used at Swedish nuclear plants. To this end and in order to establish a frame of reference several theories on motivation were consulted regarding the relevance of monetary rewards. In addition empirical evidence on effects upon behaviours in general and safety behaviours in particular was taken into consideration, as well as a systems and a rationalist perspective on organisations. The resulting frame of reference was used for a descriptive mapping of the bonus systems and for the formulation of a semi-structured interview schedule intended to capture the experiences of those concerned by the systems. A total of 15 interviews were performed with staff of different functions and organisational positions. Results of the study do not indicate any negative effects on safety-related behaviours. Rather they indicate that safety-behaviours may be promoted insofar as bonus rewards are linked to performance goals concerning safety. All of the bonus-systems may be characterised as low in incentive intensity, i.e. produce small effects on motivation and performance. Still, as the systems differ in design and in the way they are perceived, they also represent different challenges in order to function more efficiently as parameters

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  6. The role of pharmacoeconomics in current Indian healthcare system.

    Science.gov (United States)

    Ahmad, Akram; Patel, Isha; Parimilakrishnan, Sundararajan; Mohanta, Guru Prasad; Chung, HaeChung; Chang, Jongwha

    2013-01-01

    Phamacoeconomics can aid the policy makers and the healthcare providers in decision making in evaluating the affordability of and access to rational drug use. Efficiency is a key concept of pharmacoeconomics, and various strategies are suggested for buying the greatest amount of benefits for a given resource use. Phamacoeconomic evaluation techniques such as cost minimization analysis, cost effectiveness analysis, cost benefit analysis, and cost utilization analysis, which support identification and quantification of cost of drugs, are conducted in a similar way, but vary in measurement of value of health benefits and outcomes. This article provides a brief overview about pharmacoeconomics, its utility with respect to the Indian pharmaceutical industry, and the expanding insurance system in India. Pharmacoeconomic evidences can be utilized to support decisions on licensing, pricing, reimbursement, and maintenance of formulary procedure of pharmaceuticals. For the insurance companies to give better facility at minimum cost, India must develop the platform for pharmacoeconomics with a validating methodology and appropriate training. The role of clinical pharmacists including PharmD graduates are expected to be more beneficial than the conventional pharmacists, as they will be able to apply the principles of economics in daily basis practice in community and hospital pharmacy.

  7. 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.

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

    OpenAIRE

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

    2011-01-01

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

  9. Accounting for external costs in a study of a Swedish district-heating system - An assessment of environmental policies

    International Nuclear Information System (INIS)

    Fahlen, E.; Ahlgren, E.O.

    2010-01-01

    Sweden has historically had strict emission control by implementation of economic policy instruments with the aim of internalising the external costs of air pollution. This study aims to evaluate how well current Swedish policy instruments reflect the environmental costs associated with heat generation in several district-heating (DH) plants in the DH system of Goeteborg. Furthermore, it aims to simulate and evaluate the operation of the DH system based on its social cost-effectiveness which takes into account the DH system's private and external costs (non-internalised environmental costs). The study shows that the economic policy instruments do not fully internalise all external costs whereas for certain technologies, the costs in terms of taxes, emission permits, environmental fees, etc. are higher than the environmental costs caused by the pollutants, given the environmental cost estimates used in the study. The simulation results show that the deviating internalisation of external costs affects the economic ranking of the different plants within the studied DH system. The estimated loss in social-cost effectiveness of the operation of the DH system of Goeteborg is noticable but relatively small if compared to the variable heat generation costs for most of the studied DH plants.

  10. 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.

  11. Experiences of working from a freestanding position as a case manager when supporting clients in the Swedish welfare system.

    Science.gov (United States)

    Klockmo, Carolina; Marnetoft, Sven-Uno

    2016-06-01

    The Swedish state uses a case management function known as Personligt Ombud (PO). The role as PO differs from the traditional professional roles. It has a freestanding position in the welfare system. The aim of this study was to investigate POs' experiences of working from a freestanding position when supporting clients. Telephone interviews were conducted with 22 POs across Sweden. The interviews were recorded, transcribed, and analyzed by latent qualitative content analysis. The findings were reflected in three categories - freedom-promoted flexibility, surfing through a complex welfare system, and working for legitimacy. POs developed a holistic view to both the client as well as to the welfare system. POs experienced solely representing the client, which is a positive feature because part of the POs' role is advocating for the clients rights. The PO service differs from the PO service from other existing case management models and may need to develop strategies for decision-making and support in their own role. For example, they may use group supervision teams or 'reflective teams'. The freestanding position may also entail problems in terms of lack of legitimacy. It is important for POs to develop good platforms with the surrounding actors among others things to improve the co-ordination process. It could be interesting if the PO model would be tested in other countries that have a fragmented welfare system. The PO model may also be useful to other 'target groups' who are in need of co-ordinated rehabilitation services.

  12. An Intergrated Sustainability Assessment of the Swedish Sugar Production System from a Life-Cycle Perspective: 2003-2015

    Directory of Open Access Journals (Sweden)

    Barry Ness

    2011-06-01

    Full Text Available The article presents a sustainability assessment of the beet-to-sugar production system in Sweden from 2003 until 2015. It focuses on the life-cycle phases of beet growing, beet transport and sugar processing. Based on the Swedish sustainable development strategy, eight indicators in environmental and socio-economic domains based significantly on EU price and production quota changes are assessed. The study also appraises the autumn wheat-to-flour production system as an alternative scenario to provide a better understanding of the overall impacts on the region of the effects of the EU price and quota changes. The method used is a system analysis (simulation model developed with the software STELLA 9.1. The study is a part of a broader regional sustainability assessment that focuses on the sugar sector in Sweden. Model results of the combined sugar and flour systems show general declines in agricultural landscape diversity and revenues earned in the region with only slight decreases in the number of full-time jobs in the region. Results also reveal decreases in the amount of nutrient runoff, fossil fuel energy use, greenhouse gas releases and field chemical use, with more substantial decreases in biodiversity via the suspension of organic beet growing in the region.

  13. Deaf women: experiences and perceptions of healthcare system access.

    Science.gov (United States)

    Steinberg, Annie G; Wiggins, Erin A; Barmada, Carlin Henry; Sullivan, Vicki Joy

    2002-10-01

    The authors investigated the knowledge, attitudes, and healthcare experiences of Deaf women. Interviews with 45 deaf women who participated in focus groups in American Sign Language were translated, transcribed, and analyzed. Deaf women's understanding of women's health issues, knowledge of health vocabulary in both English and American Sign Language, common health concerns among Deaf women, and issues of access to information, including pathways and barriers, were examined. As a qualitative study, the results of this investigation are limited and should be viewed as exploratory. A lack of health knowledge was evident, including little understanding of the meaning or value of cancer screening, mammography, or Pap smears; purposes of prescribed medications, such as hormone replacement therapy (HRT); or necessity for other medical or surgical interventions. Negative experiences and avoidance or nonuse of health services were reported, largely due to the lack of a common language with healthcare providers. Insensitive behaviors were also described. Positive experiences and increased access to health information were reported with practitioners who used qualified interpreters. Providers who demonstrated minimal signing skills, a willingness to use paper and pen, and sensitivity to improving communication were appreciated. Deaf women have unique cultural and linguistic issues that affect healthcare experiences. Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must be trained to become more effective communicators with Deaf patients and to use qualified interpreters to assure access to healthcare for Deaf women.

  14. Lean healthcare.

    Science.gov (United States)

    Weinstock, Donna

    2008-01-01

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

  15. 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.

  16. The Swedish Energy Market 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-10-01

    The Swedish Energy Market, 2005 is an annual publication that presents information and statistics on the network based energy markets in Sweden, i.e. the markets for electricity, natural gas and district heating. It also provides an overview of the issues that have arisen on these markets during the second half of 2004 and the first half of 2005. Considerable work is being carried out in the EU on creating a single market for electricity and natural gas. This publication therefore describes expansion of the Swedish market towards a Nordic and a European market. The publication normally includes a theme chapter, describing some event of particular interest for the Swedish energy market during the year. This year, the theme chapter is devoted to the Storm Gudrun, which struck the south of the country at the beginning of January, and its effects on electricity supply throughout the country. The chapter is based on the report submitted to the Government by the Energy Markets Inspectorate in the spring of 2005, and also includes a summary of the Inspectorate's proposals for measures to improve the security of electricity transmission. Energy in Sweden, which is another of the Swedish Energy Agency's annual publications, provides information and statistics on the development of the entire Swedish energy system.

  17. The Swedish Energy Market 2005

    International Nuclear Information System (INIS)

    2005-10-01

    The Swedish Energy Market, 2005 is an annual publication that presents information and statistics on the network based energy markets in Sweden, i.e. the markets for electricity, natural gas and district heating. It also provides an overview of the issues that have arisen on these markets during the second half of 2004 and the first half of 2005. Considerable work is being carried out in the EU on creating a single market for electricity and natural gas. This publication therefore describes expansion of the Swedish market towards a Nordic and a European market. The publication normally includes a theme chapter, describing some event of particular interest for the Swedish energy market during the year. This year, the theme chapter is devoted to the Storm Gudrun, which struck the south of the country at the beginning of January, and its effects on electricity supply throughout the country. The chapter is based on the report submitted to the Government by the Energy Markets Inspectorate in the spring of 2005, and also includes a summary of the Inspectorate's proposals for measures to improve the security of electricity transmission. Energy in Sweden, which is another of the Swedish Energy Agency's annual publications, provides information and statistics on the development of the entire Swedish energy system

  18. 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

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

    Science.gov (United States)

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

    2011-10-01

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

  20. 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.

  1. Is Canadian Healthcare Affordable? A Comparative Analysis of the Canadian Healthcare System from 2004 to 2014.

    Science.gov (United States)

    Soril, Lesley J J; Adams, Ted; Phipps-Taylor, Madeleine; Winblad, Ulrika; Clement, Fiona

    2017-08-01

    To compare cost-related non-adherence (CRNA), serious problems paying medical bills and average annual out-of-pocket cost over time in five countries. Repeated cross-sectional analysis of the Commonwealth Fund International Health Policy survey from 2004 to 2014. Responses were compared between Canada, the UK, Australia, New Zealand and the US. Compared to the UK, respondents in Canada, Australia and New Zealand were two to three times and respondents in the US were eight times more likely to experience CRNA; these odds remained stable over time. From 2004 to 2014, Canadian respondents paid US $852-1,767 out-of-pocket for care. The US reported the largest risks of serious problems paying for care (13-18.5%), highest out-of-pocket costs (US $2,060-3,319) and greatest rise in expenditures. Over the 10-year period, financial barriers to care were identified in Canada and internationally. Such persistent challenges are of great concern to countries striving for equitable access to healthcare. Copyright © 2017 Longwoods Publishing.

  2. Young people with intellectual disability—The role of self-advocacy in a transformed Swedish welfare system

    Directory of Open Access Journals (Sweden)

    Magnus Tideman

    2015-03-01

    Full Text Available A growing number of young people in Sweden with intellectual disability have organized themselves during the last 15 years in self-advocacy groups for socializing, empowerment, and expressing opposition to the norms and attitudes in a society that labels them as disabled. At the same time, the Swedish welfare system has transformed dramatically with processes of far-reaching individualization, closure of the major institutions, decentralization of responsibility from the state to local governments, and an emerging welfare market where service users are turned into customers. The aim of this article is to analyse and discuss the significance of self-advocacy in the new welfare context. Data were collected over a period of more than 10 years using repeated interviews with members of two self-advocacy groups and participation observations. Findings suggest that participation in self-advocacy groups opens up members for increasing health and well-being through new roles and identities, and it strengthens their control over everyday life. Support is still needed, however, but in new ways; otherwise, the restrictions of the institutions will simply be reconstructed in the new welfare system.

  3. A comparative study of contemporary user involvement within healthcare systems across England, Poland and Slovenia.

    Science.gov (United States)

    Lichon, Mateusz; Kavcic, Matic; Masterson, Daniel

    2015-01-01

    The purpose of this paper is to explore how healthcare-users' engagement is perceived, how it occurs and how these perceptions differ between three European countries: England, Poland and Slovenia, using the concepts of voice, choice and coproduction. This comparative, qualitative study is based on a review of legal documents, academic literature and semi-structured interviews conducted in October and November 2011. A research sample consisted of 21 interviewees representing various stakeholders including healthcare-users, doctors and managers. Primary and secondary data were analysed using theoretical thematic analysis. Emerging themes were identified from the interviews and related to the indicators describing healthcare-users' involvement in the voice, choice and coproduction model. Results of the comparative qualitative research suggest that the healthcare-users' influence is strongly grounded in England where the healthcare system and professionals are prepared to include healthcare-users in the decision-making process. In Slovenia, cultural development of healthcare-users' involvement seems to proceed the institutional development. In Poland, institutions are ready to involve healthcare-users in decision-making process although the cultural desirability of involving users among doctors and patients is lacking. The notion of user involvement is increasingly gaining importance and research attention, yet there is still little known about the way cultural, political, historical differences between various European countries influence it. This paper explores this little known area using the original approach of user involvement (Dent et al., 2011) with input from various stakeholders including patients, healthcare representatives and academics.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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....

  9. Optimisation of a Swedish district heating system with reduced heat demand due to energy efficiency measures in residential buildings

    International Nuclear Information System (INIS)

    Åberg, M.; Henning, D.

    2011-01-01

    The development towards more energy efficient buildings, as well as the expansion of district heating (DH) networks, is generally considered to reduce environmental impact. But the combined effect of these two progressions is more controversial. A reduced heat demand (HD) due to higher energy efficiency in buildings might hamper co-production of electricity and DH. In Sweden, co-produced electricity is normally considered to displace electricity from less efficient European condensing power plants. In this study, a potential HD reduction due to energy efficiency measures in the existing building stock in the Swedish city Linköping is calculated. The impact of HD reduction on heat and electricity production in the Linköping DH system is investigated by using the energy system optimisation model MODEST. Energy efficiency measures in buildings reduce seasonal HD variations. Model results show that HD reductions primarily decrease heat-only production. The electricity-to-heat output ratio for the system is increased for HD reductions up to 30%. Local and global CO 2 emissions are reduced. If co-produced electricity replaces electricity from coal-fired condensing power plants, a 20% HD reduction is optimal for decreasing global CO 2 emissions in the analysed DH system. - Highlights: ► A MODEST optimisation model of the Linköping district heating system is used. ► The impact of heat demand reduction on heat and electricity production is examined. ► Model results show that heat demand reductions decrease heat-only production. ► Local and global CO 2 emissions are reduced. ► The system electricity-to-heat output increases for reduced heat demand up to 30%.

  10. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Munro, Neil; Duckett, Jane

    2016-06-01

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

  13. 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.

  14. Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region.

    Science.gov (United States)

    Nyström, M E; Höög, E; Garvare, R; Andersson Bäck, M; Terris, D D; Hansson, J

    2018-05-24

    Eldercare and care of people with functional impairments is organized by the municipalities in Sweden. Improving care in these areas is complex, with multiple stakeholders and organizations. Appropriate strategies to develop capability for continuing organizational improvement and learning (COIL) are needed. The purpose of our study was to develop and pilot-test a flexible, multilevel approach for COIL capability building and to identify what it takes to achieve changes in key actors' approaches to COIL. The approach, named "Sustainable Improvement and Development through Strategic and Systematic Approaches" (SIDSSA), was applied through an action-research and action-learning intervention. The SIDSSA approach was tested in a regional research and development (R&D) unit, and in two municipalities handling care of the elderly and people with functional impairments. Our approach included a multilevel strategy, development loops of five flexible phases, and an action-learning loop. The approach was designed to support systems understanding, strategic focus, methodological practices, and change process knowledge - all of which required double-loop learning. Multiple qualitative methods, i.e., repeated interviews, process diaries, and documents, provided data for conventional content analyses. The new approach was successfully tested on all cases and adopted and sustained by the R&D unit. Participants reported new insights and skills. The development loop facilitated a sense of coherence and control during uncertainty, improved planning and problem analysis, enhanced mapping of context and conditions, and supported problem-solving at both the individual and unit levels. The systems-level view and structured approach helped participants to explain, motivate, and implement change initiatives, especially after working more systematically with mapping, analyses, and goal setting. An easily understood and generalizable model internalized by key organizational actors is an

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

    Science.gov (United States)

    Nardon, Fabiane Bizinella; de A Moura, Lincoln

    2007-01-01

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

  16. Developing patient portals in a fragmented healthcare system.

    Science.gov (United States)

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

    2015-10-01

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

  17. Swedish district heating—A system in stagnation: Current and future trends in the district heating sector

    International Nuclear Information System (INIS)

    Magnusson, Dick

    2012-01-01

    This paper argues that Sweden’s old and established district heating sector is heading into a stagnation phase. The aim is to analyse the factors influencing this development as well as the strategies used by involved parties to prevent stagnation. Using large technical system theory, I analyse internal and external factors potentially causing stagnation. The most obvious external factors are: an increase in the number of energy-efficient buildings, in response to stricter energy policies, which reduces the future potential for district heating in new and existing buildings; climate change; competition from other heating systems; and market saturation in the key sector, multi-dwelling buildings. The main internal factor is changed business strategies following electricity market deregulation, when energy companies were supposed to be run on businesslike terms. I also argue that stagnation can be defined as occurring when the key measure feature of a system, in this case, heat load is starting to stagnate or decline, even though the trend is positive in other areas. The strategies for avoiding stagnation are various forms of broadening scope, primarily by focusing more on electricity production by building combined heat and power plants, or using the alternative value of the technical system for new applications. - Highlights: ► The Swedish district heating sector is heading into a stage of stagnation. ► The main reasons are: climate change, competition and energy efficient buildings. ► Strategies to change trend: broadening of scope by focusing on electricity in CHP plants. ► Contribution to Large Technical Systems—theory and the later phases of system development.

  18. 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.

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

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

    29 juin 2016 ... 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. ... des chercheurs et des praticiens se sont réunis à Montréal dans le cadre de la conférence d'une journée intitulée The Global Need for Formal Child Care.

  20. 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.

  1. Transformacija partijno-politicheskoj sistemy Shvecii v konce XX — nachale XXI veka [The transformation of the Swedish political party system in the late 20th/early 21st century

    Directory of Open Access Journals (Sweden)

    Ryabichenko Arkady

    2013-01-01

    Full Text Available This article studies the process of transformation of the Swedish political party system in the 1980s. The study aims to develop a typology of the Swedish political party system before and after the transformation processes commenced. The article identifies the key prerequisites for such transformation: the crisis of social democracy and an increase in the nationalist attitudes in the society caused by the negative repercussions of the system of integration of migrants into the society based on the multiculturalism principles. The interethnic tension manifested itself in the wide support for the Swedish Democrats Party in the 2010 parliamentary election. From a political party system dominated by social democrats, the Swedish political party system turned into one with two leading parties – the centre-left Swedish Social Democratic Labour Party and the centre-right Moderate Party. The Swedish Democrats position themselves as an alternative to the two party blocs headed by the dominating parties (the Alliance and the Red-Green. The study employs an interdisciplinary approach in the framework of science synthesis. Its results can be of practical significance for politicians, social activists, and academicians.

  2. An Intelligent Virtual Human System For Providing Healthcare Information And Support

    Science.gov (United States)

    2011-01-01

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

  3. Impact of telephone nursing education program for equity in healthcare

    OpenAIRE

    H?glund, Anna T.; Carlsson, Marianne; Holmstr?m, Inger K.; Kaminsky, Elenor

    2016-01-01

    Background The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person?s human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing. Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare...

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

    Science.gov (United States)

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

    2018-03-21

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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

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

    Science.gov (United States)

    Graber, David R; Kilpatrick, Anne Osborne

    2008-01-01

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

  11. 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

  12. Swedish Disarmament Policy

    OpenAIRE

    2012-01-01

    NPIHP Partners Host Conference on Swedish Disarmament Policy Dec 05, 2012 The Nuclear Proliferation International History Project is pleased to announce a conference on Swedish nuclear disarmament policy, organized and hosted by Stockholm University on 26 november 2012. Organized by Stockholm University Professor Thomas Jonter, Emma Rosengren, Goran Rydeberg, and Stellan Andersson under the aegis of the Swedish Disarmament Resaerch Project, the conference featured keynote addresses by Hans Bl...

  13. Strengthening the Radiation Protection System in Cuba (SRPS - Cuba). A co-operation project between Cuban and Swedish institutions, February 2001 - June 2003

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Larsson, Carl-Magnus; Prendes, Miguel; Zerquera, Juan Tomas

    2004-02-01

    This project results from the co-operation between a number of Cuban and Swedish institutions. It started in February 2001 and ended in June 2003 and was made possible thanks to the contributions of the Swedish International Development Co-operation Agency (SIDA), the Centro de Proteccion e Higiene de las Radiaciones, Cuba (CPHR), and the Swedish Radiation Protection Authority (SSI). The overall objective was to strengthen the radiation protection system in Cuba, and in this way contribute with the control and reduction of risks to man and the environment from exposures to ionizing radiation. The project focused on four priority areas: 1) Protection of workers and patients exposed to radiation in radiation practices; 2) Preparedness for response to an emergency situation; 3) Environmental radiological protection; and, 4) Exposure to radiation in areas with high levels of natural radioactivity. The present report summarizes the findings of the whole project period, providing an overview of the overall achievements, as well as listing its deliverables. The results of an evaluation of the project, conducted during the final workshop, are also included. The report ends with a list of generic and specific conclusions and recommendations for implementation of the project's achievements and for further development of co-operation.

  14. Strengthening the Radiation Protection System in Cuba (SRPS - Cuba). A co-operation project between Cuban and Swedish institutions, February 2001 - June 2003

    International Nuclear Information System (INIS)

    Avila, Rodolfo; Larsson, Carl-Magnus; Prendes, Miguel; Zerquera, Juan Tomas

    2004-02-01

    This project results from the co-operation between a number of Cuban and Swedish institutions. It started in February 2001 and ended in June 2003 and was made possible thanks to the contributions of the Swedish International Development Co-operation Agency (SIDA), the Centro de Proteccion e Higiene de las Radiaciones, Cuba (CPHR), and the Swedish Radiation Protection Authority (SSI). The overall objective was to strengthen the radiation protection system in Cuba, and in this way contribute with the control and reduction of risks to man and the environment from exposures to ionizing radiation. The project focused on four priority areas: 1) Protection of workers and patients exposed to radiation in radiation practices; 2) Preparedness for response to an emergency situation; 3) Environmental radiological protection; and, 4) Exposure to radiation in areas with high levels of natural radioactivity. The present report summarizes the findings of the whole project period, providing an overview of the overall achievements, as well as listing its deliverables. The results of an evaluation of the project, conducted during the final workshop, are also included. The report ends with a list of generic and specific conclusions and recommendations for implementation of the project's achievements and for further development of co-operation

  15. The Perceived Efficacy and Goal Setting System (PEGS), part II: evaluation of test-retest reliability and differences between child and parental reports in the Swedish version.

    Science.gov (United States)

    Vroland-Nordstrand, Kristina; Krumlinde-Sundholm, Lena

    2012-11-01

    to evaluate the test-retest reliability of children's perceptions of their own competence in performing daily tasks and of their choice of goals for intervention using the Swedish version of the perceived efficacy and goal setting system (PEGS). A second aim was to evaluate agreement between children's and parents' perceptions of the child's competence and choices of intervention goals. Forty-four children with disabilities and their parents completed the Swedish version of the PEGS. Thirty-six of the children completed a retest session allocated into one of two groups: (A) for evaluation of perceived competence and (B) for evaluation of choice of goals. Cohen's kappa, weighted kappa and absolute agreement were calculated. Test-retest reliability for children's perceived competence showed good agreement for the dichotomized scale of competent/non-competent performance; however, using the four-point scale the agreement varied. The children's own goals were relatively stable over time; 78% had an absolute agreement ranging from 50% to 100%. There was poor agreement between the children's and their parents' ratings. Goals identified by the children differed from those identified by their parents, with 48% of the children having no goals identical to those chosen by their parents. These results indicate that the Swedish version of the PEGS produces reliable outcomes comparable to the original version.

  16. A fatigue analysis including environmental effects for a pipe system in a Swedish BWR

    International Nuclear Information System (INIS)

    Steingrimsdottir, Kristin; Dahlberg, Magnus

    2011-10-01

    A BWR feed water piping system (austenitic steel) has been analyzed with two different fatigue curves and environmental factors. Original fatigue curve from ASME is compared to a new fatigue curve; ANL. The influence of environmental correction factors (Fen) is studied further for the piping system. It is noted that the results apply for this particular system, and general conclusions should be cautiously drawn. Typical for this system is that all dominant loads are within the low-cycle regime. This implies that the change of fatigue curve only leads to limited increases in usage factors. Larger changes can occur if larger number of cycles is within the high-cycle regime

  17. 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.

  18. 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.

  19. Patient Populations, Clinical Associations, and System Efficiency in Healthcare Delivery System

    Science.gov (United States)

    Liu, Yazhuo

    The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes' perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease' correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

  20. Visible Parts, Invisible Whole: Swedish Technology Student Teachers' Conceptions about Technological Systems

    Science.gov (United States)

    Hallström, Jonas; Klasander, Claes

    2017-01-01

    Technological systems are included as a component of national technology curricula and standards for primary and secondary education as well as corresponding teacher education around the world. Little is known, however, of how pupils, students, and teachers conceive of technological systems. In this article we report on a study investigating…

  1. Designing Temporary Systems: Exploring Local School Improvement Intentions in the Swedish Context

    Science.gov (United States)

    Nordholm, Daniel; Blossing, Ulf

    2014-01-01

    This article targets local school improvement in Sweden and temporary systems as a model to organize improvement work. These data are based on a qualitative case study of teacher groups constituting a temporary system representing the different subjects in comprehensive school in a medium-sized urban municipality. A total of eight interviews were…

  2. 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.

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

    Science.gov (United States)

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

    2010-11-01

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

  4. 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.

  5. [Data coding in the Israeli healthcare system - do choices provide the answers to our system's needs?].

    Science.gov (United States)

    Zelingher, Julian; Ash, Nachman

    2013-05-01

    The IsraeLi healthcare system has undergone major processes for the adoption of health information technologies (HIT), and enjoys high Levels of utilization in hospital and ambulatory care. Coding is an essential infrastructure component of HIT, and ts purpose is to represent data in a simplified and common format, enhancing its manipulation by digital systems. Proper coding of data enables efficient identification, storage, retrieval and communication of data. UtiLization of uniform coding systems by different organizations enables data interoperability between them, facilitating communication and integrating data elements originating in different information systems from various organizations. Current needs in Israel for heaLth data coding include recording and reporting of diagnoses for hospitalized patients, outpatients and visitors of the Emergency Department, coding of procedures and operations, coding of pathology findings, reporting of discharge diagnoses and causes of death, billing codes, organizational data warehouses and national registries. New national projects for cLinicaL data integration, obligatory reporting of quality indicators and new Ministry of Health (MOH) requirements for HIT necessitate a high Level of interoperability that can be achieved only through the adoption of uniform coding. Additional pressures were introduced by the USA decision to stop the maintenance of the ICD-9-CM codes that are also used by Israeli healthcare, and the adoption of ICD-10-C and ICD-10-PCS as the main coding system for billing purpose. The USA has also mandated utilization of SNOMED-CT as the coding terminology for the ELectronic Health Record problem list, and for reporting quality indicators to the CMS. Hence, the Israeli MOH has recently decided that discharge diagnoses will be reported using ICD-10-CM codes, and SNOMED-CT will be used to code the cLinical information in the EHR. We reviewed the characteristics, strengths and weaknesses of these two coding

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

    OpenAIRE

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

    2011-01-01

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

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

    Science.gov (United States)

    Lauerer, M; Emmert, M; Schöffski, O

    2013-08-01

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

  8. 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

  9. 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.

  10. Design and implementation of a wearable healthcare monitoring system.

    Science.gov (United States)

    Sagahyroon, Assim; Raddy, Hazem; Ghazy, Ali; Suleman, Umair

    2009-01-01

    A wearable healthcare monitoring unit that integrates various technologies was developed to provide patients with the option of leading a healthy and independent life without risks or confinement to medical facilities. The unit consists of various sensors integrated to a microcontroller and attached to the patient's body, reading vital signs and transmitting these readings via a Bluetooth link to the patient's mobile phone. Short-Messaging-Service (SMS) is incorporated in the design to alert a physician in emergency cases. Additionally, an application program running on the mobile phone uses the internet to update (at regular intervals) the patient records in a hospital database with the most recent readings. To reduce development costs, the components used were both off-the-shelf and affordable.

  11. Collaboration in a competitive healthcare system: negotiation 101 for clinicians.

    Science.gov (United States)

    Clay-Williams, Robyn; Johnson, Andrew; Lane, Paul; Li, Zhicheng; Camilleri, Lauren; Winata, Teresa; Klug, Michael

    2018-04-09

    Purpose The purpose of this paper is to evaluate the effectiveness of negotiation training delivered to senior clinicians, managers and executives, by exploring whether staff members implemented negotiation skills in their workplace following the training, and if so, how and when. Design/methodology/approach This is a qualitative study involving face-to-face interviews with 18 senior clinicians, managers and executives who completed a two-day intensive negotiation skills training course. Interviews were transcribed verbatim, and inductive interpretive analysis techniques were used to identify common themes. Research setting was a large tertiary care hospital and health service in regional Australia. Findings Participants generally reported positive affective and utility reactions to the training, and attempted to implement at least some of the skills in the workplace. The main enabler was provision of a Negotiation Toolkit to assist in preparing and conducting negotiations. The main barrier was lack of time to reflect on the principles and prepare for upcoming negotiations. Participants reported that ongoing skill development and retention were not adequately addressed; suggestions for improving sustainability included provision of refresher training and mentoring. Research limitations/implications Limitations include self-reported data, and interview questions positively elicited examples of training translation. Practical implications The training was well matched to participant needs, with negotiation a common and daily activity for most healthcare professionals. Implementation of the skills showed potential for improving collaboration and problem solving in the workplace. Practical examples of how the skills were used in the workplace are provided. Originality/value To the authors' knowledge, this is the first international study aimed at evaluating the effectiveness of an integrative bargaining negotiation training program targeting executives, senior

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

    Science.gov (United States)

    Tivatansakul, S; Ohkura, M

    2015-01-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2013-12-01

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

  15. Characterization of Sphingomonas isolates from Finnish and Swedish drinking water distribution systems.

    Science.gov (United States)

    Koskinen, R; Ali-Vehmas, T; Kämpfer, P; Laurikkala, M; Tsitko, I; Kostyal, E; Atroshi, F; Salkinoja-Salonen, M

    2000-10-01

    Sphingomonas species were commonly isolated from biofilms in drinking water distribution systems in Finland (three water meters) and Sweden (five water taps in different buildings). The Sphingomonas isolates (n = 38) were characterized by chemotaxonomic, physiological and phylogenetic methods. Fifteen isolates were designated to species Sphingomonas aromaticivorans, seven isolates to S. subterranea, two isolates to S. xenophaga and one isolate to S. stygia. Thirteen isolates represented one or more new species of Sphingomonas. Thirty-three isolates out of 38 grew at 5 degrees C on trypticase soy broth agar (TSBA) and may therefore proliferate in the Nordic drinking water pipeline where the temperature typically ranges from 2 to 12 degrees C. Thirty-three isolates out of 38 grew at 37 degrees C on TSBA and 15 isolates also grew on blood agar at 37 degrees C. Considering the potentially pathogenic features of sphingomonas, their presence in drinking water distribution systems may not be desirable.

  16. 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

  17. 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.

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

    Science.gov (United States)

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

    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, 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. PMID:27657096

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

    Science.gov (United States)

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

    2016-09-19

    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.

  1. Artistic and Engineering Design of Platform-Based Production Systems: A Study of Swedish Architectural Practice

    Directory of Open Access Journals (Sweden)

    Gustav Jansson

    2018-02-01

    Full Text Available Research on platform-based production systems for house-building has focused on production and manufacturing issues. The aim of this research is to explore how the architectural design process contributes to the industrialised house-building industry from the perspective of creative design work. It also aims to describe how constraints affect architectural design work in the engineer-to-order context, when using platform-based production systems. Architects with experience in using platform-based building systems with different degrees of constraints were interviewed regarding creative aspects of the design work. The interviews, together with documents relating to platform constraints, were then analysed from the perspective of artistic and engineering design theories. The results show the benefits and issues of using platform constraints, both with prefabrication of volumetric modules, as well as prefabricated slab and wall elements. The study highlights a major research gap by describing how architectural work, from both the creative artistic and engineering design perspectives, is affected by constraints in the building platform: (1 the architectural design work goes through a series of divergent and convergent processes where the divergent processes are explorative and the convergent processes are solution-oriented; and (2, there is a trade-off between creativity and efficiency in the design work. Open parameters for layout design are key to architectural creativity, while predefinition supports efficiency. The results also provide an understanding of the potential for creativity in artistic and engineering work tasks through different phases in design, and how they are related to constraints in the platform. The main limitation of the research is the number of interviewed architects who had different background experiences of working with different types of platform constraints. More studies are needed to confirm the observations and to

  2. Periodontal and systemic diseases among Swedish dental school patients - a retrospective register study.

    Science.gov (United States)

    Marjanovic, Marija; Buhlin, Kåre

    2013-01-01

    To investigate if patients with periodontitis attending the Dental School in Huddinge, Sweden presented with more signs of systemic diseases, such as cardiovascular disease, diabetes mellitus and respiratory diseases, compared to healthy and gingivitis patients. In this retrospective study, dental charts were examined where the periodontal diagnoses of patients were known. A total of 325 patients with severe periodontitis and 149 patients without periodontitis, born 1928 to 1968, were identified. Diagnosis regarding the systemic diseases was self-reported. Odds ratios for cardiovascular diseases, diabetes mellitus and respiratory diseases were calculated with a logistic regression model that was adjusted for age, gender and smoking. It was observed that more cases of periodontitis were found in older individuals than the controls (61.7 vs 56.2 years; P < 0.001). A total of 44.3% of patients with severe periodontitis also suffered from cardiovascular diseases, 19.1% respiratory diseases and 21.2% from diabetes mellitus. Among the controls, 30.9% had cardiovascular disease, 23.5% suffered from respiratory diseases and 6.7% had diabetes mellitus. Across both groups, hypertension was the most frequent diagnosis. There was a significant association between periodontitis and cardiovascular disease (odds ratio [OR] = 1.79, confidence interval [CI] 1.12-2.86), but not between respiratory diseases and periodontitis (OR= 0.88, CI 0.53-1.47). The risk of diabetes mellitus was greater among those patients with periodontitis (OR= 2.95, CI 1.45- 6.01). This study found that patients with periodontitis presented with more systemic diseases, such as cardiovascular disease and diabetes mellitus than control patients. However, no association was found between periodontitis and respiratory diseases. At the present time, the reasons for the associations or lack of association are unknown.

  3. 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.

  4. Career histories as determinants of gendered retirement timing in the Danish and Swedish pension systems.

    Science.gov (United States)

    König, Stefanie

    2017-12-01

    After reforms in pension systems had taken place in most European countries within the last two decades, the concern was raised that women may be disadvantaged by these reforms. It is suggested that they are faced with a higher financial need to work longer. Retrospective data from SHARELIFE are used to run an event history analysis on the timing of the final employment exit, separately for gender, country and exit cohort. This study aims to disentangle the influence of gendered labour markets and pension regulations on retirement timing by investigating conditions in Denmark and Sweden. Some evidence was found that women compensate for lower labour market attachment due to long part-time periods by working longer, especially in younger cohorts. This seems to depend on the pension system. In countries with broad basic pensions, high replacement rates for low-income groups and fewer penalties for early retirement, the compensation is suggested to be less frequent. This study indicates the growing importance of the "compensation hypothesis" compared to the "status maintenance hypothesis" of previous careers in relation with retirement timing.

  5. 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.

  6. Big problems for Swedish nuclear industry

    International Nuclear Information System (INIS)

    Holmstroem, Anton; Runesson, Linda

    2006-01-01

    A report of the problems for Swedish nuclear industry the summer of 2006. A detailed description of the 25th of July incident at Forsmark 1 is provided. The incident was classified as level two on the INIS scale. The other Swedish nuclear plants were subject to security evaluations in the aftermath, and at Forsmark 2 similar weaknesses were found in the security system (ml)

  7. 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

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

    Science.gov (United States)

    Chuang, Sheuwen; Inder, Kerry

    2009-10-24

    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. 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. 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 surveyors is developed that provides a systematic search for

  9. 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.

  10. The Resilience of a Sustainability Entrepreneur in the Swedish Food System

    Directory of Open Access Journals (Sweden)

    Markus Larsson

    2016-06-01

    Full Text Available Organizational resilience emphasizes the adaptive capacity for renewal after crisis. This paper explores the sustainability and resilience of a not-for-profit firm that claims to contribute to sustainable development of the food system. We used semi-structured interviews and Holling’s adaptive cycle as a heuristic device to assess what constitutes social and sustainable entrepreneurship in this case, and we discuss the determinants of organizational resilience. The business, Biodynamiska Produkter (BP, has experienced periods of growth, conservation and rapid decline in demand, followed by periods of re-organization. Our results suggest that BP, with its social mission and focus on organic food, meets the criteria of both a social and sustainability entrepreneurial organization. BP also exhibits criteria for organizational resilience: two major crises in the 1970s and late 1990s were met by re-organization (transformation and novel market innovations (adaptations. BP has promoted the organic food sector in Sweden, but not profited from this. In this case study, resilience has enhanced sustainability in general, but trade-offs were also identified. The emphasis on trust, local identity, social objectives and slow decisions may have impeded both economic performance and new adaptations. Since the successful innovation Ekolådan in 2003, crises have been met by consolidation rather than new innovations.

  11. 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.

  12. Hand hygiene and healthcare system change within multi-modal promotion: a narrative review.

    Science.gov (United States)

    Allegranzi, B; Sax, H; Pittet, D

    2013-02-01

    Many factors may influence the level of compliance with hand hygiene recommendations by healthcare workers. Lack of products and facilities as well as their inappropriate and non-ergonomic location represent important barriers. Targeted actions aimed at making hand hygiene practices feasible during healthcare delivery by ensuring that the necessary infrastructure is in place, defined as 'system change', are essential to improve hand hygiene in healthcare. In particular, access to alcohol-based hand rubs (AHRs) enables appropriate and timely hand hygiene performance at the point of care. The feasibility and impact of system change within multi-modal strategies have been demonstrated both at institutional level and on a large scale. The introduction of AHRs overcomes some important barriers to best hand hygiene practices and is associated with higher compliance, especially when integrated within multi-modal strategies. Several studies demonstrated the association between AHR consumption and reduction in healthcare-associated infection, in particular, meticillin-resistant Staphylococcus aureus bacteraemia. Recent reports demonstrate the feasibility and success of system change implementation on a large scale. The World Health Organization and other investigators have reported the challenges and encouraging results of implementing hand hygiene improvement strategies, including AHR introduction, in settings with limited resources. This review summarizes the available evidence demonstrating the need for system change and its importance within multi-modal hand hygiene improvement strategies. This topic is also discussed in a global perspective and highlights some controversial issues. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. [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.

  14. Complexity, flow, and antifragile healthcare systems: implications for nurse executives.

    Science.gov (United States)

    Clancy, Thomas R

    2015-04-01

    As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on the application of management strategies in health systems. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. In this article, I further discuss the concept of fragility, its impact on system behavior, and ways to reduce it.

  15. Swedish nuclear waste efforts

    International Nuclear Information System (INIS)

    Rydberg, J.

    1981-09-01

    After the introduction of a law prohibiting the start-up of any new nuclear power plant until the utility had shown that the waste produced by the plant could be taken care of in an absolutely safe way, the Swedish nuclear utilities in December 1976 embarked on the Nuclear Fuel Safety Project, which in November 1977 presented a first report, Handling of Spent Nuclear Fuel and Final Storage of Vitrified Waste (KBS-I), and in November 1978 a second report, Handling and Final Storage of Unreprocessed Spent Nuclear Fuel (KBS II). These summary reports were supported by 120 technical reports prepared by 450 experts. The project engaged 70 private and governmental institutions at a total cost of US $15 million. The KBS-I and KBS-II reports are summarized in this document, as are also continued waste research efforts carried out by KBS, SKBF, PRAV, ASEA and other Swedish organizations. The KBS reports describe all steps (except reprocessing) in handling chain from removal from a reactor of spent fuel elements until their radioactive waste products are finally disposed of, in canisters, in an underground granite depository. The KBS concept relies on engineered multibarrier systems in combination with final storage in thoroughly investigated stable geologic formations. This report also briefly describes other activities carried out by the nuclear industry, namely, the construction of a central storage facility for spent fuel elements (to be in operation by 1985), a repository for reactor waste (to be in operation by 1988), and an intermediate storage facility for vitrified high-level waste (to be in operation by 1990). The R and D activities are updated to September 1981

  16. 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, pdetection 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.

  17. 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.

  18. An Efficient and Secure Certificateless Authentication Protocol for Healthcare System on Wireless Medical Sensor Networks

    Science.gov (United States)

    Guo, Rui; Wen, Qiaoyan; Jin, Zhengping; Zhang, Hua

    2013-01-01

    Sensor networks have opened up new opportunities in healthcare systems, which can transmit patient's condition to health professional's hand-held devices in time. The patient's physiological signals are very sensitive and the networks are extremely vulnerable to many attacks. It must be ensured that patient's privacy is not exposed to unauthorized entities. Therefore, the control of access to healthcare systems has become a crucial challenge. An efficient and secure authentication protocol will thus be needed in wireless medical sensor networks. In this paper, we propose a certificateless authentication scheme without bilinear pairing while providing patient anonymity. Compared with other related protocols, the proposed scheme needs less computation and communication cost and preserves stronger security. Our performance evaluations show that this protocol is more practical for healthcare system in wireless medical sensor networks. PMID:23710147

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

    Science.gov (United States)

    Thom, S E

    2018-02-01

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

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

    Science.gov (United States)

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

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Wang Peng

    2015-01-01

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

  4. Healthcare Text Classification System and its Performance Evaluation: A Source of Better Intelligence by Characterizing Healthcare Text.

    Science.gov (United States)

    Srivastava, Saurabh Kumar; Singh, Sandeep Kumar; Suri, Jasjit S

    2018-04-13

    A machine learning (ML)-based text classification system has several classifiers. The performance evaluation (PE) of the ML system is typically driven by the training data size and the partition protocols used. Such systems lead to low accuracy because the text classification systems lack the ability to model the input text data in terms of noise characteristics. This research study proposes a concept of misrepresentation ratio (MRR) on input healthcare text data and models the PE criteria for validating the hypothesis. Further, such a novel system provides a platform to amalgamate several attributes of the ML system such as: data size, classifier type, partitioning protocol and percentage MRR. Our comprehensive data analysis consisted of five types of text data sets (TwitterA, WebKB4, Disease, Reuters (R8), and SMS); five kinds of classifiers (support vector machine with linear kernel (SVM-L), MLP-based neural network, AdaBoost, stochastic gradient descent and decision tree); and five types of training protocols (K2, K4, K5, K10 and JK). Using the decreasing order of MRR, our ML system demonstrates the mean classification accuracies as: 70.13 ± 0.15%, 87.34 ± 0.06%, 93.73 ± 0.03%, 94.45 ± 0.03% and 97.83 ± 0.01%, respectively, using all the classifiers and protocols. The corresponding AUC is 0.98 for SMS data using Multi-Layer Perceptron (MLP) based neural network. All the classifiers, the best accuracy of 91.84 ± 0.04% is shown to be of MLP-based neural network and this is 6% better over previously published. Further we observed that as MRR decreases, the system robustness increases and validated by standard deviations. The overall text system accuracy using all data types, classifiers, protocols is 89%, thereby showing the entire ML system to be novel, robust and unique. The system is also tested for stability and reliability.

  5. Consequences of the quota requirement for energy efficiency. Can a Swedish quota obligation systems give less energy usage?; Konsekvenser av kvotplikt foer energieffektivisering. Kan ett svenskt kvotpliktssystem ge mindre energianvaendning?

    Energy Technology Data Exchange (ETDEWEB)

    Bjoerkroth, Sara; Bladh, Mats; Holmberg, Rurik; Lock, Anna; Naderi, Ronak; Widerstroem, Glenn

    2012-11-01

    The Agency has on behalf of the government investigated what the consequences would be of the introduction of a compulsory quota system in Sweden. Under the proposed new EU directive on energy efficiency, all Member States should introduce a compulsory quota system, where energy companies actively initiate measures for energy efficiency among end users. In Sweden, a quota obligation system of this kind would mean energy efficiency of about 3 TWh per year, which can be difficult to achieve. The Swedish Energy Agency suggests that if a compulsory quota system is introduced, the quota obligation should be placed on the network companies. If not, there is a risk of complications in the Swedish and Nordic electricity market. The Energy Markets Inspectorate consider that the quota obligation can not be on the network companies because of their function as regulated monopoly. The Swedish Energy Agency suggests that efficiency measures can be implemented in all sectors, including transport.

  6. Benefits negotiation: three Swedish hospitals pursuit of potential electronic health record benefits.

    Science.gov (United States)

    Jeansson, John S

    2013-01-01

    At the very heart of Swedish healthcare digitalisation are large investments in electronic health records (EHRs). These integrated information systems (ISs) carry promises of great benefits and value for organisations. However, realising IS benefits and value has, in general, proven to be a challenging task, and as organisations strive to formalise their realisation efforts a misconception of rationality threatens to emerge. This misconception manifests itself when the formality of analysis threatens to underrate the impact of social processes in deciding which potential benefits to pursue. This paper suggests that these decisions are the result of a social process of negotiation. The purpose of this paper is to observe three benefits analysis projects of three Swedish hospitals to better understand the character and management of proposed benefits negotiations. Findings depict several different categories of benefits negotiations, as well as key factors to consider during the benefits negotiation process.

  7. Efficiency as a parameter for assessing the Polish healthcare system

    Directory of Open Access Journals (Sweden)

    Magdalena Bogdan

    2018-04-01

    Full Text Available Introduction. Efficacy is defined as one of the most valid parameters of health system evaluation. It should be said that there is no consistent definition of the concept of effectiveness in health care, which would allow for the evaluation and comparison of health systems in the world. One can not point to the best or even near ideal of the health system. However, you can rank individual health systems with respect to the evaluation of individual parameters or groups of parameters. One of the possibilities is to evaluate the effectiveness of the system. Aim of the study. The aim of the article is to define and analyze particular types of system effectiveness in the context of the Polish health system. Description of knowledge. The literature on the subject is divided into operational and dynamic efficiency. Dynamic efficiency is divided into adaptive and innovative. The Polish health system is characterized by high operational efficiency. Operational efficiency determines the intensity of the system. The key factor for improving the health of the Polish society, as a factor of socio-economic development of the country is to improve the dynamic efficiency of the system. Conclusions. Health care in Poland has high operational efficiency while low dynamic efficiency, both adaptive and innovative, which clearly demonstrates the existence of a paradox of the overall effectiveness of the health care system in Poland.

  8. 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.

  9. [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.

  10. Reliable in their failure: an analysis of healthcare reform policies in public systems.

    Science.gov (United States)

    Contandriopoulos, Damien; Brousselle, Astrid

    2010-05-01

    In this paper, we analyze recommendations of past governmental commissions and their implementation in Quebec as a case to discuss the obstacles that litter the road to healthcare system reform. Our analysis shows that the obstacles to tackling the healthcare system's main problems may have less to do with programmatic (what to do) than with political and governance (how to do it) questions. We then draw on neo-institutional theory to discuss the causes and effects of this situation. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

  11. Swedish Government Minister at CERN

    CERN Document Server

    2008-01-01

    The Swedish Minister for Higher Education and Research recently visited CERN. The Swedish Minister was greeted by Swedish scientists working at CERN. Signing of the Swedish Computing Memorandum of Understanding. Pär Omling, Director-General of the Swedish Research Council (left), and Jos Engelen, CERN’s Chief Scientific Officer. Lars Leijonborg, the Swedish Minister for Higher Education and Research, was welcomed to CERN by Director-General Robert Aymar on 10 March. After an introduction to the Laboratory’s activities, the Minister was given guided tours of the control room, the ATLAS surface hall and experiment cavern and the adjoining LHC tunnel. Mr Leijonborg was then greeted by Swedish scientists and given an overview of the Swedish research programme at CERN. Five Swedish university groups are taking part in LHC research. Swedish universities are notably involved in the manufacture of parts for the sub-detectors of AT...

  12. Implementation of a healthcare process in four different workflow systems

    NARCIS (Netherlands)

    Mans, R.S.; Aalst, van der W.M.P.; Russell, N.C.; Bakker, P.J.M.

    2009-01-01

    Currently, many hospitals are investigating the use of a work-flow management system in order to provide support for care processes. However, today's workow management systems fall short in supporting care processes as exibility is required for its execution. In this paper, we investigate the

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

    Science.gov (United States)

    Santos, Lenir

    2017-04-01

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

  14. 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.

  15. Improving compliance in remote healthcare systems through smartphone battery optimization.

    Science.gov (United States)

    Alshurafa, Nabil; Eastwood, Jo-Ann; Nyamathi, Suneil; Liu, Jason J; Xu, Wenyao; Ghasemzadeh, Hassan; Pourhomayoun, Mohammad; Sarrafzadeh, Majid

    2015-01-01

    Remote health monitoring (RHM) has emerged as a solution to help reduce the cost burden of unhealthy lifestyles and aging populations. Enhancing compliance to prescribed medical regimens is an essential challenge to many systems, even those using smartphone technology. In this paper, we provide a technique to improve smartphone battery consumption and examine the effects of smartphone battery lifetime on compliance, in an attempt to enhance users' adherence to remote monitoring systems. We deploy WANDA-CVD, an RHM system for patients at risk of cardiovascular disease (CVD), using a wearable smartphone for detection of physical activity. We tested the battery optimization technique in an in-lab pilot study and validated its effects on compliance in the Women's Heart Health Study. The battery optimization technique enhanced the battery lifetime by 192% on average, resulting in a 53% increase in compliance in the study. A system like WANDA-CVD can help increase smartphone battery lifetime for RHM systems monitoring physical activity.

  16. 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.

  17. 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

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

    NARCIS (Netherlands)

    van der Zwart, J.; van der Voordt, Theo; de Jonge, H.

    2010-01-01

    Objectives: 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

  19. National healthcare systems and the need for health information governance.

    Science.gov (United States)

    Hovenga, Evelyn J S

    2013-01-01

    This chapter gives an overview of health data, information and knowledge governance needs and associated generic principles so that information systems are able to automate such data collections from point-of-care operational systems. Also covered are health information systems' dimensions and known barriers to the delivery of quality health services, including environmental, technology and governance influences of any population's health status within the context of national health systems. This is where health information managers and health informaticians need to resolve the many challenges associated with eHealth implementations where data are assets, efficient information flow is essential, the ability to acquire new knowledge desirable, and where the use of data and information needs to be viewed from a governance perspective to ensure reliable and quality information is obtained to enhance decision making.

  20. 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.

  1. Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

    Directory of Open Access Journals (Sweden)

    Johanna Martinez

    2013-09-01

    Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

  2. Toward the modelling of safety violations in healthcare systems.

    Science.gov (United States)

    Catchpole, Ken

    2013-09-01

    When frontline staff do not adhere to policies, protocols, or checklists, managers often regard these violations as indicating poor practice or even negligence. More often than not, however, these policy and protocol violations reflect the efforts of well intentioned professionals to carry out their work efficiently in the face of systems poorly designed to meet the diverse demands of patient care. Thus, non-compliance with institutional policies and protocols often signals a systems problem, rather than a people problem, and can be influenced among other things by training, competing goals, context, process, location, case complexity, individual beliefs, the direct or indirect influence of others, job pressure, flexibility, rule definition, and clinician-centred design. Three candidates are considered for developing a model of safety behaviour and decision making. The dynamic safety model helps to understand the relationship between systems designs and human performance. The theory of planned behaviour suggests that intention is a function of attitudes, social norms and perceived behavioural control. The naturalistic decision making paradigm posits that decisions are based on a wider view of multiple patients, expertise, systems complexity, behavioural intention, individual beliefs and current understanding of the system. Understanding and predicting behavioural safety decisions could help us to encourage compliance to current processes and to design better interventions.

  3. 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.

  4. UP-report. Buildings in the energy system. Basis of the Development platform. Build to the Swedish Energy Agency's strategy work FOKUS; UP-rapport. Byggnader i energisystemet. Underlag fraan Utvecklingsplattformen. Bygg till Energimyndighetens strategiarbete FOKUS

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-01

    The report serves as input to the Swedish Energy Agency's strategies and priorities for research and innovation in the thematic area buildings in the energy system for the period 2011 - 2016. The report has been compiled by members of the development platform Build. This report provides background and the conditions of the area buildings in the energy system, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and knowledge which enabled the Swedish Energy Agency to then develop a strategy that meets the needs of the society and business.

  5. UP-report. Fuel-based energy systems. Basis of the Development platform. Fuel to the Swedish Energy Agency's strategy work FOKUS; UP-rapport. Braenslebaserade energisystem. Underlag fraan Utvecklingsplattformen. Braensle till Energimyndighetens strategiarbete FOKUS

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-01

    The report serves as input to the Swedish Energy Agency's strategies and priorities for research and innovation in the fuel-based energy system for the period 2011 - 2016. The report has been compiled by members of the development platform Fuel. This report provides background and conditions for the fuel based energy system, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and knowledge which enabled the Swedish Energy Agency to then develop a strategy that meets the needs of the society and business.

  6. UP-report. The power system. Basis of the Development platform. Power to Swedish Energy Agency's strategy work FOKUS; UP-rapport. Kraftsystemet. Underlag fraan Utvecklingsplattformen. Kraft till Energimyndighetens strategiarbete FOKUS

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-01

    The report serves as input to to Swedish Energy Agency's strategies and priorities for research and innovation in the power system for the period 2011 - 2016. The report has been compiled by members of the development platform Kraft. This report provides background and circumstances for the power system theme, and proposed priorities and activities for future efforts in this area. The development platform has contributed with valuable experience and skills that enabled the Swedish Energy Agency to then develop a strategy that meets the needs of society and business.

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

    Directory of Open Access Journals (Sweden)

    Chien-wen Shen

    2016-01-01

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

  9. 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

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

    Science.gov (United States)

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

    2003-05-01

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

  11. Injustice to transsexual women in a hetero-normatie healthcare system

    Directory of Open Access Journals (Sweden)

    Douglas Newman-Valentine

    2014-11-01

    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.

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

    Science.gov (United States)

    Juhnke, Christin; Bethge, Susanne

    2016-01-01

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

  13. 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…

  14. 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+.

  15. [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.

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

    African Journals Online (AJOL)

    Background: Community health centres (CHCs) are an important component of the health system in Mali and China. Despite patient support and commitment from the authorities, the management and the quality of care of these structures need to be improved. This research aimed to compare the management style of the ...

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

    CSIR Research Space (South Africa)

    Barjis, J

    2013-12-01

    Full Text Available . The proposed system is decision support driven in that it supports medical staff (nurses, doctors) to decide on the course of intervention or further treatment based on the vital signs of the patients that are tele-monitored on a regular basis. This patient...

  18. 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

  19. Modelling vital success factors in adopting personalized medicine system in healthcare technology and management

    Directory of Open Access Journals (Sweden)

    Subhas C. Misra

    2018-06-01

    Full Text Available Biomedical engineering has grown as a vast field of research that includes many areas of engineering and technology also. Personalized Medicine is an emerging approach in today’s medicare system. It bears a very strong potential to consolidate modern e-health systems fundamentally. Scientists have already discovered some of the personalized drugs that can shift the whole medicare system into a new dimension. However, bringing the change in the whole medicare system is not an easy task. There are several factors that can affect the successful adoption of Personalized Medicine systems in the healthcare management sector. This paper aims at identifying the critical factors with the help of an empirical study. A questionnaire was distributed amongst some clinicians, clinical researchers, practitioners in pharmaceutical industries, regulatory board members, and a larger section of patients. The response data collected thereby were analyzed by using appropriate statistical methods. Based on the statistical analysis, an attempt is made to prepare a list of critical success factors in the adoption of personalized medicine in healthcare management. The study indicates that eight of the thirteen hypothesized factors have statistical relationship with “Success”. The important success factors detected are: data management, team work and composition, privacy and confidentiality, mind-set, return on investment, sufficient time, R&D and alignment. To the best of our knowledge, this is the first academic paper in which an attempt has been made to model the vital critical factors for the successful implementation of Personalized Medicine in healthcare management. The study bears the promise of important applications in healthcare engineering and technology. Keywords: Healthcare management, Personalized medicine, E-health, Success factors, Medicare systems, Regression analysis

  20. [Digital imaging system are rapidly introduced in Swedish departments of radiography. This calls for new strategic planning].

    Science.gov (United States)

    Laurin, S; Norberg, K A

    2000-10-11

    Diagnostic radiology in Sweden is changing rapidly to digital (filmless) technique. The advantages are more rapid delivery of radiologic service, better working conditions and less negative effects on the environment. Teleradiology is also facilitated. The Swedish Board of Health and Welfare has investigated the speed with which this change is taking place. In 1998, 26 of the 118 departments of diagnostic radiology had already turned digital; it is estimated that in the near future at least five departments will become fully digital each year. For planning purposes, less emphasis should be put on the supply of radiographic film, and more on telecommunications, computer hardware and digital storage.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  7. 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.

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

    Science.gov (United States)

    Byrne, M M; Ashton, C M

    1999-01-01

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

  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. Printable low-cost sensor systems for healthcare smart textiles

    Science.gov (United States)

    Rai, Pratyush; Kumar, Prashanth S.; Oh, Sechang; Kwon, Hyeokjun; Mathur, Gyanesh N.; Varadan, Vijay K.

    2011-04-01

    Smart textiles-based wearable health monitoring systems (ST-HMS) have been presented as elegant solutions to the requirements of individuals across a wide range of ages. They can be used to monitor young or elderly recuperating /convalescent patients either in hospital or at home, or they can be used by young athletes to monitor important physiological parameters to better design their training or fitness program. Business and academic interests, all over the world, have fueled a great deal of work in the development of this technology since 1990. However, two important impediments to the development of ST-HMS are:-integration of flexible electrodes, flexible sensors, signal conditioning circuits and data logging or wireless transmission devices into a seamless garment and a means to mass manufacture the same, while keeping the costs low. Roll-to-roll printing and screen printing are two low cost methods for large scale manufacturing on flexible substrates and can be extended to textiles as well. These two methods are, currently, best suited for planar structures. The sensors, integrated with wireless telemetry, facilitate development of a ST-HMS that allows for unobtrusive health monitoring. In this paper, we present our results with planar screen printable sensors based on conductive inks which can be used to monitor EKG, abdominal respiration effort, blood pressure, pulse rate and body temperature. The sensor systems were calibrated, and tested for sensitivity, reliability and robustness to ensure reuse after washing cycles.

  11. Epigenetics: Its Understanding Is Crucial to a Sustainable Healthcare System

    Directory of Open Access Journals (Sweden)

    Michelle Thunders

    2015-04-01

    Full Text Available Understanding the molecular impact of lifestyle factors has never been so important; a period in time where there are so many adults above retirement age has been previously unknown. As a species, our life expectancy is increasing yet the period of our lives where we enjoy good health is not expanding proportionately. Over the next 50 years we will need to almost double the percentage of GDP spent on health care, largely due to the increasing incidence of obesity related chronic diseases. A greater understanding and implementation of an integrated approach to health is required. Research exploring the impact of nutritional and exercise intervention on the epigenetically flexible genome is up front in terms of addressing healthy aging. Alongside this, we need a greater understanding of the interaction with our immune and nervous systems in preserving and maintaining health and cognition.

  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. 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.

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

    Science.gov (United States)

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

    2010-07-01

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

  15. 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.

  16. 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.

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

    Science.gov (United States)

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

    2013-05-01

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

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

    Science.gov (United States)

    Maskileyson, Dina

    2014-10-01

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

  19. 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.

  20. Assessment of management capacity to improve the value of health-care systems: a survey

    OpenAIRE

    Rebecca L Weintraub, MD; Keri Wachter, BA; Jennifer Goldsmith, MS; Marie J Teichman, BA; Eda Algur; Julie D Rosenberg, MPH

    2017-01-01

    Background: Strong management is important for high-value health-care systems if returns on global health investments are to be delivered and the Sustainable Development Goals met by 2030. Managers are responsible for care delivery systems and strategies, making sure that health services benefit the population they intend to serve. Most managers in resource-limited settings work at the district level and below, with little training in non-clinical skills. They are often health care providers ...

  1. 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.

  2. 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.

  3. An Overview of Research Issues in the Modern Healthcare Monitoring System Design using Wireless Body area Network

    OpenAIRE

    D. Suresh; P. Alli

    2012-01-01

    Problem statement: Healthcare is recognized various leading edge technologies and new scientific discoveries to enable better cures for diseases and better means to enable early detection of most life threatening diseases. The modern health care focused for optimally reducing the healthcare costs. Approach: The modern healthcare system enables medical professionals to remotely perform real-time monitoring, early diagnosis and treatment for potential risky disease. A mobile patient monitoring ...

  4. Swedish encapsulation station review

    International Nuclear Information System (INIS)

    Andersson, Sven Olof; Brunzell, P.; Heibel, R.; McCarthy, J.; Pennington, C.; Rusch, C.; Varley, G.

    1998-06-01

    In the Encapsulation Station (ES) Review performed by NAC International, a number of different areas have been studied. The main objectives with the review have been to: Perform an independent review of the cost estimates for the ES presented in SKB's document 'Plan 1996'. This has been made through comparisons between the ES and BNFL's Waste Encapsulation Plant (WEP) at Sellafield as well as with the CLAB facility. Review the location of the ES (at the CLAB site or at the final repository) and its interaction with other parts of the Swedish system for spent fuel management. Review the logistics and plant capacity of the ES. Identify important safety aspects of the ES as a basis for future licensing activities. Based on NAC International's experience of casks for transport and storage of spent fuel, review the basic design of the copper/steel canister and the transport cask. This review insides design, manufacturing, handling and licensing aspects. Perform an overall comparison between the ES project and the CLAB project with the objective to identify major project risks and discuss their mitigation

  5. Swedish encapsulation station review

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Sven Olof; Brunzell, P.; Heibel, R.; McCarthy, J.; Pennington, C.; Rusch, C.; Varley, G. [NAC International, Zuerich (Switzerland)

    1998-06-01

    In the Encapsulation Station (ES) Review performed by NAC International, a number of different areas have been studied. The main objectives with the review have been to: Perform an independent review of the cost estimates for the ES presented in SKB`s document `Plan 1996`. This has been made through comparisons between the ES and BNFL`s Waste Encapsulation Plant (WEP) at Sellafield as well as with the CLAB facility. Review the location of the ES (at the CLAB site or at the final repository) and its interaction with other parts of the Swedish system for spent fuel management. Review the logistics and plant capacity of the ES. Identify important safety aspects of the ES as a basis for future licensing activities. Based on NAC International`s experience of casks for transport and storage of spent fuel, review the basic design of the copper/steel canister and the transport cask. This review insides design, manufacturing, handling and licensing aspects. Perform an overall comparison between the ES project and the CLAB project with the objective to identify major project risks and discuss their mitigation 19 refs, 9 figs, 35 tabs

  6. 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.

  7. Evaluation and implementation of QR Code Identity Tag system for Healthcare in Turkey

    OpenAIRE

    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 hospi...

  8. 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.

  9. Imperatives for "Right" Educational Choices in Swedish Educational Policy

    Science.gov (United States)

    Puaca, Goran

    2014-01-01

    The present article is based on a critical semiotic investigation of the Swedish Long-Term Survey on economic development. It aims to examine how recent Swedish policy trends bring specific economic, political and social processes together to form a system of meaning for both motivation and regulation over individuals' educational choices. What is…

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

    Science.gov (United States)

    McQuillen, Daniel P; MacIntyre, Ann T

    2017-09-15

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

  11. 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.

  12. 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.

  13. How are homeless people treated in the healthcare system and other societal institutions? Study of their experiences and trust.

    Science.gov (United States)

    Irestig, Robert; Burström, Kristina; Wessel, Maja; Lynöe, Niels

    2010-05-01

    To elucidate the perceived treatment that the homeless have received from the healthcare and other societal organisations and to present homeless persons' trust in the healthcare system and suggestions of necessary changes for improving it. Homeless individuals in special houses and institutions in the County of Stockholm were asked to answer a short version of a public health survey, including added questions about how they experienced the healthcare providers' attitudes towards them and how much trust they had in the healthcare system. A total of 155 homeless persons (123 male and 32 female) were interviewed. Three-quarters of the participants stated that they had fairly or very high trust in healthcare services and also felt that they had been fairly or very well treated. Fewer females than males reported being treated well and they declared a lower degree of trust in the healthcare system. The homeless suggest that extra resources be set aside to organise their healthcare, including a higher level of knowledge of the medical problems prevailing in the group. Those who felt badly treated also asked for less neglect and disrespect from the healthcare staff. Even though a majority experience that they are being well treated within the healthcare system, the study also indicated disadvantages in the treatment of homeless persons in Sweden. The study also reveals an imbalance between the official ethical framework in Sweden and of the specific moral of some individual healthcare providers. One way to facilitate their entry into the healthcare system might be to create special surgeries for the homeless.

  14. Curing a meagre health care system by lean methods--translating 'chains of care' in the Swedish health care sector.

    Science.gov (United States)

    Trägårdh, Björn; Lindberg, Kajsa

    2004-01-01

    The purpose of this article is to discuss what happens when work embedded in a 'meagre' organizational context is changed by lean production-related methods. The article is based on studies of seven lean production-inspired projects in the Swedish health care sector, a sector already poor due to organizational slack. The projects were directed to develop 'health care chains', an organizational concept regarded as a way to rationalize health care organizations as well as to develop them, i.e. increase productivity, quality from a customer perspective and quality of working conditions. The article analyses the projects from an interpretative perspective and discusses how modem management models with ambitions to concurrently rationalize and develop organizations--e.g. lean production and health care chains--are used in a 'meagre' organizational field. As an outcome, a model is presented that explores what is beyond simple imitations and unique translations of ideas when a new concept is implemented in local organizations.

  15. 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.

  16. Funding New Zealand's public healthcare system: time for an honest appraisal and public debate.

    Science.gov (United States)

    Keene, Lyndon; Bagshaw, Philip; Nicholls, M Gary; Rosenberg, Bill; Frampton, Christopher M; Powell, Ian

    2016-05-27

    Successive New Zealand governments have claimed that the cost of funding the country's public healthcare services is excessive and unsustainable. We contest that these claims are based on a misrepresentation of healthcare spending. Using data from the New Zealand Treasury and the Organisation for Economic Cooperation and Development (OECD), we show how government spending as a whole is low compared with most other OECD countries and is falling as a proportion of GDP. New Zealand has a modest level of health spending overall, but government health spending is also falling as a proportion of GDP. Together, the data indicate the New Zealand Government can afford to spend more on healthcare. We identify compelling reasons why it should do so, including forecast growing health need, signs of increasing unmet need, and the fact that if health needs are not met the costs still have to be borne by the economy. The evidence further suggests it is economically and socially beneficial to meet health needs through a public health system. An honest appraisal and public debate is needed to determine more appropriate levels of healthcare spending.

  17. Levelling vs competition – political trend reversal in the German healthcare system?

    Directory of Open Access Journals (Sweden)

    Sascha Wolf

    2014-12-01

    Full Text Available For almost 20 years, the German federal government has declared that competition is the key to ensuring the financial sustainability of the healthcare system. The aim of this paper is to investigate if German government indeed has followed a direct path to enhancing competition. For this purpose, a qualitative analysis of the most important healthcare reform acts has been conducted. In conclusion, especially since the introduction of the Health Fund in 2009, a clear trend towards more levelling and regulation can be observed. This trend is confirmed by the most recent healthcare reform act in June 2014. The abolishment of flat-rate premiums is the expression of the government’s fear that competitive pressure could endanger the solvency and viability of sickness funds (statutory health insurance funds. In contrast, on the market for selective contracts, an ambivalent picture emerges. On the one hand, several possibilities for establishing new forms of healthcare and strengthening competition have been introduced. On the other hand, sickness funds as well as service providers are often reluctant to enter into selective contracts.

  18. Convergencias y divergencias entre el sistema educativo sueco y el español = Divergences and convergences between Swedish and Spanish educational system

    Directory of Open Access Journals (Sweden)

    Pilar García-Zarza

    2014-01-01

    Full Text Available Este artículo contrasta dos sistemas educativos, el sueco y el español, por presentar rasgos característicos propios desde los que se explica la consecución de logros diversos. Así, la educación sueca dispone de una estructura administrativa descentralizada que concede un alto nivel de autonomía que llega hasta los municipios y centros, descentralización que ha de convivir con las nuevas medidas recentralizadoras, una alta inversión en materia educativa, una estructura institucional que introduce nuevas medidas de control alejadas del modelo sueco de escuela comprensiva, una creciente polarización en los centros docentes, así como un profesorado a quien se le demanda una formación especializada y exigente, atendiendo al nuevo modelo formativo nacido en 2011. La educación española, por su parte, tampoco parece haber resuelto de manera decidida cuestiones nucleares de índole administrativa y organizativa, aspectos a los que se suman una inversión deficitaria, una integración escolar que parece tambalearse de nuevo, así como un profesorado con frecuencia desmotivado, cuya labor no siempre se reconoce debidamente, y cuya formación también asiste a los vaivenes característicos del sistema. Tiempos convulsos para dos sistemas educativos aquejados de constantes reformas, que confluyen en ciertos cambios de rumbo.This article contrasts two educational systems, Swedish and Spanish, because they show their own characteristic features which explain different achievements. So, Swedish Education has a decentralized administrative structure that grants a high level of autonomy to the municipalities and to the schools, decentralization that lives with the new recentralizing measures, a high investment in education, an institutional structure that introduces new control measures, away from the Swedish comprehensive school model, an emerging polarization in schools and teachers who must have specialized training, in response to the new

  19. Redistributive effects of Swedish health care finance.

    Science.gov (United States)

    Gerdtham, U G; Sundberg, G

    1998-01-01

    This paper investigates the redistributive effects of the Swedish health care financing system in 1980 and 1990 for four different financial sources: county council taxes, payroll taxes, direct payments and state grants. The redistributive effects are decomposed into vertical, horizontal and 'reranking' segments for each of the four financial sources. The data used are based on probability samples of the Swedish population, from the Level of Living Survey (LNU) from 1981 and 1991. The paper concludes that the Swedish health care financing system is weakly progressive, although direct payments are regressive. There is some horizontal inequity and 'reranking', which mainly comes from the county council taxes, since those tax rates vary for each county council. The implication is that, to some extent, people with equal incomes are treated unequally.

  20. 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.

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

    Science.gov (United States)

    Kamel Boulos, Maged N; Berry, Geoff

    2012-06-28

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

  2. 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.

  3. '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.

  4. A study of leading indicators for occupational health and safety management systems in healthcare.

    Science.gov (United States)

    Almost, Joan M; VanDenKerkhof, Elizabeth G; Strahlendorf, Peter; Caicco Tett, Louise; Noonan, Joanna; Hayes, Thomas; Van Hulle, Henrietta; Adam, Ryan; Holden, Jeremy; Kent-Hillis, Tracy; McDonald, Mike; Paré, Geneviève C; Lachhar, Karanjit; Silva E Silva, Vanessa

    2018-04-23

    In Ontario, Canada, approximately $2.5 billion is spent yearly on occupational injuries in the healthcare sector. The healthcare sector has been ranked second highest for lost-time injury rates among 16 Ontario sectors since 2009 with female healthcare workers ranked the highest among all occupations for lost-time claims. There is a great deal of focus in Ontario's occupational health and safety system on compliance and fines, however despite this increased focus, the injury statistics are not significantly improving. One of the keys to changing this trend is the development of a culture of healthy and safe workplaces including the effective utilization of leading indicators within Occupational Health and Safety Management Systems (OHSMSs). In contrast to lagging indicators, which focus on outcomes retrospectively, a leading indicator is associated with proactive activities and consists of selected OHSMSs program elements. Using leading indicators to measure health and safety has been common practice in high-risk industries; however, this shift has not occurred in healthcare. The aim of this project is to conduct a longitudinal study implementing six elements of the Ontario Safety Association for Community and Healthcare (OSACH) system identified as leading indicators and evaluating the effectiveness of this intervention on improving selected health and safety workplace indicators. A quasi-experimental longitudinal research design will be used within two Ontario acute care hospitals. The first phase of the study will focus on assessing current OHSMSs using the leading indicators, determining potential facilitators and barriers to changing current OHSMSs, and identifying the leading indicators that could be added or changed to the existing OHSMS in place. Phase I will conclude with the development of an intervention designed to support optimizing current OHSMSs in participating hospitals based on identified gaps. Phase II will pilot test and evaluate the tailored

  5. 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.

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

    NARCIS (Netherlands)

    van der Zwart, J.; de Jonge, H.; van der Voordt, Theo; van de Zwart, J; Jonge, H

    2009-01-01

    Subject/Research problem
    Healthcare is both important and expensive, and is likely to become even more expensive in the future. To keep healthcare affordable in the future, the Dutch government is currently in the process of changing legislation in order to move from a centrally directed system

  7. Swedish Cleantech Opportunities 2010

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-01

    A market overview from the Swedish Energy Agency. 'Cleantech (short for clean technologies) refers to energy and environmentally friendly related technologies. Global demand for this kind of products continues to grow and cleantech can thus generate new jobs, growth and tax revenues. The Swedish Energy Agency is active in the energy segment of cleantech and support companies in their early stages of development. This market overview outlines the current status of the sector, in Sweden and globally. It also presents business leaders and innovators in this field.'

  8. Swedish Cleantech Opportunities 2010

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-01

    A market overview from the Swedish Energy Agency. 'Cleantech (short for clean technologies) refers to energy and environmentally friendly related technologies. Global demand for this kind of products continues to grow and cleantech can thus generate new jobs, growth and tax revenues. The Swedish Energy Agency is active in the energy segment of cleantech and support companies in their early stages of development. This market overview outlines the current status of the sector, in Sweden and globally. It also presents business leaders and innovators in this field.'

  9. Child-Sized Gaps in the System: Case Studies of Child Suicidality and Support within the Australian Healthcare System

    Science.gov (United States)

    McKay, Kathy; Shand, Fiona

    2016-01-01

    While children both understand the concept of, and have died by, suicide, little research has been conducted on children's experiences of healthcare systems during and after a suicidal crisis. This article focuses on three case studies of mothers with suicidal daughters and aims to describe the health service experiences of parents whose children…

  10. 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

  11. 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

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

    Science.gov (United States)

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

    2012-12-01

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

  13. 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.

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

    Science.gov (United States)

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

    2012-07-01

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

  15. Investigation of Swedish cases reveals an outbreak of cryptosporidiosis at a Norwegian hotel with possible links to in-house water systems

    Science.gov (United States)

    Hajdu, Agnes; Vold, Line; Østmo, Torild A; Helleve, Anna; Helgebostad, Sigrid R; Krogh, Truls; Robertson, Lucy; de Jong, Birgitta; Nygård, Karin

    2008-01-01

    Background In March 2007, the Norwegian Institute of Public Health was notified of Swedish individuals diagnosed with cryptosporidiosis after staying at a Norwegian hotel. In Norway, cryptosporidiosis is not reportable, and human infections are rarely diagnosed. Methods A questionnaire on illness and exposure history was e-mailed to seven organised groups who had visited the hotel in March. Cases were defined as persons with diarrhoea for more than two days or laboratory-confirmed cryptosporidiosis during or within two weeks of the hotel visit. The risk factor analysis was restricted to two groups with the highest attack rates (AR) and same hotel stay period. Local food safety authorities conducted environmental investigations. Results In total, 25 diarrhoeal cases (10 laboratory-confirmed) were identified among 89 respondents. Although environmental samples were negative, epidemiological data suggest an association with in-house water consumption. In one group, the AR was higher amongst consumers of water from hotel dispenser (relative risk [RR] = 3.0; 95% confidence interval [CI]: 0.9–9.8), tap water (RR = 2.3; CI: 0.9–5.8), and lower amongst commercial bottled water drinkers (RR = 0.6; CI: 0.4–1.0). Consumption of ice cubes was a risk-factor (RR = 7.1; CI: 1.1–45.7) in the two groups combined. Conclusion This outbreak would probably have remained undetected without the alert from Swedish health authorities, illustrating the difficulties in outbreak detection due to low health care seeking behaviour for diarrhoea and limited parasite diagnostics in Norway. Awareness of cryptosporidiosis should be raised amongst Norwegian medical personnel to improve case and outbreak detection, and possible risks related to in-house water systems should be assessed. PMID:18976495

  16. Investigation of Swedish cases reveals an outbreak of cryptosporidiosis at a Norwegian hotel with possible links to in-house water systems

    Directory of Open Access Journals (Sweden)

    Krogh Truls

    2008-11-01

    Full Text Available Abstract Background In March 2007, the Norwegian Institute of Public Health was notified of Swedish individuals diagnosed with cryptosporidiosis after staying at a Norwegian hotel. In Norway, cryptosporidiosis is not reportable, and human infections are rarely diagnosed. Methods A questionnaire on illness and exposure history was e-mailed to seven organised groups who had visited the hotel in March. Cases were defined as persons with diarrhoea for more than two days or laboratory-confirmed cryptosporidiosis during or within two weeks of the hotel visit. The risk factor analysis was restricted to two groups with the highest attack rates (AR and same hotel stay period. Local food safety authorities conducted environmental investigations. Results In total, 25 diarrhoeal cases (10 laboratory-confirmed were identified among 89 respondents. Although environmental samples were negative, epidemiological data suggest an association with in-house water consumption. In one group, the AR was higher amongst consumers of water from hotel dispenser (relative risk [RR] = 3.0; 95% confidence interval [CI]: 0.9–9.8, tap water (RR = 2.3; CI: 0.9–5.8, and lower amongst commercial bottled water drinkers (RR = 0.6; CI: 0.4–1.0. Consumption of ice cubes was a risk-factor (RR = 7.1; CI: 1.1–45.7 in the two groups combined. Conclusion This outbreak would probably have remained undetected without the alert from Swedish health authorities, illustrating the difficulties in outbreak detection due to low health care seeking behaviour for diarrhoea and limited parasite diagnostics in Norway. Awareness of cryptosporidiosis should be raised amongst Norwegian medical personnel to improve case and outbreak detection, and possible risks related to in-house water systems should be assessed.

  17. Investigation of Swedish cases reveals an outbreak of cryptosporidiosis at a Norwegian hotel with possible links to in-house water systems.

    Science.gov (United States)

    Hajdu, Agnes; Vold, Line; Østmo, Torild A; Helleve, Anna; Helgebostad, Sigrid R; Krogh, Truls; Robertson, Lucy; de Jong, Birgitta; Nygård, Karin

    2008-11-01

    In March 2007, the Norwegian Institute of Public Health was notified of Swedish individuals diagnosed with cryptosporidiosis after staying at a Norwegian hotel. In Norway, cryptosporidiosis is not reportable, and human infections are rarely diagnosed. A questionnaire on illness and exposure history was e-mailed to seven organised groups who had visited the hotel in March. Cases were defined as persons with diarrhoea for more than two days or laboratory-confirmed cryptosporidiosis during or within two weeks of the hotel visit. The risk factor analysis was restricted to two groups with the highest attack rates (AR) and same hotel stay period. Local food safety authorities conducted environmental investigations. In total, 25 diarrhoeal cases (10 laboratory-confirmed) were identified among 89 respondents. Although environmental samples were negative, epidemiological data suggest an association with in-house water consumption. In one group, the AR was higher amongst consumers of water from hotel dispenser (relative risk [RR] = 3.0; 95% confidence interval [CI]: 0.9-9.8), tap water (RR = 2.3; CI: 0.9-5.8), and lower amongst commercial bottled water drinkers (RR = 0.6; CI: 0.4-1.0). Consumption of ice cubes was a risk-factor (RR = 7.1; CI: 1.1-45.7) in the two groups combined. This outbreak would probably have remained undetected without the alert from Swedish health authorities, illustrating the difficulties in outbreak detection due to low health care seeking behaviour for diarrhoea and limited parasite diagnostics in Norway. Awareness of cryptosporidiosis should be raised amongst Norwegian medical personnel to improve case and outbreak detection, and possible risks related to in-house water systems should be assessed.

  18. The Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART).

    Science.gov (United States)

    Jernberg, Tomas; Attebring, Mona F; Hambraeus, Kristina; Ivert, Torbjorn; James, Stefan; Jeppsson, Anders; Lagerqvist, Bo; Lindahl, Bertil; Stenestrand, Ulf; Wallentin, Lars

    2010-10-01

    The aims of the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) are to support the improvement of care and evidence-based development of therapy of coronary artery disease (CAD). To provide users with online interactive reports monitoring the processes of care and outcomes and allowing direct comparisons over time and with other hospitals. National, regional and county-based reports are publicly presented on a yearly basis. Every hospital (n=74) in Sweden providing the relevant services participates. Launched in 2009 after merging four national registries on CAD. Consecutive acute coronary syndrome (ACS) patients, and patients undergoing coronary angiography/angioplasty or heart surgery. Includes approximately 80, 000 new cases each year. On admission in ACS patients, at coronary angiography in patients with stable CAD. 106 variables for patients with ACS, another 75 variables regarding secondary prevention after 12-14 months, 150 variables for patients undergoing coronary angiography/angioplasty, 100 variables for patients undergoing heart surgery. Web-based registry with all data registered online directly by the caregiver. A monitor visits approximately 20 hospitals each year. In 2007, there was a 96% agreement. Merged with the National Cause of Death Register, including information about vital status of all Swedish citizens, the National Patient Registry, containing diagnoses at discharge for all hospital stays in Sweden and the National Registry of Drug prescriptions recording all drug prescriptions in Sweden. Available for research by application to the SWEDEHEART steering group.

  19. PARTICIPATORY GOVERNANCE IN THE PUBLIC HEALTHCARE SYSTEMS OF THE SCANDINAVIAN AND BALTIC COUNTRIES

    Directory of Open Access Journals (Sweden)

    Stefanescu Aurelia

    2011-12-01

    Full Text Available The diminished trust of citizens in the public sector, the increased complexity of policy issues and the reforms in accordance with the new public management principles generate the need of focusing more extensively on participatory governance. Participatory governance can be defined as the genuine engagement of citizens and other organizations in the formulation of policies and strategies, in the decision-making process from the public sector and in the implementation of the decisions. The present paper's objectives are to define the concept of participatory governance, to argue in favor of implementing it in the public sector and to find to what extent public healthcare institutions from Scandinavian and Baltic countries publish information on participatory governance and how they perceive community engagement. The research findings are that the information on participatory governance disclosed on the websites of relevant institutions from within the Scandinavian and Baltic public healthcare systems is scarce. The countries with the greatest concern for community engagement are Denmark and Sweden. It is argued that there should be a shift in focus within the public sector in general and within the healthcare system in particular, so that citizens are genuinely involved in the relevant processes and their satisfaction is indeed at an adequate level.

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

    Science.gov (United States)

    Gortzis, Lefteris G

    2010-01-01

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

  2. The future of UK healthcare: problems and potential solutions to a system in crisis.

    Science.gov (United States)

    Montgomery, H E; Haines, A; Marlow, N; Pearson, G; Mythen, M G; Grocott, M P W; Swanton, C

    2017-08-01

    The UK's Health System is in crisis, central funding no longer keeping pace with demand. Traditional responses-spending more, seeking efficiency savings or invoking market forces-are not solutions. The health of our nation demands urgent delivery of a radical new model, negotiated openly between public, policymakers and healthcare professionals. Such a model could focus on disease prevention, modifying health behaviour and implementing change in public policy in fields traditionally considered unrelated to health such as transport, food and advertising. The true cost-effectiveness of healthcare interventions must be balanced against the opportunity cost of their implementation, bolstering the central role of NICE in such decisions. Without such action, the prognosis for our healthcare system-and for the health of the individuals it serves-may be poor. Here, we explore such a new prescription for our national health. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  3. Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis

    Directory of Open Access Journals (Sweden)

    An Pan

    2017-01-01

    Full Text Available Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an (Q,r inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

  4. Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis.

    Science.gov (United States)

    Pan, An; Hui, Chi-Leung

    2017-01-01

    Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an ( Q , r ) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

  5. 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.

  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

  7. Space weather events in July 1982 and October 2003 and the effects of geomagnetically induced currents on Swedish technical systems

    Directory of Open Access Journals (Sweden)

    M. Wik

    2009-04-01

    Full Text Available In this paper, we analyse in detail two famous space weather events; a railway problem on 13–14 July 1982 and a power blackout on 30 October 2003. Both occurred in Sweden during very intensive space weather storms and each of them a few years after the sunspot maximum. This paper provides a description of the conditions on the Sun and in the solar wind leading to the two GIC events on the ground. By applying modelling techniques introduced and developed in our previous paper, we also calculate the horizontal geoelectric field at the Earth's surface in southern Sweden during the two storms as well as GIC flowing in the southern Swedish 400 kV power grid during the event in October 2003. The results from the calculations agree with all measured data available. In the July-1982 storm, the geomagnetic field variation, ΔBx, reached values up to ~2500 nT/min and the geoelectric field reached values in the order of several volts per kilometer. In the October-2003 storm, the geomagnetic field fluctuations were smaller. However, GIC of some hundreds of amperes flowed in the power grid during the October-2003 event. Technological issues related to the railway signalling in July 1982 and to the power network equipment in October 2003 are also discussed.

  8. Are impact assessment procedures actually promoting sustainable development? Institutional perspectives on barriers and opportunities found in the Swedish committee system

    International Nuclear Information System (INIS)

    Nykvist, Bjoern; Nilsson, Mans

    2009-01-01

    Impact assessment frameworks are gaining increasing attention as a procedure to integrate sustainability concerns in European and national policy-making. The gap between political visions on sustainable development and the reality of policy-making is, however, still pronounced, and a very limited range and scope of available assessment methods are used in practice. This study examines why this pattern prevails, in this case within the Swedish Committees of Inquiry, with a focus on institutional factors determining the function of Impact Assessments. The findings suggest that assessment procedures have little value when not accompanied by clear specific instructions on priorities. A range of institutional constraints emerge in the interface between policy makers and knowledge providers in committees. Dominant professional, organisational, and disciplinary cultures constrain the assessment, and socio-economic priorities are by tradition most important. Based on our analysis, we conclude that to enhance the potential for integrating sustainability concerns, it seems less fruitful to develop more advanced and complex assessment frameworks and models than strengthening institutional arenas for social learning. Such arenas should be; defined by a broad mandate and instructions, characterised by key personal skills and resources, and build institutional capacity for a range of stakeholders to engage with them

  9. 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.

  10. Cadeia de valor da saúde: um modelo para o sistema de saúde brasileiro Healthcare value chain: a model for the Brazilian healthcare system

    Directory of Open Access Journals (Sweden)

    Marcelo Caldeira Pedroso

    2012-10-01

    Full Text Available Este artigo apresenta um modelo de cadeia de valor da saúde que representa, de maneira esquemática, o sistema de saúde do Brasil. O modelo proposto tem como intuito apresentar uma adequação à realidade brasileira, bem como abrangência e flexibilidade para utilização em atividades acadêmicas e análises do setor de saúde do Brasil. O modelo coloca ênfase em três componentes: principais atividades dessa cadeia, agrupadas em elos verticais e horizontais; missão de cada um desses elos; e principais fluxos da cadeia. A cadeia proposta é formada por seis elos verticais e três horizontais, perfazendo um total de nove: desenvolvimento de conhecimento em saúde; fornecimento de produtos e tecnologias; serviços de saúde; intermediação financeira; financiamento da saúde; consumo de saúde; regulação; distribuição de produtos de saúde; e serviços de apoio e complementares. A análise da cadeia proposta pode ser realizada por meio de quatro fluxos: inovação e conhecimento; produtos e serviços; financeiro; e de informação.This article presents a model of the healthcare value chain which consists of a schematic representation of the Brazilian healthcare system. The proposed model is adapted for the Brazilian reality and has the scope and flexibility for use in academic activities and analysis of the healthcare sector in Brazil. It places emphasis on three components: the main activities of the value chain, grouped in vertical and horizontal links; the mission of each link and the main value chain flows. The proposed model consists of six vertical and three horizontal links, amounting to nine. These are: knowledge development; supply of products and technologies; healthcare services; financial intermediation; healthcare financing; healthcare consumption; regulation; distribution of healthcare products; and complementary and support services. Four flows can be used to analyze the value chain: knowledge and innovation; products and

  11. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of ambulatory surgical center ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey....

  12. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital outpatient department ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS)...

  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. 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.

  15. The Healthcare Public System – Does Standardization Withhold the Bucket from Leaking?

    Directory of Open Access Journals (Sweden)

    Biţoiu Teodora

    2017-12-01

    Full Text Available The public healthcare system is heavily influenced by the 3C trilemma - cost - coverage - choice. The paper’s argument tackles the fact that should the public decision on improving capacity be leaning towards universal coverage in would result in efficiency losses and, in an attempt to control the costs it would limit patients’ choice. Should priority be given to performance or value? The present paper deals with the compromise between the equity and efficiency, a leaky bucket that becomes more visible in the struggle to build capacity and intervene in the market by setting standards. Setting healthcare standards is a global concern, the 3rd Sustainable Development Goal is a clear proof of that the aim to emphasise and better analyse two of the most influential variables: efficiency and equity. All in all, what we argue is that the current leaky bucket is a trade-off between choice, coverage, and cost. For a complex public service like healthcare, targeting a full coverage and multiple choice would incur huge costs and, cutting costs considerably restricts both the choice and coverage. The cost is influenced by the production capacity use when the activity has large fixed costs.

  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. 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.

  18. Readiness of Sub-Saharan Africa Healthcare Systems for the New Pandemic, Diabetes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Bernardo Nuche-Berenguer

    2018-01-01

    Full Text Available Background. Effective health systems are needed to care for the coming surge of diabetics in sub-Saharan Africa (SSA. Objective. We conducted a systematic review of literature to determine the capacity of SSA health systems to manage diabetes. Methodology. We used three different databases (Embase, Scopus, and PubMed to search for studies, published from 2004 to 2017, on diabetes care in SSA. Results. Fifty-five articles met the inclusion criteria, covering the different aspects related to diabetes care such as availability of drugs and diagnostic tools, the capacity of healthcare workers, and the integration of diabetes care into HIV and TB platforms. Conclusion. Although chronic care health systems in SSA have developed significantly in the last decade, the capacity for managing diabetes remains in its infancy. We identified pilot projects to enhance these capacities. The scale-up of these pilot interventions and the integration of diabetes care into existing robust chronic disease platforms may be a feasible approach to begin to tackle the upcoming pandemic in diabetes. Nonetheless, much more work needs to be done to address the health system-wide deficiencies in diabetes care. More research is also needed to determine how to integrate diabetes care into the healthcare system in SSA.

  19. Learning to navigate the healthcare system in a new country: a qualitative study

    Science.gov (United States)

    Straiton, Melanie L.; Myhre, Sonja

    2017-01-01

    Objective 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. Design A qualitative interview study using thematic analysis. Setting Norway. Participants Fifteen Thai and 15 Filipino immigrant women over the age of 18 who had been living in Norway at least one year. Results 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. Conclusions 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. PMID:29087232

  20. An Analysis of Different Solar-Assisted Heating Systems and Their Effect on the Energy Performance of Multifamily Buildings—A Swedish Case

    Directory of Open Access Journals (Sweden)

    Richard Thygesen

    2017-01-01

    Full Text Available Today, the household sector in the European Union and in Sweden accounts for approximately 25% and 22% of the final energy demand, respectively, and the sector will continue to grow in the next decades. To limit the impact on the energy demand of buildings, the European Union has introduced the Energy Performance of Building Directive. In Sweden, a proposal for building regulations adapted to the Energy Performance of Buildings Directive has been released, but no decision on implementation of it has been made. In this article, a real building is simulated to evaluate how different combinations of heating and decentralized energy generation systems are affecting the specific energy demand of the building. Also, an analysis on how the Swedish incentive schemes affect the choice of decentralized energy generation systems is conducted. Furthermore, it is investigated if it is necessary to adopt the incentive schemes to steer towards systems that reduce the specific energy demand of the building. The conclusion in this article is that the current incentive system is ineffective in terms of specific energy demand reduction of buildings. It needs to be adapted so it steers towards a reduction of the specific energy demand of buildings.

  1. Healing or harming? Healthcare provider interactions with injured workers and insurers in workers' compensation systems.

    Science.gov (United States)

    Kilgour, Elizabeth; Kosny, Agnieszka; McKenzie, Donna; Collie, Alex

    2015-03-01

    Healthcare providers (HCPs) are influential in the injured worker's recovery process and fulfil many roles in the delivery of health services. Interactions between HCPs and insurers can also affect injured workers' engagement in rehabilitation and subsequently their recovery and return to work. Consideration of the injured workers' perceptions and experiences as consumers of medical and compensation services can provide vital information about the quality, efficacy and impact of such systems. The aim of this systematic review was to identify and synthesize published qualitative research that focused on the interactions between injured workers, HCPs and insurers in workers' compensation systems in order to identify processes or interactions which impact injured worker recovery. A search of six electronic databases for literature published between 1985 and 2012 revealed 1,006 articles. Screening for relevance identified 27 studies which were assessed for quality against set criteria. A final 13 articles of medium and high quality were retained for data extraction. Findings were synthesized using a meta-ethnographic approach. Injured workers reported that HCPs could play both healing and harming roles in their recovery. Supportive patient-centred interaction with HCPs is important for injured workers. Difficult interactions between HCPs and insurers were highlighted in themes of adversarial relations and organisational pressures. Insurer and compensation system processes exerted an influence on the therapeutic relationship. Recommendations to improve relationships included streamlining administrative demands and increasing education and communication between the parties. Injured workers with long term complex injuries experience difficulties with healthcare in the workers' compensation context. Changes in insurer administrative demands and compensation processes could increase HCP participation and job satisfaction. This in turn may improve injured worker recovery

  2. Diffusion and use of health technology assessment in policy making: what lessons for decentralised healthcare systems?

    Science.gov (United States)

    Ciani, Oriana; Tarricone, Rosanna; Torbica, Aleksandra

    2012-12-01

    The Italian National Healthcare System (NHS) is one of the most decentralised systems since the devolution reform approved in 2001. HTA is spreading as an important tool for decision-making processes both at central and local levels. The aims of this study were to review the state of the health technology assessment (HTA) programmes in Italy - with a focus on regional and central initiatives - and to discuss consequences of a multi-level structure of HTA agencies in highly regionalised healthcare systems. Our method combined documentary review with interviews. We reviewed scientific literature about HTA's activities in decentralised systems, legislative and administrative documents from national as well as regional authorities. Semi-structured interviews were conducted with 18 key individuals associated with HTA both at the national and regional levels. Data on HTA programmes implemented or under development in nine regions were collected and analysed according to key principles for the improved conduct of health technology assessments for resource allocation decisions. HTA is in the early stage of development in Italy, although with great heterogeneity across regions. The National Agency for Health Services has certainly contributed to HTA diffusion through supporting and training activities. However, the multi-level structure of HTA in Italy has not yet provided full coordination and harmonisation of practices and outcomes across the country, with a consequent exacerbate inequality of access to services and technologies. There is probably need to rethink the multi-layer organizational framework of HTA in Italy by leveraging on current knowledge and efficient redistribution of activities across regions. We would advise for different jurisdictions playing different roles while achieving similar health outcomes for their patients, rather than jurisdictions aiming at doing exactly the same things resulting in unequal access to healthcare service provision. Copyright

  3. Embedding 'speaking up' into systems for safe healthcare product development and marketing surveillance.

    Science.gov (United States)

    Edwards, Brian; Hugman, Bruce; Tobin, Mary; Whalen, Matthew

    2012-04-01

    Robust, active cooperation, and effective, open communication between all stakeholders is essential for ensuring regulatory compliance and healthcare product safety; avoiding the necessity for whistle-blowing; and, most essentially, meeting the transparency requirements of public trust.The focus here is on what can be done within a healthcare product organization (HPO) to achieve actionable, sustainable policies and practices such as leadership, management, and supervision role-modelling of best practice; ongoing process review and improvements in every department; protection of those who report concerns through robust policies endorsed at Board level throughout an organization to eliminate the fear of retaliation; training in open, non-defensive team-working principles; and mediation structure and process for resolution of differences of opinion or interpretation of contradictory and volatile data.Based on analyses of other safety systems, workplace silence and interpersonal breakdowns are warning signs of defective systems underlying poor compliance and compromising safety. Remedying the situation requires attention to the root causes underlying such symptoms of dysfunction, especially the human factor, i.e. those factors that influence human performance. It is essential that leadership and management listen to employees' concerns about systems and processes, assess them impartially and reward contributions that improve safety.Fundamentally, the safety, transparency, and trustworthiness of HPOs, both commercial and regulatory, can be judged by the extent of the freedom of their staff to 'speak up' when the time is right. This, in turn, consolidates the trust of external stakeholders in the safety of a system and its products. The promotion of 'speaking up' in an organization provides an important safeguard against the risk of poor compliance and the undermining of societal confidence in the safety of healthcare products.

  4. 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.

  5. Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study.

    Science.gov (United States)

    Kumar, Sameer; Aldrich, Krista

    2010-12-01

    An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system major expense. Yet, compared to other developed nations, the US lags behind. This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for implementation of EMR, industry comparisons to highlight the differences between successful and non-successful EMR ventures, references to costs and benefit information, and identification of root causes. 'Poka-yokes' (avoid (yokeru) mistakes (poka)) will be inserted to provide insight into how to systematically overcome challenges. Implementation will require upfront costs including patient privacy that must be addressed early in the development process. Government structure, incentives and mandates are required for nationwide EMR system in the US.

  6. 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.

  7. The systematic roles of SKI and SSI in the Swedish nuclear waste management system. Syncho`s report for project RISCOM

    Energy Technology Data Exchange (ETDEWEB)

    Espejo, R. [Syncho, Solihull (United Kingdom); Gill, A. [Syncho, Oxon (United Kingdom)

    1998-01-01

    The purpose of this report is to share and summarize our findings about the regulatory roles of SKI/SSI in the context of the Swedish Nuclear System (SNS), with an emphasis on nuclear waste management. The driving force in this review is to make decision processes more transparent. What is reported is based on interviews conducted with employees at SKI/SSI/SKB during early December 1996, the presentation to SKI/SSI in January 1997, discussions during the Shap Wells meeting in Cumbria during March 1997 and RISCOM internal discussions. We offer two hypotheses about the way the Nuclear Waste Management System (NWMS) appears to work. We choose one and derive from it a view about structural issues in SNS and NWMS. The conclusion is a set of systemic roles for the regulators. It is the comparison between these systemic roles and the actual situation that may trigger some adjustments in the system. Our hope is that these findings will make apparent feasible and desirable changes in the system in order to increase the chances for transparent decisions in the Nuclear Waste Management System. In summary, Section 2 includes a general background of the NWMS based on interviews and general information. Section 3 makes a more focused attempt to work out the issues expressed by people in the interviews. Section 4 discusses at a more conceptual level systemic ideas such as the unfolding of complexity. Section 5 is an attempt to organize viewpoints about the NWMS and offers hypotheses to support a preliminary diagnosis of the system in Section 6. We call this section `A problem of identity`. It is only in Section 7 that basic systemic arguments are unfolded with the intention of supporting an appreciation of SKI/SSI`s regulatory roles in the nuclear industry as a whole and nuclear waste management in particular. Section 8 offers a summary of conclusions.

  8. 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.

  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. Healthcare Lean.

    Science.gov (United States)

    Long, John C

    2003-01-01

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

  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. [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.

  13. The Swedish Model

    DEFF Research Database (Denmark)

    Kokko, Ari

    2012-01-01

    The main characteristics of ‘the Swedish model’ are arguably related to the country's knowledge-intensive industry and its advanced welfare state. The purpose of this chapter is to discuss the historical development of these two features of the Swedish economy. The first part looks at industrial...... development, highlighting both the reasons for the rapid industrialization in the late 19th century and the subsequent shift from raw materials to human capital and knowledge as the main competitive advantages. The second part turns to the development of welfare state, stressing the gradual increase...... in benefits and coverage as well as the emphasis on universal rather than means-tested benefits. The final part suggests some policy conclusions for today's developing countries and emerging economies....

  14. 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.

  15. 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

  16. The swedish challenge

    International Nuclear Information System (INIS)

    Tregouet, R.

    2006-01-01

    Sweden decided to be the first country without petroleum for 2020. The author presents the major energy policy axis implemented by the swedish government to delete the part of the produced energy by the petroleum: development of the renewable energies, research programs of the transportation sector concerning the alternative fuels for the motors, energy efficiency and development of the biomass to replace the nuclear energy. (A.L.B.)

  17. 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.

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

    Science.gov (United States)

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

    1999-01-01

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

  20. Biomass and Swedish energy policy

    International Nuclear Information System (INIS)

    Johansson, Bengt

    2001-01-01

    The use of biomass in Sweden has increased by 44% between 1990 and 1999. In 1999 it was 85 TWh, equivalent to 14% of the total Swedish energy supply. The existence of large forest industry and district heating systems has been an essential condition for this expansion. The tax reform in 1991 seems, however, to have been the most important factor responsible for the rapid bioenergy expansion. Through this reform, the taxation of fossil fuels in district heating systems increased by approximately 30-160%, depending on fuel, whereas bioenergy remained untaxed. Industry is exempted from the energy tax and pays reduced carbon tax. No tax is levied on fossil fuels used for electricity production. Investment grants have existed for biomass-based electricity production but these grants have not been large enough to make biomass-based electricity production economically competitive in a period of falling electricity prices. Despite this, the biomass-based electricity production has increased slightly between 1990 and 1999. A new taxation system aiming at a removal of the tax difference between the industry, district heating and electricity sectors has recently been analysed by the Swedish government. One risk with such a system is that it reduces the competitiveness for biomass in district heating systems as it seems unlikely that the taxes on fossil fuels in the industry and electricity sectors will increase to a level much higher than in other countries. A new system, based on green certificates, for supporting electricity from renewable energy sources has also been proposed by the government.

  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. The healthcare system in the Caucasus at the beginning of the XX century: the development features

    Directory of Open Access Journals (Sweden)

    Tatiana E. Gvarliani

    2016-03-01

    Full Text Available The article based on the archival material deals with the healthcare system in the Caucasus at the beginning of the XX century. In writing this article, the authors made use of reports from national archives of Georgia (Tbilisi, Georgia, the archival department of administration of Sochi (Sochi, Russian Federation. There is given the statistics from the works of Russian and foreign authors, and also reference literature. The authors’ use of the principles of objectivity, historicism, systematic, the integrated consideration of socio-subjective in the subject of study and the maximum possible neutrality of the relationship of the researcher to interpret and evaluate the factual material. In conclusion, the authors stated that in the late of XIX – early XX centuries the healthcare system in the Caucasus has experienced a period of significant development. In this time, taking into account the regional peculiarities, there were developed the institutions of the health system, and have been taken measures of anti-epidemic struggle. Despite the difficulties of conducting the health activities in a multinational region the Russian administration managed to significantly reduce the number of patients in the Caucasus.

  4. Accumulation of Domain-Specific Physical Inactivity and Presence of Hypertension in Brazilian Public Healthcare System.

    Science.gov (United States)

    Turi, Bruna Camilo; Codogno, Jamile S; Fernandes, Romulo A; Sui, Xuemei; Lavie, Carl J; Blair, Steven N; Monteiro, Henrique Luiz

    2015-11-01

    Hypertension is one of the most common noncommunicable diseases worldwide, and physical inactivity is a risk factor predisposing to its occurrence and complications. However, it is still unclear the association between physical inactivity domains and hypertension, especially in public healthcare systems. Thus, this study aimed to investigate the association between physical inactivity aggregation in different domains and prevalence of hypertension among users of Brazilian public health system. 963 participants composed the sample. Subjects were divided into quartiles groups according to 3 different domains of physical activity (occupational; physical exercises; and leisure-time and transportation). Hypertension was based on physician diagnosis. Physical inactivity in occupational domain was significantly associated with higher prevalence of hypertension (OR = 1.52 [1.05 to 2.21]). The same pattern occurred for physical inactivity in leisure-time (OR = 1.63 [1.11 to 2.39]) and aggregation of physical inactivity in 3 domains (OR = 2.46 [1.14 to 5.32]). However, the multivariate-adjusted model showed significant association between hypertension and physical inactivity in 3 domains (OR = 2.57 [1.14 to 5.79]). The results suggest an unequal prevalence of hypertension according to physical inactivity across different domains and increasing the promotion of physical activity in the healthcare system is needed.

  5. 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.

  6. 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

  7. 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.

  8. Provincial health accounts in Kerman, Iran: an evidence of a "mixed" healthcare financing system.

    Science.gov (United States)

    Mehrolhassani, Mohammad Hossein; Jafari, Mohammad; Zeinali, Javad; Ansari, Mina

    2014-02-01

    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. 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. 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. 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 emphasizing on 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 initiatives and reforms in healthcare sector.

  9. 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

  10. Modelling the external radiation exposure from the Chernobyl fallout using data from the Swedish municipality measurement system.

    Science.gov (United States)

    Jönsson, Mattias; Tondel, Martin; Isaksson, Mats; Finck, Robert; Wålinder, Robert; Mamour, Afrah; Rääf, Christopher

    2017-11-01

    In connection with the Chernobyl fallout and the subsequent deposition of radionuclides in Sweden, Swedish municipalities launched a measurement program to monitor the external radiation exposure. This program encompasses measurements of the ambient dose equivalent rate 1 m above ground at selected locations, and repeats those measurements at the same locations at 7-month intervals. Measurement data compiled from the seven locations with the highest deposition were combined with data from aerial surveys since May 1986 of ground deposition of 137 Cs, high-resolution gamma spectrometry performed at four locations in May 1986, and measurements from fixed continuous air gamma rate monitoring stations from 28 April to 15 May 1986. Based on these datasets, a model of the time pattern of the external dose rate in terms of ambient dose equivalent rate from the Chernobyl fallout was developed. The decrease in the ambient dose equivalent rate could, on average, be described by a four-component exponential decay function with effective half-times of 6.8 ± 0.3 d, 104 ± 26 d, 1.0 ± 0.02 y and 5.5 ± 0.09 y, respectively. The predominant contributions to the external dose rate in the first month were from short-lived fission products superseded by 134 Cs and then 137 Cs. Integrated over 70 y and using extrapolation of the curve fits, our model predicts that 137 Cs contributes about 60% and 134 Cs contributes about 30% of the external effective dose at these seven locations. The projected time-integrated 70 y external effective dose to an unshielded person from all nuclides per unit total activity deposition of 137 Cs is estimated to be 0.29 ± 0.0.08 mSv/(kBq m -2 ). These results are in agreement with those found in Chernobyl contaminated Russian forest areas, and emphasize the usefulness of maintaining a long-term and regular measurement program in contaminated areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Exploring the Barriers: A Qualitative Study about the Experiences of Mid-SES Roma Navigating the Spanish Healthcare System.

    Science.gov (United States)

    Aiello, Emilia; Flecha, Ainhoa; Serradell, Olga

    2018-02-22

    Whereas the topic of the 'cultural sensitivity' of healthcare systems has been addressed extensively in the US and the UK, literature on the subject in most European countries, specifically looking at the situation of Roma, is still scarce. Drawing on qualitative research conducted mainly in the city of Barcelona under the communicative approach with Roma subjects who have stable socioeconomic positions and higher cultural capitals (end-users, professionals of the healthcare system, and key informants of a regional policy oriented to the improvement of Roma living conditions), the present study aims to fill this gap. We explore the barriers that the Roma face in accessing the healthcare system, reflecting on how these barriers are accentuated by the existing anti-Roma prejudices and institutional arrangements that do not account for minority cultures. Our results point out a series of obstacles at two levels, in the interaction with healthcare professionals, and in relation to existing institutional arrangements, which prevent Roma families from having equal access to the healthcare system. Education stands up as a mechanism to contest anti-Roma sentiments among healthcare professionals.

  12. A network approach for researching political feasibility of healthcare reform: the case of universal healthcare system in Taiwan.

    Science.gov (United States)

    Wang, Guang-Xu

    2012-12-01

    This study evaluates the political feasibility of healthcare reform taking place in Taiwan in the past decade. Since Taiwan adopted National Health Insurance (NHI) in 1995, it has provided coverage for virtually all of the island's citizens. However, the imbalance between expenditure and revenue has resulted in a cycle of unsustainable spending which has necessitated financial reforms and political confrontations. By applying social network analysis, this paper examines multiple types of ties between policy elites and power distribution that have evolved in crucial policy events of the NHI's financial reforms between 1998 and 2010. Data sources include official documents and 62 social network interviews that were held with government officials and related unofficial policy participants. Blockmodeling and multidimensional scaling (MDS) are used to determine the major participants and network structures in the NHI domain, as well as the influential policy actors, based on information transmission, resource exchange, reputation attribution and action-set coalition networks in Taiwan's current political situation. The results show that although both public actors and all medical associations are the leading actors in the NHI reform, without good communication with societal actors, the promotion of reform proposals ends in failure. As a tool of political feasibility evaluation, social network analysis can map the political conflict between policy stakeholders systematically when policy makers pursue the result of policy adoption. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Perceived determinants of cardiovascular risk management in primary care: disconnections between patient behaviours, practice organisation and healthcare system.

    Science.gov (United States)

    Huntink, E; Wensing, M; Klomp, M A; van Lieshout, J

    2015-12-15

    Although conditions for high quality cardiovascular risk management in primary care in the Netherlands are favourable, there still remains a gap between practice guideline recommendations and practice. The aim of the current study was to identify determinants of cardiovascular primary care in the Netherlands. We performed a qualitative study, using semi-structured interviews with healthcare professionals and patients with established cardiovascular diseases or at high cardiovascular risk. A framework analysis was used to cluster the determinants into seven domains: 1) guideline factors, 2) individual healthcare professional factors, 3) patient factors, 4) professional interaction, 5) incentives and recourses, 6) mandate, authority and accountability, and 7) social, political and legal factors. Twelve healthcare professionals and 16 patients were interviewed. Healthcare professionals and patients mentioned a variety of factors concerning all seven domains. Determinants of practice according to the health care professionals were related to communication between healthcare professionals, patients' lack of knowledge and self-management, time management, market mechanisms in the Dutch healthcare system and motivational interviewing skills of healthcare professionals. Patients mentioned determinants related to their knowledge of risk factors for cardiovascular diseases, medication adherence and self-management as key determinants. A key finding is the mismatch between healthcare professionals' and patients' views on patient's knowledge and self-management. Perceived determinants of cardiovascular risk management were mainly related to patient behaviors and (but only for health professionals) to the healthcare system. Though health care professionals and patients agree upon the importance of patients' knowledge and self-management, their judgment of the current state of knowledge and self-management is entirely different.

  14. 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.

  15. 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.

  16. My care pathways - creating open innovation in healthcare.

    Science.gov (United States)

    Lundberg, Nina; Koch, Sabine; Hägglund, Maria; Bolin, Peter; Davoody, Nadia; Eltes, Johan; Jarlman, Olof; Perlich, Anja; Vimarlund, Vivian; Winsnes, Casper

    2013-01-01

    In this paper we describe initial results from the Swedish innovation project "My Care Pathways" which envisions enabling citizens to track their own health by providing them with online access to their historical, current and prospective future events. We describe an information infrastructure and its base services as well as the use of this solution as an open source platform for open innovation in healthcare. This will facilitate the development of end-user e-services for citizens. We have technically enabled the information infrastructure in close collaboration with decision makers in three Swedish health care regions, and system vendors as well as with National eHealth projects. Close collaboration between heterogeneous actors made implementation in real practice possible. However, a number of challenges, mainly related to legal and business issues, persist when implementing our results. Future work should therefore target the development of business models for sustainable provision of end-user e-services in a public health care system such as the Swedish one. Also, a legal analysis of the development of third party provider (nonhealthcare based) personal health data e-services should be done.

  17. 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.

  18. 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.

  19. Bridging the knowledge gap: an innovative surveillance system to monitor the health of British Columbia's healthcare workforce.

    Science.gov (United States)

    Gilligan, Tony; Alamgir, Hasanat

    2008-01-01

    Healthcare workers are exposed to a variety of work-related hazards including biological, chemical, physical, ergonomic, psychological hazards; and workplace violence. The Occupational Health and Safety Agency for Healthcare in British Columbia (OHSAH), in conjunction with British Columbia (BC) health regions, developed and implemented a comprehensive surveillance system that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of healthcare workers. Workplace Health Indicator Tracking and Evaluation (WHITE) is a secure operational database, used for data entry and transaction reporting. It has five modules: Incident Investigation, Case Management, Employee Health, Health and Safety, and Early Intervention/Return to Work. Since the WHITE database was first introduced into BC in 2004, it has tracked the health of 84,318 healthcare workers (120,244 jobs), representing 35,927 recorded incidents, resulting in 18,322 workers' compensation claims. Currently, four of BC's six healthcare regions are tracking and analyzing incidents and the health of healthcare workers using WHITE, providing OHSAH and healthcare stakeholders with comparative performance indicators on workplace health and safety. A number of scientific manuscripts have also been published in peer-reviewed journals. The WHITE database has been very useful for descriptive epidemiological studies, monitoring health risk factors, benchmarking, and evaluating interventions.

  20. 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.

  1. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. 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 requiremen