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Sample records for regional healthcare information

  1. From Regional Healthcare Information Organizations to a National Healthcare Information Infrastructure

    PubMed Central

    Kaufman, James H; Eiron, Iris; Deen, Glenn; Ford, Dan A; Smith, Eishay; Knoop, Sarah; Nelken, H; Kol, Tomer; Mesika, Yossi; Witting, Karen; Julier, Kevin; Bennett, Craig; Rapp, Bill; Carmeli, Boaz; Cohen, Simona

    2005-01-01

    Recently there has been increased focus on the need to modernize the healthcare information infrastructure in the United States.14 The U.S. healthcare industry is by far the largest in the world in both absolute dollars and in percentage of GDP (more than $1.5 trillion, or 15 percent of GDP). It is also fragmented and complex. These difficulties, coupled with an antiquated infrastructure for the collection of and access to medical data, lead to enormous inefficiencies and sources of error. Consumer, regulatory, and governmental pressure drive a growing consensus that the time has come to modernize the U.S. healthcare information infrastructure (HII). While such transformation may be disruptive in the short term, it will, in the future, significantly improve the quality, expediency, efficiency, and successful delivery of healthcare while decreasing costs to patients and payers and improving the overall experiences of consumers and providers. The launch of a national health infrastructure initiative in the United States in May 2004-with the goal of providing an electronic health record for every American within the next decade-will eventually transform the healthcare industry in general, just as information technology (IT) has transformed other industries in the past. The key to this successful outcome will be based on the way we apply IT to healthcare data and the services delivered through IT. This must be accomplished in a way that protects individuals and allows competition but gives caregivers reliable and efficient access to the data required to treat patients and to improve the practice of medical science. This paper describes key IT solutions and technologies that address the challenges of creating a nation-wide healthcare IT infrastructure. Furthermore we discuss the emergence of new electronic healthcare services and the current efforts of IBM Research, Software Group, and Healthcare Life Sciences to realize this new vision for healthcare. PMID:18066378

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

    PubMed

    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, 180,000 first aid medical reports, and 58,000 discharge summaries. Hence, despite there being still work in progress, the Lombardy Region healthcare system is a fully interoperable social healthcare system connecting patients, healthcare providers, healthcare organizations, and healthcare professionals in a large and heterogeneous territory through the implementation of international health standards. PMID:22285983

  3. Healthcare Information Framework.

    PubMed

    Saranummi, N; Demeester, M; Fernandez Perez de Talens, A; Harrington, J; Heimly, V; de la Riva Grandal, J M; Taylor, J

    1995-04-01

    CEN committee TC 251 Medical Informatics, has set up a project team charged with producing a European pre-standard ENV on Healthcare Information Framework (HIF). The HIF is based on abstraction from a specific information system architecture to a reference architecture and further to a conceptual architectural framework based on serving open, distributed and heterogeneous healthcare enterprises. To specify the suitable healthcare information system architecture modelling of the healthcare enterprise is required. As there is no one method serving all needs, the HIF gives guidance on what aspects to look at in selecting a suitable modelling method. It is expected that the work will be completed by early 1995. PMID:7601549

  4. Healthcare information systems architecture.

    PubMed

    Ferrara, F M

    1997-01-01

    The integration and evolution of existing systems represents one of the most urgent priorities of healthcare information systems in order to allow the whole organisation to meet the increasing clinical organisational and managerial needs. This paper discusses how an open architecture, based on the introduction of a middleware of common healthcare-specific services not only reduces the effort necessary for allowing existing systems to interwork, but also automatically establishes a functional and information basis common to the whole organisation, on top of which also new applications can be rapidly developed, natively integrated with the rest of the system. Such architecture has been already formalised through the proposed European preStandard, defined by the CEN/TC251/PT1-013 "Standard Architecture for Healthcare Information Systems" [1]. Through the utilisation of the DHE middleware, the effectiveness and validity of this approach is also being demonstrated in practice by several hospitals and healthcare industries from 13 European countries, which collaborate in the Hansa project, presently running under the Telematics Application Programme of the Commission of the European Communities. PMID:10175347

  5. Securing Information Technology in Healthcare

    PubMed Central

    Anthony, Denise; Campbell, Andrew T.; Candon, Thomas; Gettinger, Andrew; Kotz, David; Marsch, Lisa A.; Molina-Markham, Andrés; Page, Karen; Smith, Sean W.; Gunter, Carl A.; Johnson, M. Eric

    2014-01-01

    Dartmouth College’s Institute for Security, Technology, and Society conducted three workshops on securing information technology in healthcare, attended by a diverse range of experts in the field. This article summarizes the three workshops. PMID:25379030

  6. General Information about MRSA in Healthcare Settings

    MedlinePLUS

    ... Infections Share Compartir General Information About MRSA in Healthcare Settings In a healthcare setting, such as a ... at Risk, and How is MRSA Spread in Healthcare Settings? MRSA is usually spread by direct contact ...

  7. Healthcare information technology and economics

    PubMed Central

    Bates, David W; Berner, Eta S; Bernstam, Elmer V; Covvey, H Dominic; Frisse, Mark E; Graf, Thomas; Greenes, Robert A; Hoffer, Edward P; Kuperman, Gil; Lehmann, Harold P; Liang, Louise; Middleton, Blackford; Omenn, Gilbert S; Ozbolt, Judy

    2013-01-01

    At the 2011 American College of Medical Informatics (ACMI) Winter Symposium we studied the overlap between health IT and economics and what leading healthcare delivery organizations are achieving today using IT that might offer paths for the nation to follow for using health IT in healthcare reform. We recognized that health IT by itself can improve health value, but its main contribution to health value may be that it can make possible new care delivery models to achieve much larger value. Health IT is a critically important enabler to fundamental healthcare system changes that may be a way out of our current, severe problem of rising costs and national deficit. We review the current state of healthcare costs, federal health IT stimulus programs, and experiences of several leading organizations, and offer a model for how health IT fits into our health economic future. PMID:22781191

  8. Guest editorial. Integrated healthcare information systems.

    PubMed

    Li, Ling; Ge, Ri-Li; Zhou, Shang-Ming; Valerdi, Ricardo

    2012-07-01

    The use of integrated information systems for healthcare has been started more than a decade ago. In recent years, rapid advances in information integration methods have spurred tremendous growth in the use of integrated information systems in healthcare delivery. Various techniques have been used for probing such integrated systems. These techniques include service-oriented architecture (SOA), EAI, workflow management, grid computing, and others. Many applications require a combination of these techniques, which gives rise to the emergence of enterprise systems in healthcare. Development of the techniques originated from different disciplines has the potential to significantly improve the performance of enterprise systems in healthcare. This editorial paper briefly introduces the enterprise systems in the perspective of healthcare informatics. PMID:22760931

  9. Healthcare Information Technology Infrastructures in Turkey

    PubMed Central

    Yuksel, M.; Ertürkmen, G. L.; Kabak, Y.; Namli, T.; Yıldız, M. H.; Ay, Y.; Ceyhan, B.; Hülür, Ü.; Öztürk, H.; Atbakan, E.

    2014-01-01

    Summary Objectives The objective of this paper is to describe some of the major healthcare information technology (IT) infrastructures in Turkey, namely, Sağlık-Net (Turkish for “Health-Net”), the Centralized Hospital Appointment System, the Basic Health Statistics Module, the Core Resources Management System, and the e-prescription system of the Social Security Institution. International collaboration projects that are integrated with Sağlık-Net are also briefly summarized. Methods The authors provide a survey of the some of the major healthcare IT infrastructures in Turkey. Results Sağlık-Net has two main components: the National Health Information System (NHIS) and the Family Medicine Information System (FMIS). The NHIS is a nation-wide infrastructure for sharing patients’ Electronic Health Records (EHRs). So far, EHRs of 78.9 million people have been created in the NHIS. Similarly, family medicine is operational in the whole country via FMIS. Centralized Hospital Appointment System enables the citizens to easily make appointments in healthcare providers. Basic Health Statistics Module is used for collecting information about the health status, risks and indicators across the country. Core Resources Management System speeds up the flow of information between the headquarters and Provincial Health Directorates. The e-prescription system is linked with Sağlık-Net and seamlessly integrated with the healthcare provider information systems. Finally, Turkey is involved in several international projects for experience sharing and disseminating national developments. Conclusion With the introduction of the “Health Transformation Program” in 2003, a number of successful healthcare IT infrastructures have been developed in Turkey. Currently, work is going on to enhance and further improve their functionality. PMID:24853036

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

    PubMed Central

    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

  11. Clinical information systems for integrated healthcare networks.

    PubMed Central

    Teich, J. M.

    1998-01-01

    In the 1990's, a large number of hospitals and medical practices have merged to form integrated healthcare networks (IHN's). The nature of an IHN creates new demands for information management, and also imposes new constraints on information systems for the network. Important tradeoffs must be made between homogeneity and flexibility, central and distributed governance, and access and confidentiality. This paper describes key components of clinical information systems for IHN's, and examines important design decisions that affect the value of such systems. Images Figure 1 PMID:9929178

  12. Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources.

    PubMed

    Barengo, Nol C; Tamayo, Diana Carolina

    2015-01-01

    The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20-79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000; p value: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000; p value: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system. PMID:26494999

  13. Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources

    PubMed Central

    Barengo, Noël C.; Tamayo, Diana Carolina

    2015-01-01

    The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20–79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000; p value: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000; p value: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system. PMID:26494999

  14. Patients and Loved Ones: Information about MRSA in Healthcare Settings

    MedlinePLUS

    ... Patients and Loved Ones: Information about MRSA in Healthcare Settings Available for download: FAQs about MRSA [PDF - ... and on the hands of doctors, nurses, other healthcare providers and visitors. Top Can MRSA infections be ...

  15. Role of Healthcare Information Technology in handoffs.

    PubMed

    Koppel, Ross; Telles, Joel Leon

    2013-01-01

    Handoffs-transfer of patient care from one clinician or service to another-are well known patient safety dangers. Healthcare Information Technology (HIT) as an intervening and powerful force in handoffs has received comparatively little attention. The role of HIT in concert with paper documentation has received even less attention. We analyze handoffs in relation to electronic records and hybrid systems (both paper and HIT) to identify sources of error and miscommunication. We propose a typology of handoffs and illustrate several of them. PMID:23388248

  16. Security threats categories in healthcare information systems.

    PubMed

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

    2010-09-01

    This article attempts to investigate the various types of threats that exist in healthcare information systems (HIS). A study has been carried out in one of the government-supported hospitals in Malaysia.The hospital has been equipped with a Total Hospital Information System (THIS). The data collected were from three different departments, namely the Information Technology Department (ITD), the Medical Record Department (MRD), and the X-Ray Department, using in-depth structured interviews. The study identified 22 types of threats according to major threat categories based on ISO/IEC 27002 (ISO 27799:2008). The results show that the most critical threat for the THIS is power failure followed by acts of human error or failure and other technological factors. This research holds significant value in terms of providing a complete taxonomy of threat categories in HIS and also an important component in the risk analysis stage. PMID:20889850

  17. [Healthcare research and regional programming in Umbria (Italy)].

    PubMed

    Romagnoli, Carlo; Minelli, Liliana

    2008-01-01

    This paper discusses the relationship between regional programming and national health research policy, and in particular evaluates the role that intellectual capital plays in innovation processes of knowledge-based organizations. The concepts of intellectual capital and knowledge-based organization are defined in the paper, as these are especially useful when speaking of university, healthcare systems and research and development companies. The paper also examines the various types of healthcare research (basic research, clinical trial, epidemiological research, valutative research) and the role that each type of research plays in healthcare programming at the national and regional levels. PMID:19219082

  18. Picture archiving and communications systems for integrated healthcare information solutions

    NASA Astrophysics Data System (ADS)

    Goldburgh, Mitchell M.; Glicksman, Robert A.; Wilson, Dennis L.

    1997-05-01

    The rapid and dramatic shifts within the US healthcare industry have created unprecedented needs to implement changes in the delivery systems. These changes must not only address the access to healthcare, but the costs of delivery, and outcomes reporting. The resulting vision to address these needs has been called the Integrated Healthcare Solution whose core is the Electronic Patient Record. The integration of information by itself is not the issue, nor will it address the challenges in front of the healthcare providers. The process and business of healthcare delivery must adopt, apply and expand its use of technology which can assist in re-engineering the tools for healthcare. Imaging is becoming a larger part of the practice of healthcare both as a recorder of health status and as a defensive record for gatekeepers of healthcare. It is thus imperative that imaging specialists adopt technology which competitively integrates them into the process, reduces the risk, and positively effects the outcome.

  19. Pittsburgh Regional Healthcare Initiative puts new spin on improving healthcare quality.

    PubMed

    2002-11-01

    For nearly 4 years, the Pittsburgh Regional Healthcare Initiative (PRHI) has been working to improve the way healthcare is delivered in southwestern Pennsylvania by combining the voices and resources of hospitals, providers, the business community, insurers, health plans, and federal agencies. As one example of borrowing from business, the PRHI has created a new learning and management system, called Perfecting Patient Care, which is based on the Toyota Production System model and is now being used successfully in hospitals. PMID:12497771

  20. Successfully integrating information systems into healthcare.

    PubMed

    Wallhouse, R

    1992-01-01

    Many hospital managers are currently looking at implementing hospital information systems (HIS) for the first time, or planning replacement of their first HIS. This article is intended as a resume of 'best practice' in terms of how to approach the selection and implementation of an integrated HIS--a "Do's and Don'ts Guide" for hospital managers. Emphasis is placed on the importance of management assuming overall responsibility for the HIS as a vital communications tool to support the provision of healthcare. Since the HIS underpins the 'business aims' of the institution, these need to be clearly defined at the outset. How to evaluate the benefits of an HIS supplier and aspects such as encouraging an atmosphere of ownership of the HIS by all staff are reviewed in the article. PMID:10123004

  1. Factors affecting the adoption of healthcare information technology.

    PubMed

    Phichitchaisopa, Nisakorn; Naenna, Thanakorn

    2013-01-01

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

  2. Factors affecting the adoption of healthcare information technology

    PubMed Central

    Phichitchaisopa, Nisakorn; Naenna, Thanakorn

    2013-01-01

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

  3. 78 FR 21502 - Proposed Information Collection (Women Veterans Healthcare Barriers Survey)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... AFFAIRS Proposed Information Collection (Women Veterans Healthcare Barriers Survey) AGENCY: Veterans...) 395-7316. Please refer to ``OMB Control No. 2900-NEW, Women Veterans Healthcare Barriers Survey'' in... Veterans Healthcare Barriers Survey.'' SUPPLEMENTARY INFORMATION: Title: Women Veterans Healthcare...

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

    PubMed Central

    2009-01-01

    Background To date, online public healthcare reports have not been effectively used by consumers. Therefore, we qualitatively examined how healthcare consumers process and evaluate comparative healthcare information on the Internet. Methods Using semi-structured cognitive interviews, interviewees (n = 20) were asked to think aloud and answer questions, as they were prompted with three Dutch web pages providing comparative healthcare information. Results We identified twelve themes from consumers' thoughts and evaluations. These themes were categorized under four important areas of interest: (1) a response to the design; (2) a response to the information content; (3) the use of the information, and (4) the purpose of the information. Conclusion Several barriers to an effective use of comparative healthcare information were identified, such as too much information and the ambiguity of terms presented on websites. Particularly important for future research is the question of how comparative healthcare information can be integrated with alternative information, such as patient reviews on the Internet. Furthermore, the readability of quality of care concepts is an issue that needs further attention, both from websites and communication experts. PMID:19930564

  5. Healthcare

    MedlinePLUS

    ... Español A to Z Index Contact Us FAQs Healthcare Culture of Safety Infectious Diseases Safe Patient Handling Workplace Violence Other Hazards Standards/Enforcement What is healthcare? Healthcare is involved, directly or indirectly, with the ...

  6. Older Adults Seeking Healthcare Information on the Internet

    ERIC Educational Resources Information Center

    Hardt, Jeffrey H.; Hollis-Sawyer, Lisa

    2007-01-01

    Due to an aging population and increases in healthcare costs, particular attention needs to be focused on developing Internet sites that provide older adults with credible and accurate healthcare information. Present research findings suggest that motivation is only one factor that influences whether or not older adults utilize the World Wide Web

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

    ERIC Educational Resources Information Center

    Pirhonen, Antti; Silvennoinen, Minna; Sillence, Elizabeth

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Pirhonen, Antti; Silvennoinen, Minna; Sillence, Elizabeth

    2014-01-01

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

  9. Integrated healthcare delivery systems: an overview for health information managers.

    PubMed

    Jones-Burns, M

    1997-10-01

    As integrated healthcare delivery systems stake their claims for the future, it is rapidly becoming the health information manager's duty to integrate and manage healthcare data. Read on for a general outlook on the changes surrounding integration activities, from new trends to integration's impact on the profession. PMID:10173202

  10. Developing a secure healthcare information network on the Internet.

    PubMed

    Calcote, S

    1997-01-01

    Healthcare professionals across the country are using the Internet for a variety of activities, including the transmission of medical record data via e-mail. The transmission of confidential information, however, is a serious concern of healthcare consumers, providers, and payers alike. At Indiana University School of Medicine, security on the Internet is no longer a concern. The Internet is, in fact, the heart of a healthcare information network currently in development for the Indianapolis area. A complex set of encryption/decryption algorithms and user identifier and private passwords currently in development should greatly reduce the risk of security breach on the network. PMID:10163896

  11. A Theoretical Approach to Information Needs Across Different Healthcare Stakeholders

    NASA Astrophysics Data System (ADS)

    Raitoharju, Reetta; Aarnio, Eeva

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

  12. 78 FR 4983 - Proposed Information Collection; Women Veterans Healthcare Barriers Survey Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ... AFFAIRS Proposed Information Collection; Women Veterans Healthcare Barriers Survey Activity: Comment... to ``OMB Control No. 2900-NEW, Women Veterans Healthcare Barriers Survey'' in any correspondence... use of other forms of information technology. Title: Women Veterans Healthcare Barriers Survey ....

  13. ARTEMIS: towards a secure interoperability infrastructure for healthcare information systems.

    PubMed

    Boniface, Mike; Wilken, Paul

    2005-01-01

    The ARTEMIS project is developing a semantic web service based P2P interoperability infrastructure for healthcare information systems. The strict legislative framework in which these systems are deployed means that the interoperability of security and privacy mechanisms is an important requirement in supporting communication of electronic healthcare records across organisation boundaries. In ARTEMIS, healthcare providers define semantically annotated security and privacy policies for web services based on organisational requirements. The ARTEMIS mediator uses these semantic web service descriptions to broker between organisational policies by reasoning over security and clinical concept ontologies. PMID:15923727

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

    PubMed

    El Azami, Ikram; Cherkaoui Malki, Mohammed Ouamah; 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. PMID:22086739

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

    PubMed Central

    Masaud-Wahaishi, Abdulmutalib; Ghenniwa, Hamada

    2009-01-01

    Healthcare industry is facing a major reform at all levelslocally, regionally, nationally, and internationally. Healthcare services and systems become very complex and comprise of a vast number of components (software systems, doctors, patients, etc.) that are characterized by shared, distributed and heterogeneous information sources with varieties of clinical and other settings. The challenge now faced with decision making, and management of care is to operate effectively in order to meet the information needs of healthcare personnel. Currently, researchers, developers, and systems engineers are working toward achieving better efficiency and quality of service in various sectors of healthcare, such as hospital management, patient care, and treatment. This paper presents a novel information brokering architecture that supports privacy-based information gathering in healthcare. Architecturally, the brokering is viewed as a layer of services where a brokering service is modeled as an agent with a specific architecture and interaction protocol that are appropriate to serve various requests. Within the context of brokering, we model privacy in terms of the entities ability to hide or reveal information related to its identities, requests, and/or capabilities. A prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform JADE. PMID:19325918

  16. Seeking health information online: does limited healthcare access matter?

    PubMed

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2014-01-01

    Consumers facing barriers to healthcare access may use online health information seeking and online communication with physicians, but the empirical relationship has not been sufficiently analyzed. Our study examines the association of barriers to healthcare access with consumers' health-related information searching on the internet, use of health chat groups, and email communication with physicians, using data from 27,210 adults from the 2009 National Health Interview Survey. Individuals with financial barriers to healthcare access, difficulty getting timely appointments with doctors, and conflicts in scheduling during clinic hours are more likely to search for general health information online than those without these access barriers. Those unable to get timely appointments with physicians are more likely to participate in health chat groups and email physicians. The internet may offer a low-cost source of health information and could help meet the heightened demand for health-related information among those facing access barriers to care. PMID:24948558

  17. 77 FR 18821 - Agency for Healthcare Research and Quality; Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... HUMAN SERVICES Agency for Healthcare Research and Quality; Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: Agency for Healthcare Research and Quality, HHS. ACTION: Notice. SUMMARY: This notice announces the intention of the Agency for Healthcare Research and...

  18. 77 FR 60997 - Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: Agency for Healthcare Research and Quality, HHS. ACTION: Notice. SUMMARY: This notice announces the intention of the Agency for Healthcare Research and...

  19. 76 FR 61707 - Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed Collection; Comment Request AGENCY: Agency for Healthcare Research and Quality, HHS. ACTION: Notice. SUMMARY: This notice announces the intention of the Agency for Healthcare Research and...

  20. Healthcare

    ERIC Educational Resources Information Center

    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…

  1. Web-Based Integrated Public Healthcare Information System of Korea: Development and Performance

    PubMed Central

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

    2013-01-01

    Objectives 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. Methods 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. Results 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. Conclusions 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. PMID:24523997

  2. MobiDis: Toward a Patient Centric Healthcare Information System.

    PubMed

    Ricci, Fabrizio L; Serbanati, Luca D

    2005-01-01

    The paper presents some results of the MobiDis project. MobiDis is an information system that includes healthcare consumers and providers in a unique, virtual organisation aimed at promoting a patient centric paradigm in healthcare. It allows logons from desktop or laptop computers, as well as wireless PDAs or tablet PCs connected to Internet. In MobiDis the clinical data of each consumer are stored in the consumer's virtual healthcare record (VHR), a highly structured entity that exists on the network and is simultaneously updated with information from multiple locations. The MobiDis architecture creates an environment for VHRs by providing them with a large variety of services. In order to prove that our proposed architectural solution meets the project goals a prototype was developed. The paper describes the MobiDis architecture and the VHR services, and briefly presents the prototype. PMID:16160316

  3. Information overload in healthcare: too much of a good thing?

    PubMed

    Klerings, Irma; Weinhandl, Alexandra S; Thaler, Kylie J

    2015-01-01

    The rapidly growing production of healthcare information - both scientific and popular - increasingly leads to a situation of information overload affecting all actors of the healthcare system and threatening to impede the adoption of evidence-based practice. In preparation for the 2015 Cochrane Colloquium in Vienna, we discuss the issues faced by three major actors of this system: patients, healthcare practitioners, and systematic reviewers. We analyze their situation through the concept of "filter failure", positing that the main problem is not that there is "too much information", but that the traditional means of managing and evaluating information are ill-suited to the realities of the digital age. Some of the major instances of filter failure are inadequate information retrieval systems for point-of-care settings, the problem of identifying all relevant evidence in an exceedingly diverse landscape of information resources, and the very basic lack of health information literacy, concerning not only the general public. Finally, we give an overview of proposed solutions to the problem of information overload. These new or adapted filtering systems include adapting review literature to the specific needs of practitioners or patients, technological improvements to information systems, strengthening the roles of intermediaries, as well as improving health literacy. PMID:26354128

  4. Design of an image-enabled electronic healthcare record system for regional collaborative healthcare applications

    NASA Astrophysics Data System (ADS)

    Zhang, Kai; Yang, Yuanyuan; He, Zhenyu; Sun, Jianyong; Ling, Tonghui; Zhang, Jianguo

    2009-02-01

    Shanghai is piloting to develop an EHR system to solve the problems of medical document sharing for collaborative healthcare, the solution of which is considering to following IHE XDS (cross-enterprise document sharing) and XCA (cross-community access) technical profiles as well as combined with grid storage for images. The first phase of the project targets text and image documents sharing cross four local domains or communities, each of which consists of multiple hospitals. The prototype system was designed and developed with service-oriented architecture (SOA) and Event-Driven Architecture (EDA), basing on IHE XDS.b and XCA profiles, and consists of four level components: one central city registry; the multiple domain registries, each of which is for one local domain or community; the multiple repositories corresponding to multiple local domain registries; and multiple document source agents, each of which is located in each hospital to provide the patient healthcare information. The system was developed and tested for performance evaluation including data publication, user query and image retrieval. The results are extremely positive and demonstrate that the designed EHR solution based on SOA with grid concept can scale effectively to serve medical document sharing cross-domain or community in a large city.

  5. Healthcare information on YouTube: A systematic review.

    PubMed

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

    2015-09-01

    This article reviews the peer-reviewed literature addressing the healthcare information available on YouTube. Inclusion and exclusion criteria were determined, and the online databases PubMed and Web of Knowledge were searched using the search phrases: (1) YouTube* AND Health* and (2) YouTube* AND Healthcare*. In all, 18 articles were reviewed, with the results suggesting that (1) YouTube is increasingly being used as a platform for disseminating health information; (2) content and frame analysis were the primary techniques employed by researchers to analyze the characteristics of this information; (3) YouTube contains misleading information, primarily anecdotal, that contradicts the reference standards and the probability of a lay user finding such content is relatively high; (4) the retrieval of relevant videos is dependent on the search term used; and (5) videos from government organizations and professional associations contained trustworthy and high-quality information. YouTube is used as a medium for promoting unscientific therapies and drugs that are yet to be approved by the appropriate agencies and has the potential to change the beliefs of patients concerning controversial topics such as vaccinations. This review recognizes the need to design interventions to enable consumers to critically assimilate the information posted on YouTube with more authoritative information sources to make effective healthcare decisions. PMID:24670899

  6. CHIME (College of Healthcare Information Management Executives) board members 'tell Hillary' goals for healthcare I/S. Interview by Carolyn Dunbar.

    PubMed

    Reed, W C; Mazzuckelli, K; Tucker, D H

    1993-04-01

    At press time, the details of the Clinton administration's healthcare reform package were not yet public. Some information has been leaked, however, fueling speculation about the plan's exact points. Computers in Healthcare asked three board members of the College of Healthcare Information Management Executives what they thought the Clinton healthcare team should know about the information piece of the puzzle. PMID:10125051

  7. Healthcare Information Systems - Requirements and Vision

    NASA Astrophysics Data System (ADS)

    Williams, John G.

    The introduction of sophisticated information, communications and technology into health care is not a simple task, as demonstrated by the difficulties encountered by the Department of Health's multi-billion programme for the NHS. This programme has successfully implemented much of the infrastructure needed to support the activities of the NHS, but has made less progress with electronic patient records. The case for health records that are focused on the individual patient will be outlined, and the need for these to be underpinned by professionally agreed standards for structure and content. Some of the challenges will be discussed, and the benefits to health care and clinical research will be explored.

  8. Introducing guideline management in the healthcare information system architecture.

    PubMed

    Romn, I; Roa, L M; Madinabeitia, G; Milln, A

    2007-01-01

    This paper analyses different benefits of the full integration of components for clinical guideline management in the information system architecture of a healthcare organization. Subsequently, we propose a methodology for the development of these components based on the European prEN12967 standard, in order to facilitate this integration. Benefits are studied from several viewpoints. First, from the healthcare professional user viewpoint, as a powerful decision support tool, by which the Electronic Health Record of a specific patient could suggest the appropriate guidelines to apply and a particular assistance plan for him or her. We are centered in co-morbidity patients because these tasks are especially difficult to accomplish in this kind of patients. Second, from the guideline creation viewpoint, we analyze how the tacit knowledge implicit in the healthcare information system could be the base for the explicit representation of knowledge in a guideline and the posterior validation of these guidelines. Our approach is in agreement with today's new paradigm for evidence-based medicine demanded by healthcare professionals. The proposed method for guideline management components development is compliant with CEN's prEN12967 European standard, and consequently follows ITU-T's ODP methodology. PMID:17901605

  9. Healthcare Information Systems to Assess Influenza Outbreaks

    PubMed Central

    Figar, S.; Aliperti, V.; Salazar, E.; Otero, C.; Schpilberg, M.; Taliercio, V.; Otero, P.; de Quirs, F. Gonzlez Bernaldo

    2011-01-01

    Objective To determine whether a private HIS could have detected the influenza epidemic outbreaks earlier through changes in morbidity and mortality patterns. Methods Data Source included a health information system (HIS) from an academic tertiary health care center integrating administrative and clinical applications. It used a local interface terminology server which provides support through data autocoding of clinical documentation. Specific data subsets were created to compare the burden of influenza during the epidemiological week (EW) 21 to 26 for years 2007 to 2009 among 150,000 Health Maintenance Organization members in Argentina. The threshold for identifying an epidemic was considered met when the weekly influenza-like illness (ILI) rate exceeded 200 per 100,000 visits. Case fatality rates and mortality rates of severe acute respiratory infection (SARI) from 2007 to 2009 were retrospectively compared. Case fatality rates and mortality rates for A/H1N1 influenza 2009 also were estimated. Results The HIS detected the outbreak in EW 23 while the government Ministry of Health (MoH) gave a national epidemic alert during EW 25. The number of visits for ILI increased more than fourfold when comparing 2009 to the period 2007-2008. The SARI mortality rate in 2009 was higher than in 2008 (RR 2.8; 95%CI 1.18-6.63) and similar to that of 2007 (RR 1.05; 95%CI 0.56-1.49). 2009 was the first year with mortalities younger than 65 years attributable to SARI. The estimated A/H1N1 case fatality rate for SARI was 6.2% (95%CI 2.5 to 15.5) and A/H1N1 mortality rate was 6 per 100,000 (95%CI 0 to 11.6). Conclusion Our HIS detected the outbreak two weeks before than the MoH gave a national alert. The information system was useful in assessing morbidity and mortality during the 2009 influenza epidemic H1N1 outbreak suggesting that with a private-public integration a more real-time outbreak and disease surveillance system could be implemented. PMID:23616861

  10. Experience on healthcare utilization in seven administrative regions of Tanzania

    PubMed Central

    2012-01-01

    Health care utilization in many developing countries, Tanzania included, is mainly through the use of traditional medicine (TRM) and its practitioners despite the presence of the conventional medicine. This article presents findings on the study that aimed to get an experience of health care utilization from both urban and rural areas of seven administrative regions in Tanzania. A total of 33 health facility managers were interviewed on health care provision and availability of supplies including drugs, in their respective areas. The findings revealed that the health facilities were overburden with higher population to serve than it was planned. Consequently essential drugs and other health supplies were available only in the first two weeks of the month. Conventional health practitioners considered traditional health practitioners to be more competent in mental health management, and overall, they were considered to handle more HIV/AIDS cases knowingly or unknowingly due to shear need of healthcare by this group. In general conventional health practitioners were positive towards traditional medicine utilization; and some of them admitted using traditional medicines. Traditional medicines like other medical health systems worldwide have side effects and some contentious ethical issues that need serious consideration and policy direction. Since many people will continue using traditional/alternative medicine, there is an urgent need to collaborate with traditional/alternative health practitioners through the institutionalization of basic training including hygiene in order to improved healthcare in the community and attain the Millennium Development Goals by 2015. PMID:22284539

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

    NASA Astrophysics Data System (ADS)

    Kostagiolas, P.; Lappa, E.

    2015-02-01

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

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

    SciTech Connect

    Kostagiolas, P.; Lappa, E.

    2015-02-09

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

  13. A review of healthcare information system usability & safety.

    PubMed

    Minshall, Simon

    2013-01-01

    Healthcare information systems have been designed to increase the efficiency and safety of healthcare processes. Systems such as electronic health records and pervasive computing devices have been shown to improve the safety of healthcare. However, increasing research has indicated that the design of such systems, in particular the user interface, may be related to increased incidence of other types of error. In this review, the relationship between human factors and usability will be considered in the context of designing safe and effective healthcare applications, with a focus on hand-held computing devices. Medline was searched for the specific terms listed below and restricted to the date ranges 2006-01-01 through to 2011-03-03: (error AND technology AND human factors); (error AND (CPOE OR (Computerized AND provider AND order AND entry))); (Technology AND Induced AND Error). The returned list of papers was screened by examining titles and abstracts to select candidate papers for further review. The initial search yield was 239 papers. On reviewing the title and abstract, 186 were rejected and 51 papers remained for analysis. New technology, such as CPOE, offers improvements over traditional paper tools and it is shown to have a positive effect on patient safety. New technology also creates the opportunity for new errors to occur and lead to the coining of the term "technology-induced error". The magnitude of the usability-testing needs is larger than it may seem. PMID:23388273

  14. Model-driven traceability in healthcare information systems development.

    PubMed

    Walderhaug, Stle; Hartvigsen, Gunnar; Stav, Erlend

    2010-01-01

    To improve the quality of software used in healthcare information systems, traceability can play an important role. The concept of traceability establishes explicit trace links in the design, development and maintenance processes, keeping documentation complete and updated. Trace information allows validating bodies, domain experts, system designers and programmers to easily navigate along artefact dependencies and perform simple traceability analysis such as coverage and change impact. This paper presents a novel solution for traceability applied in model-driven development for services in a distributed healthcare environment. The results demonstrate the feasibility of explicitly modelling dependencies using a formal language such as UML. Based on the experience from implementing two full-scale homecare systems in the EU-IST MPOWER project, the potential improvements and challenges with a traceability solution are discussed. PMID:20841686

  15. Regional Health Information Systems

    PubMed Central

    Fuller, Sherrilynne

    1997-01-01

    Abstract In general, there is agreement that robust integrated information systems are the foundation for building successful regional health care delivery systems. Integrated Advanced Information Management System (IAIMS) institutions that, over the years, have developed strategies for creating cohesive institutional information systems and services are finding that IAIMS strategies work well in the even more complex regional environment. The key elements of IAIMS planning are described and lessons learned are discussed in the context of regional health information systems developed. The challenges of aligning the various information agencies and agendas in support of a regional health information system are complex ; however, the potential rewards for health care in quality, efficacy, and cost savings are enormous. PMID:9067887

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

    PubMed

    Ziegenfuss, J T

    1987-10-01

    Research is the key to dealing with the major issues facing the healthcare industry. And an information system for organization and management research is a necessary component in healthcare organizations. Research information systems should support action, not theory. Their purpose is to educate information users about their system of services; provide data for planning, developing, directing, and evaluating both technical and management work; and provide a basis for "steering" the program. Four key subjects for a research information system are service activities, patient characteristics, costs and budget, and outcomes. The goal in developing a research information system is to integrate the various types of information into a format that provides the information for management use at a given time. Development of a research information system requires concentrating on the design and the process of developing and using the data for action research. Each design step requires an analysis of existing and future research requirements, of what clinical and managerial leaders would like to know. Identifying users is important, since they will ultimately judge the adequacy of the system. Each user has to make decisions based on the data. Such decisions include setting goals, forming policy, organizing activities, and budgeting. PMID:10284221

  17. The fear factor in healthcare: employee information sharing.

    PubMed

    Malvey, Donna; Fottler, Myron D; Sumner, Jennifer

    2013-01-01

    This study looks at employee information sharing among hospitals, a topic that is underresearched, underreported, and under the radar for most healthcare leaders. We initiated the research under the assumption that executives in healthcare are reluctant to share employment reference information about staff beyond the employee's name, dates of employment, and position held. We believed executives take this precaution because they fear being sued by the employee for defamation. However, not obtaining the necessary and critical information to hire a competent employee can open the potential employer up to a negligence lawsuit if it hires someone who jeopardizes the safety of patients or staff. Hence, the hiring organization faces a double-edged sword: On one side, it cannot get the critical information on a potential applicant from the previous employer due to a culture of "fear in sharing" information; on the other side, if it unwittingly hires a poor or dangerous applicant who threatens safety, it runs the risk of a negligence lawsuit for failure to ascertain information before the hire. Prior studies demonstrate that the likelihood of a successful defamation lawsuit is low and information sharing of factual incidents is unlikely to result in successful lawsuits. Why, then, are healthcare executives unwilling to provide comprehensive references when they should be aware that sustaining a culture of silence increases the potential for hiring a bad employee and seriously jeopardizes the security and safety of patients, other staff, and the public? This article's primary contribution to the literature is to offer the first nationwide study to empirically test the current levels of employee information sharing among hospitals. It is also the first study to focus exclusively on healthcare. Furthermore, this research considers factors that might influence executives in their willingness to share employee reference information. The study reveals that a culture of silence is pervasive among hospitals. Although many hospital executives are reluctant to share information, they tend to overestimate the likelihood of being sued (successfully or otherwise) by previous employees for defamation. In addition, this study shows that some hospital executives share negative information about former employees but may do so off the record. PMID:23821900

  18. Managing healthcare information: the role of the broker.

    PubMed

    Budgen, David; Turner, Mark; Kotsiopoulos, Ioannis; Zhu, Fujun; Russell, Michelle; Rigby, Michael; Bennett, Keith; Brereton, Pearl; Keane, John; Layzell, Paul

    2005-01-01

    We describe a prototype information broker that has been developed to address typical healthcare information needs, using web services to obtain data from autonomous, heterogeneous sources. Some key features are reviewed: how data sources are turned into data services; how we enforce a distributed access control policy; and how semantic interoperability is achieved between the broker and its data services. Finally, we discuss the role that such a broker might have in a Grid context, as well as the limitations this reveals in current Grid provision. PMID:15923711

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

    NASA Astrophysics Data System (ADS)

    Tanaka, Hiroshi

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

  20. Primary healthcare information system--the cornerstone for the next generation healthcare sector in Republic of Croatia.

    PubMed

    Koncar, Miroslav; Gvozdanović, Darko

    2006-01-01

    At no time in the history of medicine has the growth in knowledge and technologies been so profound [Crossing the Quality Chasm: A New Health System for the 21st Century, Institute of Medicine (IOM), 2001. ISBN 0-309-07280-8]. However, healthcare delivery systems today are not able to keep up with the pace. Studies have shown that it takes an average of about 17 years for new knowledge generated by randomized trials to be incorporated into practice [B. Andrew, S. Boren, Managing clinical knowledge for health care improvement, in: Yearbook of Medical Informatics, National Library of Medicine, Bethesda, MD, 2000, pp. 65-70]. It is safe to say that today healthcare systems "have the data, but not information". In order to provide highest quality patient care, Republic of Croatia has started the process of introducing enterprise information systems to support business processes in the healthcare domain. Two major requirements are in focus: to provide efficient healthcare related data management in support of decision-making processes; and to support continuous process of healthcare resources spending optimization. The first initiated project refers to Primary Healthcare Information System (PHCIS) that provides domain of primary care with state-of-the-art enterprise information system that connects General Practitioners, Pediatricians and Gynecologists offices with the Croatian Institute for Health Insurance and Public Health Institute. In the years to come, PHCIS will serve as the main integration platform for connecting all other stakeholders and levels of healthcare (e.g. hospitals, pharmacies, laboratories) into single enterprise healthcare network. This article gives an overview of PHCIS, explains challenges that were faced in designing and implementing the system, and elaborates PHCIS role as the cornerstone for the next generation healthcare provisioning in Republic of Croatia. PMID:16213189

  1. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Confidentiality of Healthcare Integrity and... GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the Healthcare...

  2. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Confidentiality of Healthcare Integrity and... GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the Healthcare...

  3. 45 CFR 61.14 - Confidentiality of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Confidentiality of Healthcare Integrity and... GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the Healthcare...

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

    PubMed

    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. PMID:24014266

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

    PubMed

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

    2011-01-01

    A hybrid standards-based approach has been adopted in Singapore to develop a Logical Information Model (LIM) for healthcare information exchange. The Singapore LIM uses a combination of international standards, including ISO13606-1 (a reference model for electronic health record communication), ISO21090 (healthcare datatypes), SNOMED CT (healthcare terminology) and HL7 v2 (healthcare messaging). This logic-based design approach also incorporates mechanisms for achieving bi-directional semantic interoperability. PMID:21893858

  6. Mobile healthcare information management utilizing Cloud Computing and Android OS.

    PubMed

    Doukas, Charalampos; Pliakas, Thomas; Maglogiannis, Ilias

    2010-01-01

    Cloud Computing provides functionality for managing information data in a distributed, ubiquitous and pervasive manner supporting several platforms, systems and applications. This work presents the implementation of a mobile system that enables electronic healthcare data storage, update and retrieval using Cloud Computing. The mobile application is developed using Google's Android operating system and provides management of patient health records and medical images (supporting DICOM format and JPEG2000 coding). The developed system has been evaluated using the Amazon's S3 cloud service. This article summarizes the implementation details and presents initial results of the system in practice. PMID:21097207

  7. Information technology and knowledge exchange in health-care organizations.

    PubMed Central

    Vimarlund, V.; Timpka, T.; Patel, V. L.

    1999-01-01

    Despite the increasing global interest in information technology among health care institutions, little has been discussed about its importance for the effectiveness of knowledge management. In this study, economic theories are used to analyze and describe a theoretical framework for the use of information technology in the exchange of knowledge. The analyses show that health care institutions would benefit from developing global problem-solving collaboration, which allows practitioners to exchange knowledge unrestricted by time and geographical barriers. The use of information technology for vertical integration of health-care institutions would reduce knowledge transaction costs, i.e. decrease costs for negotiating and creating communication channels, and facilitating the determination of what, when, and how to produce knowledge. A global network would allow organizations to increase existing knowledge, and thus total productivity, while also supporting an environment where the generation of new ideas is unrestricted. Using all the intellectual potential of market actors and thereby releasing economic resources can reduce today's global budget conflicts in the public sector, i.e. the necessity to choose between health care services and, for instance, schools and support for the elderly. In conclusion, global collaboration and coordination would reduce the transaction costs inherent in knowledge administration and allow a more effective total use of scarce health-care resources. PMID:10566436

  8. Institutionalization of evidence-informed practices in healthcare settings

    PubMed Central

    2012-01-01

    Background The effective and timely integration of the best available research evidence into healthcare practice has considerable potential to improve the quality of provided care. Knowledge translation (KT) approaches aim to develop, implement, and evaluate strategies to address the research-practice gap. However, most KT research has been directed toward implementation strategies that apply cognitive, behavioral, and, to a lesser extent, organizational theories. In this paper, we discuss the potential of institutional theory to inform KT-related research. Discussion Despite significant research, there is still much to learn about how to achieve KT within healthcare systems and practices. Institutional theory, focusing on the processes by which new ideas and concepts become accepted within their institutional environments, holds promise for advancing KT efforts and research. To propose new directions for future KT research, we present some of the main concepts of institutional theory and discuss their application to KT research by outlining how institutionalization of new practices can lead to their ongoing use in organizations. In addition, we discuss the circumstances under which institutionalized practices dissipate and give way to new insights and ideas that can lead to new, more effective practices. Summary KT research informed by institutional theory can provide important insights into how knowledge becomes implemented, routinized, and accepted as institutionalized practices. Future KT research should employ both quantitative and qualitative research designs to examine the specifics of sustainability, institutionalization, and deinstitutionalization of practices to enhance our understanding of these complex constructs. PMID:23171660

  9. Healthcare Personnel's Use of E-Information Sources in Riyadh Governmental Hospitals

    ERIC Educational Resources Information Center

    Khudair, Ahmad A.; Cooke, Louise

    2008-01-01

    ICT has enabled a wide dissemination of information and a sharp increase in the magnitude of electronic information sources. The use of e-information sources by healthcare personnel within Saudi Arabia has received little research attention. This paper discusses the use of e-information sources by healthcare personnel in the kingdom. A

  10. Healthcare Personnel's Use of E-Information Sources in Riyadh Governmental Hospitals

    ERIC Educational Resources Information Center

    Khudair, Ahmad A.; Cooke, Louise

    2008-01-01

    ICT has enabled a wide dissemination of information and a sharp increase in the magnitude of electronic information sources. The use of e-information sources by healthcare personnel within Saudi Arabia has received little research attention. This paper discusses the use of e-information sources by healthcare personnel in the kingdom. A…

  11. The Disparity Information and Communication Technology for Developing Countries has in the Delivery of Healthcare Information.

    PubMed

    Chhanabhai, Prajesh N; Holt, Alec

    2010-01-01

    Information and Communication Technologies (ICT) have merged into the world of healthcare slowly but surely. However, the marriage between the use of technology and its full impact in the health sector has not been fully realised. The focus of this paper is to highlight the impact of ICT on revolutionising access to healthcare information and thus quality of health for populations of the developing world. This paper highlights on the importance of being able to access health information and how traditional media methods have been utilised to allow this within a developing country setting, highlighting the clear digital divide. The paper then addresses the impact of convergent communication technologies and mobile technologies in providing a means of addressing existing healthcare problems within a developing country setting. PMID:21594006

  12. The Disparity Information and Communication Technology for Developing Countries has in the Delivery of Healthcare Information

    PubMed Central

    Chhanabhai, Prajesh N; Holt, Alec

    2010-01-01

    Information and Communication Technologies (ICT) have merged into the world of healthcare slowly but surely. However, the marriage between the use of technology and its full impact in the health sector has not been fully realised. The focus of this paper is to highlight the impact of ICT on revolutionising access to healthcare information and thus quality of health for populations of the developing world. This paper highlights on the importance of being able to access health information and how traditional media methods have been utilised to allow this within a developing country setting, highlighting the clear digital divide. The paper then addresses the impact of convergent communication technologies and mobile technologies in providing a means of addressing existing healthcare problems within a developing country setting. PMID:21594006

  13. Healthcare information technology's relativity problems: a typology of how patients physical reality, clinicians mental models, and healthcare information technology differ

    PubMed Central

    Smith, Sean W; Koppel, Ross

    2014-01-01

    Objective To model inconsistencies or distortions among three realities: patients' physical reality; clinicians' mental models of patients' conditions, laboratories, etc; representation of that reality in electronic health records (EHR). To serve as a potential tool for quality improvement of EHRs. Methods Using observations, literature, information technology (IT) logs, vendor and US Food and Drug Administration reports, we constructed scenarios/models of how patients' realities, clinicians' mental models, and EHRs can misalign to produce distortions in comprehension and treatment. We then categorized them according to an emergent typology derived from the cases themselves and refined the categories based on insights gained from the literature of interactive sociotechnical systems analysis, decision support science, and human computer interaction. Typical of grounded theory methods, the categories underwent repeated modifications. Results We constructed 45 scenarios of misalignment between patients' physical realities, clinicians' mental models, and EHRs. We then identified five general types of misrepresentation in these cases: IT data too narrowly focused; IT data too broadly focused; EHRs miss critical reality; data multiplicitiesperhaps contradictory or confusing; distortions from data reflected back and forth across users, sensors, and others. The 45 scenarios are presented, organized by the five types. Conclusions With humans, there is a physical reality and actors' mental models of that reality. In healthcare, there is another player: the EHR/healthcare IT, which implicitly and explicitly reflects many mental models, facets of reality, and measures thereof that vary in reliability and consistency. EHRs are both microcosms and shapers of medical care. Our typology and scenarios are intended to be useful to healthcare IT designers and implementers in improving EHR systems and reducing the unintended negative consequences of their use. PMID:23800960

  14. Evaluating healthcare information technology outside of academia: observations from the national resource center for healthcare information technology at the Agency for Healthcare Research and Quality.

    PubMed

    Poon, Eric G; Cusack, Caitlin M; McGowan, Julie J

    2009-01-01

    The National Resource Center for Health Information Technology (NRC) was formed in the fall of 2004 as part of the Agency for Healthcare Research and Quality (AHRQ) health IT portfolio to support its grantees. One of the core functions of the NRC was to assist grantees in their evaluation efforts of Health IT. This manuscript highlights some common challenges experienced by health IT project teams at nonacademic institutions, including inappropriately scoped and resourced evaluation efforts, inappropriate choice of metrics, inadequate planning for data collection and analysis, and lack of consideration of qualitative methodologies. Many of these challenges can be avoided or overcome. The strategies adopted by various AHRQ grantees and the lessons learned from their projects should become part of the toolset for current and future implementers of health IT as the nation moves rapidly towards its widespread adoption. PMID:19567800

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

    PubMed

    Sakamoto, N

    2001-01-01

    The digital signature is a key technology in the forthcoming Internet society for electronic healthcare as well as for electronic commerce. Efficient exchanges of authorized information with a digital signature in healthcare information networks require a construction of a public key infrastructure (PKI). In order to introduce a PKI to healthcare information networks in Japan, we proposed a development of a user authentication system based on a PKI for user management, user authentication and privilege management of healthcare information systems. In this paper, we describe the design of the user authentication system and its implementation. The user authentication system provides a certification authority service and a privilege management service while it is comprised of a user authentication client and user authentication serves. It is designed on a basis of an X.509 PKI and is implemented with using OpenSSL and OpenLDAP. It was incorporated into the financial information management system for the national university hospitals and has been successfully working for about one year. The hospitals plan to use it as a user authentication method for their whole healthcare information systems. One implementation of the system is free to the national university hospitals with permission of the Japanese Ministry of Education, Culture, Sports, Science and Technology. Another implementation is open to the other healthcare institutes by support of the Medical Information System Development Center (MEDIS-DC). We are moving forward to a nation-wide construction of a PKI for healthcare information networks based on it. PMID:11604934

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

    PubMed

    Moore, An'Nita; Fisher, Kathleen

    2012-03-01

    Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals. PMID:22209750

  17. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Privacy Act regulations set forth in 45 CFR part 5b. ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Requesting information from the Healthcare... SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...

  18. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Privacy Act regulations set forth in 45 CFR part 5b. ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Requesting information from the Healthcare... SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...

  19. 45 CFR 61.12 - Requesting information from the Healthcare Integrity and Protection Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Privacy Act regulations set forth in 45 CFR part 5b. ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Requesting information from the Healthcare... SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...

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

    ERIC Educational Resources Information Center

    Aponte, Jorge I.

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Aponte, Jorge I.

    2011-01-01

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

  2. Healthcare information exchange system based on a hybrid central/federated model.

    PubMed

    Ghane, Kamran

    2014-01-01

    The quality of care can be significantly enhanced and healthcare cost can be substantially reduced if healthcare providers can have access to patient records that are scattered among several paper and electronic based systems. Major challenges of Healthcare Information Exchange result from patient's medical records being kept in several healthcare provider offices, clinics and hospitals in different formats. There are two major problems with healthcare information retrieval. The first problem is lack of visibility and knowledge as to where patient's medical records reside. The second problem is lack of access to information and also incompatibility of data formats. A considerable coverage of Electronic Information Exchange among Electronic Health Record (EHR) systems remains to be implemented despite extensive standardization efforts toward providing solutions. The adoption pace of available standards and solutions has been slow with the exception of some public/government entities. This paper describes a comprehensive and practical solution based on a distributed system with independent subsystems that control and manage processes and data flow of information exchange. The Registrar Subsystem creates a directory of healthcare providers and patients. The Security Subsystem provides authentication and authorization services across all subsystems. The Locators address patient and medical location lookup. The Agents act on behalf of healthcare providers to communicate with other subsystems. The Mediators facilitate information retrieval. The Solution comprises of three levels of participation that allows healthcare providers to join the system easily by starting from basic semi-manual information exchange level and then migrating to a fully electronic and automated information exchange. The Solution is modeled based on variety of standards and protocols used in Internet and other application fields as well as healthcare specific standards and proposals. PMID:25570220

  3. Preferred Primary Healthcare Provider Choice Among Insured Persons in Ashanti Region, Ghana

    PubMed Central

    Boachie, Micheal Kofi

    2016-01-01

    Background: In early 2012, National Health Insurance Scheme (NHIS) members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs) and direction of association of such factors with the choice of PPP. Methods: Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results: Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63%) and doctors (39.92%), distance or proximity (49.60%), provider reputation (39.52%), waiting time (39.92), additional charges (37.10%), and recommendations (48.79%) were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027), availability of doctors (-1.82), additional charges (-2.14) and reputation (-2.09) were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59), waiting time (1.45), residence (-2.62), gender (-2.89), and reputation (-2.69) were statistically significant at 1% level. Presence of additional charges (-1.29) was statistically significant at 5% level. Conclusion: Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by ensuring constant availability of essential drugs, doctors, and shorter waiting time. However, individual enrolees may value each criterion differently. Thus, not all enrolees may be motivated by same concerns. This requires providers to be circumspect regarding the factors that may attract enrolees. The National Health Insurance Authority (NHIA) should also ensure timely release of funds to help providers procure the necessary medical supplies to ensure quality service PMID:26927586

  4. How Secure Is Your Information System? An Investigation into Actual Healthcare Worker Password Practices

    PubMed Central

    Cazier, Joseph A; Medlin, B. Dawn

    2006-01-01

    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. PMID:18066366

  5. Rural system addresses social, economic needs. Cooperation, education, and advocacy revitalize a region's healthcare delivery.

    PubMed

    Rheinecker, P

    1992-01-01

    In recent years leaders at Presentation Health System (PHS), Sioux Falls, SD, have expanded their mission to help strengthen local communities economically and socially. PHS now offers support to rural leaders in business, politics, and healthcare through its Center for Rural Health and Economic Development. In addition, educational outreach coordinators have created programs that address the needs of the entire rural community. To establish an effective network of services in the region, two of the system's tertiary care hospitals are collaborating to provide emergency helicopter service. These larger facilities also extend outreach services to rural hospitals and clinics. PHS assists rural hospitals in grant writing and in adapting to changing government reimbursement rules. In addition, the healthcare system coordinates a group purchasing program and a debt collection agency. An important voice for its region's healthcare needs, PHS has worked with the state of South Dakota to address problems and concerns about emergency medical services. The system also publishes Report, a quarterly newsletter that keeps rural residents abreast of healthcare issues affecting them. Two years ago, PHS's Center for Rural Health and Economic Development sponsored its first Invitational Rural Health Leadership Conference. These annual conferences bring together leaders to examine ways to improve rural healthcare delivery by strengthening the social and economic fabric of rural communities. PMID:10119539

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

    PubMed

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

    2009-08-01

    To gain and sustain competitive advantage, health-care providers have to continuously review and renovate their operational and information technology (IT) strategies through collaborative and cooperative endeavour with their supply chain channel members. This paper explores new ways of enhancing a health-care organization's responsiveness to changes and increasing its competitiveness through implementing strategic information technology alliances among channel members in a health-care supply chain network. An overview of issues and problems (e.g. bullwhip effect, negative externalities and free-riding phenomenon in multichannel supply chains) presented in the health-care supply chains is first delineated. This paper further goes over the issues of health-care supply chain coordination and integration for strategic IT alliances, followed by the discussion of the spillover effect of IT investments. A number of viable IT practices (such as information sharing and Internet-enabled supply chain portal) for effective health-care supply chain collaboration and coordination are then examined in this research. Finally, the paper discusses how strategic IT alliances can help improve the effectiveness of health-care supply chain management. PMID:19633183

  7. Program Evaluation of Remote Heart Failure Monitoring: Healthcare Utilization Analysis in a Rural Regional Medical Center

    PubMed Central

    Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A. Susana; Carroll, Mark

    2015-01-01

    Abstract Background: Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. Care Beyond Walls and Wires, a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Materials and Methods: Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. Results: HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. Conclusions: The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems. PMID:25025239

  8. Increasing the effectiveness of healthcare managers. Horizontal and vertical information linkages.

    PubMed

    Carson, K D; Carson, P P; Roe, C W; Authement, J P; Yallapragada, R

    1993-01-01

    In the healthcare industry, there is an increasing number of managers who operate clinics geographically separated from the administration and from other managers. Physical distance creates barriers to communication and also inhibits psychological attachment to the healthcare organization. This can result in dysfunctional management styles, with managers appearing passive, overly independent, or isolated. By choosing the best communication medium as well as the most appropriate information linkages, the administrator can improve the effectiveness of managers. Specific intervention strategies are offered for correcting dysfunctional behaviors in healthcare settings. PMID:10129076

  9. Mobile workers in healthcare and their information needs: are 2-way pagers the answer?

    PubMed Central

    Eisenstadt, S. A.; Wagner, M. M.; Hogan, W. R.; Pankaskie, M. C.; Tsui, F. C.; Wilbright, W.

    1998-01-01

    The ability to have access to information relevant to patient care is essential within the healthcare environment. To meet the information needs of its workers, healthcare information systems must fulfill a variety of functional requirements. One of these requirements is to define how workers will interact with the system to gain the information they need. Currently, most healthcare information systems rely on users querying the system via a fixed terminal for the information they desire; a method that is inefficient because there is no guarantee the information will be available at the time of their query and it interrupts their work flow. In general, clinical event monitors--systems whose efficacy relies on the delivery of time-critical information--have used e-mail and numeric pagers as their methods to deliver information. Each of these methods, however, still requires the user to perform additional steps, i.e., log into an information system in order to attain the information about which the system is alerting them. In this paper we describe the integration and use of 2-way alphanumeric pagers in CLEM, the UPMC Health System's Clinical Event Monitor, and how the use of these pagers addresses the information needs of mobile workers in healthcare. Images Figure 2 PMID:9929197

  10. [Impact and state of the art of regional healthcare planning and management guidelines in a local health authority of the Lazio region (Italy)].

    PubMed

    Priori, Maria Rosaria; Barbato, Angelo

    2007-01-01

    The aim of this study was to evaluate the impact of health care planning and management guidelines, elaborated by the Lazio regional healthcare authority, on the organizational structure and operational processes of local health authorities and, more specifically, of the Roma C local health authority. The guidelines are made up of three volumes and mainly describe an operational model, rather than being a set of standard references aimed at standardizing the quality of information low systems in local healthcare authorities. The guidelines are essentially a didactic text, and were elaborated by a consulting firm, Engineering Management Consulting, on behalf of the Lazio regional authority. In the first section, the main concepts are defined, while in subsequent sections, detailed models regarding the specific subject matter are described. Although the guidelines represent a useful tool in the process of converting local health authorities of the Lazio region into "business" organizations, so far they have been of use only in the first phase of assessment of different organizational models for healthcare planning and management. There is still a long way ahead towards defining standard procedures and references for describing activities and costs. This is what should hopefully be achieved briefly and which will necessarily require the introduction of a data warehouse and business intelligence software that will allow monitoring of activities and making short term predictions through the use balanced scorecards and data mining. PMID:18084348

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

    NASA Astrophysics Data System (ADS)

    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.

  12. HYGEIAnet: the integrated regional health information network of Crete.

    PubMed

    Orphanoudakis, Stelios

    2004-01-01

    The healthcare environment is currently changing and the health sector is being transformed to meet new challenges and to benefit from new opportunities. Priorities for the 21st century ought to be set based on emerging dominant trends in healthcare, including the shift towards shared or integrated care, in which an individual's healthcare is the responsibility of a team of professionals across all levels of the healthcare system hierarchy. In addition to the requirement for efficient and secure access to the Integrated Electronic Health Record (I-EHR) of a citizen, this necessitates the development and deployment of Regional Health Information Networks (RHINs), synchronous and asynchronous collaboration services, and novel eHealth and mHealth services, facilitated by intelligent sensors, monitoring devices, hand-held or wearable technologies, the Internet and wireless broadband communications. These further require the adoption of an open Reference Architecture and the creation of a scalable Health Information Infrastructure (HII).This paper discusses the challenges encountered in developing and deploying HYGEIAnet, the Regional Health Information Network of Crete, as well as relevant benefits for citizens and health professionals. Furthermore, HYGEIAnet systems and services are presented, with emphasis on the development of the HII and the implementation of the I-EHR service for providing secure, role-based access to validated content by authorized and authenticated users. PMID:15718565

  13. Perception Gaps and the Adoption of Information Technology in the Clinical Healthcare Environment

    ERIC Educational Resources Information Center

    Hare, Karen

    2008-01-01

    Implementation of information systems has lagged in many areas of clinical healthcare for a variety of reasons. Economics, data complexity and resistance are among the often quoted roadblocks. Research suggests that physicians play a major part in the adoption, use and diffusion of information technology (IT) in clinical settings. There are also

  14. Perception Gaps and the Adoption of Information Technology in the Clinical Healthcare Environment

    ERIC Educational Resources Information Center

    Hare, Karen

    2008-01-01

    Implementation of information systems has lagged in many areas of clinical healthcare for a variety of reasons. Economics, data complexity and resistance are among the often quoted roadblocks. Research suggests that physicians play a major part in the adoption, use and diffusion of information technology (IT) in clinical settings. There are also…

  15. Examining Informal Learning Using Mobile Devices in the Healthcare Workplace

    ERIC Educational Resources Information Center

    Fahlman, Dorothy

    2013-01-01

    The study of workplace learning and informal learning are not new to adult education and pedagogy. However, the use of mobile devices as learning tools for informal learning in the workplace is an understudied area. Using theories on informal learning and constructivism as a framework, this paper explores informal learning of registered nurses…

  16. Electronic retrieval of health information by healthcare providers to improve practice and patient care

    PubMed Central

    McGowan, Jessie; Grad, Roland; Pluye, Pierre; Hannes, Karin; Deane, Katherine; Labrecque, Michel; Welch, Vivian; Tugwell, Peter

    2014-01-01

    Background The movement towards evidence-based practice makes explicit the need for access to current best evidence to improve health. Advances in electronic technologies have made health information more available, but does availability affect the rate of use of evidence in practice? Objectives To assess the effectiveness of interventions intended to provide electronic retrieval (access to information) to health information by healthcare providers to improve practice and patient care. Search methods We obtained studies from computerized searches of multiple electronic bibliographic databases, supplemented by checking reference lists, and consultation with experts. Selection criteria Randomized controlled trials (RCTs) including cluster randomized trials (CRCTs), controlled clinical trials (CCT), and interrupted time series analyses (ITS) of any language publication status examining interventions of effectiveness of electronic retrieval of health information by healthcare providers. Data collection and analysis Duplicate relevancy screening of searches, data abstraction and risk of bias assessment was undertaken. Main results We found two studies that examined this question. Neither study found any changes in professional behavior following an intervention that facilitated electronic retrieval of health information. There was some evidence of improvements in knowledge about the electronic sources of information reported in one study. Neither study assessed changes in patient outcomes or the costs of provision of the electronic resource and the implementation of the recommended evidence-based practices. Authors conclusions Overall there was insufficient evidence to support or refute the use of electronic retrieval of healthcare information by healthcare providers to improve practice and patient care. PMID:19588361

  17. The new healthcare management information: consolidated operational reporting.

    PubMed

    Kelliher, M E

    1985-01-01

    Most healthcare executives realize that hospitals financed through prospective payment cannot be effectively managed with conventional systems. They recognize the need for improved operational accountability, control and planning, though few have determined the means for achieving it. This article discusses a prototype operational control system designed to get beyond fragmented productivity and cost accounting efforts to an integrated, consolidated operational reporting system which will assist management in achieving its fiscal objectives. Consolidated Operational Reporting (CORE) at the University of California San Diego (UCSD) Medical Center consists of integrated product costing, labor productivity, inventory control, and productivity of capital. CORE enables top management through cost and performance indicators to proactively manage operations. Mid-level managers are a critical link to the CORE system. These front-line managers must understand the relationship between their regular operational decisions and the cost of hospital services. To promote this, UCSD conducts extensive mid-management seminars in operational control. Now these managers can reasonably be expected to understand, negotiate and act on accomplishing performance targets while being regularly updated, through CORE, as to their success at attaining the objective and the cost of the accomplishment. PMID:10271910

  18. Wrestling With a Paradox: Complexity in Interoperability Standards Making for Healthcare Information Systems

    NASA Astrophysics Data System (ADS)

    Pittaway, Jeff; Archer, Norm

    Medical interventions are often delayed or erroneous when information needed for diagnosing or prescribing is missing or unavailable. In support of increased information flows, the healthcare industry has invested substantially in standards intended to specify, routinize, and make uniform the type and format of medical information in clinical healthcare information systems such as Electronic Medical Record systems (EMRs). However, fewer than one in four Canadian physicians have adopted EMRs. Deeper analysis illustrates that physicians may perceive value in standardized EMRs when they need to exchange information in highly structured situations among like participants and like environments. However, standards present restrictive barriers to practitioners when they face equivocal situations, unforeseen contingencies, or exchange information across different environments. These barriers constitute a compelling explanation for at least part of the observed low EMR adoption rates. Our recommendations to improve the perceived value of standardized clinical information systems espouse re-conceptualizing the role of standards to embrace greater flexibility in some areas.

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

    PubMed

    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. PMID:24018509

  20. [Regionalization and access to healthcare in Brazilian states: historical and political-institutional conditioning factors].

    PubMed

    de Lima, Luciana Dias; Viana, Ana Luiza d'vila; Machado, Cristiani Vieira; de Albuquerque, Mariana Vercesi; de Oliveira, Roberta Gondim; Iozzi, Fabola Lana; Scatena, Joo Henrique Gurtler; Mello, Guilherme Arantes; Pereira, Adelyne Maria Mendes; Coelho, Ana Paula Santana

    2012-11-01

    This article examines the healthcare regionalization process in the Brazilian states in the period from 2007 to 2010, seeking to identify the conditions that favor or impede this process. Referential analysis of public policies and especially of historical institutionalism was used. Three dimensions sum up the conditioning factors of regionalization: context (historical-structural, political-institutional and conjunctural), directionality (ideology, object, actors, strategies and instruments) and regionalization features (institutionality and governance). The empirical research relied mainly on the analysis of official documents and interviews with key actors in 24 states. Distinct patterns of influence in the states were observed, with regionalization being marked by important gains in institutionality and governance in the period. Nevertheless, inherent difficulties of the contexts prejudice greater advances. There is a pressing need to broaden the territorial focus in government planning and to integrate sectorial policies for medium and long-term regional development in order to empower regionalization and to overcome obstacles to the access to healthcare services in Brazil. PMID:23175295

  1. The enhancement of security in healthcare information systems.

    PubMed

    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. PMID:21104304

  2. Integrating radiology information systems with healthcare delivery environments using DICOM and HL7 standards.

    PubMed

    Blazona, Bojan; Koncar, Miroslav

    2006-01-01

    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. Interoperability presents data and communication layer interchange. In this context we identified the HL7 standard as the world's leading medical Information and communication technology (ICT) standard for the business layer in healthcare information systems and we tried to explore the ability to exchange clinical documents with minimal integrated healthcare information systems (IHCIS) change. We explored HL7 Clinical Document Architecture (CDA) abilities to achieve radiology information system integration (DICOM) to IHCIS (HL7). We introduced the use of WADO service interconnection to IHCIS and finally CDA rendering in widely used Internet explorers. PMID:17108539

  3. Helping healthcare consumers understand: an "interpretive layer" for finding and making sense of medical information.

    PubMed

    Soergel, Dagobert; Tse, Tony; Slaughter, Laura

    2004-01-01

    Healthcare consumers need to find, comprehend, and interpret health information before making informed decisions. Recent work by others and our own work suggest that mis-matches in representations of health information used by consumers and professionals occur at different levels of knowledge representation, such as terminology (i.e., form or surface structure and concept or meaning) and semantic relation-ships. A challenge for consumer health informatics research is to devise a comprehensive strategy to bridge the gap between consumer understanding and biomedical knowledge at all levels. We propose a framework to inform the design of an "interpretive layer" to "mediate" between lay (illness model) and professional (disease model) perspectives, at all levels. In our view, the goal is to assist consumers in identifying terms to describe their needs, finding and understanding relevant information, and applying that knowledge for informed healthcare decision making. PMID:15360949

  4. Seeking substance at HIMSS '96 (Healthcare Information Management Systems Society).

    PubMed

    Wenzlick, P

    1996-01-01

    A vast industry now exists to help you manage information overload. Unfortunately, that industry tends to overwhelm with information about itself. We asked technology writer Pete Wenzlick to sort out the real from the phony at the nation's biggest health info-tech expo. Here is his report. PMID:10184567

  5. Healthcare Information Fusion Using Context-Aware Agents

    NASA Astrophysics Data System (ADS)

    Tapia, Dante I.; Fraile, Juan A.; de Luis, Ana; Bajo, Javier

    Context aware systems have evolved into complex information systems capable of providing large quantities of information obtained from network sensors with heterogeneous characteristics. This article proposes a multi-agent system that monitors patients and maintains a permanent fix on their location within a given context. The system uses information provided by sensors distributed throughout the environment. The system agents take the information they receive and fuse it to improve the decisions and actions involved in their processing. The multi-agent system implements a SOA-based platform, which allows heterogeneous Wireless Sensor Networks to communicate in a distributed way. This article presents the evaluation of the solutions provided by the agents through the information flow for the organization.

  6. The natural history of the use of healthcare information by women with breast cancer: a conceptual model.

    PubMed Central

    Longo, D. R.; Patrick, T. B.; Kruse, R. L.

    2001-01-01

    The overall goal of our research agenda is to contribute to improved quality of healthcare by identifying factors that foster or inhibit the use of healthcare information by patients to make informed healthcare decisions. We propose to study the natural history of the use of healthcare information by women with breast cancer to support decisions about health care. To do so in this paper we propose a conceptual model developed based on an extensive literature review and critique that describes patients' health information use over the disease course. It will guide our further investigation of the complex relationships among patients' personal circumstances, the progress of their medical treatment, and their satisfaction and empowerment as informed decision-makers. The model will help policy makers and health professionals identify the best means to provide patients with useful information, and help all stakeholders in health care acquire information needed to improve healthcare quality. PMID:11825221

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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. PMID:20703551

  9. The standard 'Healthcare Information Systems Architecture' and the DHE middleware.

    PubMed

    Ferrara, F M

    1998-01-01

    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. This paper discusses how an open architecture, based on the introduction of a middleware of common health care-specific services not only reduces the effort necessary for allowing existing systems to interwork, but also automatically establishes a functional and information basis common to the whole organisation, on top of which also new applications can be rapidly developed, natively integrated with the rest of the system. Such architecture has been already formalised through the European standard, defined by the CEN/TC251 prENV 12967-1 'Architecture for Health care Information Systems' (CEN prENV 12967-1 'Health care Information Systems Architecture'). Thanks to the availability of industrial products conforming to the standard, the effectiveness and the validity of this approach has been already demonstrated in practice. For example, through the Hansa collaboration hospitals and industries from countries of the Western and Eastern Europe, as well as of the Middle East use the same industrial middleware (i.e. 'The DHE middleware-Information view'-SPRI, 1998, 'The DHE middleware-Functional view'-SPRI, 1998) for integrating existing systems as well as for developing new applications. PMID:9848401

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

    PubMed

    Hsieh, Chang-tseh; Lin, Binshan

    2011-01-01

    The utilisation of IS/IT could offer a substantial competitive advantage to healthcare service providers through the realisation of improved clinical, financial, and administrative outcomes. In this study, 42 journal articles were reviewed and summarised with respect to identified benefits and challenges of the development and implementation of electronic medical records, tele-health, and electronic appointment reminders. Results of this study help pave the knowledge foundation for management of the behavioural healthcare to learn how to apply state-of-the-art information technology to offer higher quality, clinically proven effective services at lower costs than those of their competitors. PMID:22189179

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

    ERIC Educational Resources Information Center

    Hao, Haijing

    2013-01-01

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

  12. 45 CFR 61.15 - How to dispute the accuracy of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false How to dispute the accuracy of Healthcare... HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the...

  13. 45 CFR 61.15 - How to dispute the accuracy of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false How to dispute the accuracy of Healthcare... HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the...

  14. 45 CFR 61.15 - How to dispute the accuracy of Healthcare Integrity and Protection Data Bank information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false How to dispute the accuracy of Healthcare... HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE INFORMATION ON HEALTH CARE PROVIDERS, SUPPLIERS AND PRACTITIONERS Disclosure of Information by the...

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

    ERIC Educational Resources Information Center

    Hao, Haijing

    2013-01-01

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

  16. EFFECTS OF USING ONLINE NARRATIVE AND DIDACTIC INFORMATION ON HEALTHCARE PARTICIPATION FOR BREAST CANCER PATIENTS

    PubMed Central

    Wise, Meg; Han, Jeong Yeob; Shaw, Bret; McTavish, Fiona; Gustafson, David H.

    2008-01-01

    Objectives To determine the effects of online narrative and didactic information on breast cancer patients’ healthcare participation and the interaction effects of race. Methods Sample: 353 breast cancer patients (111 African Americans) using an eHealth program with narratives (audiovisual and text) and didactic information (text only). Measures: healthcare participation scale (0, 4 months), online information use. Analyses: hierarchical regression. Results Narrative (β = .123, p <.01) and didactic (β = .104, p <.05) information use had independent and positive effects on healthcare participation. Effects of both were significantly greater for African Americans. Conclusions Findings are consistent with and advance prior research on online learning processes and outcomes for breast cancer patients: (1) Benefits accrue with using a variety of online learning tools; and (2) African Americans use and benefit more from online narrative and didactic information than do Caucasians. Practice implications eHealth programs should provide both didactic and narrative information—especially for African Americans and might consider making greater use of interactive and audiovisual formats. As patients increasingly use of the web for cancer information, clinicians should provide lists of web high quality resources that provide both narrative and didactic information. PMID:18201859

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

    PubMed

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

    2008-12-01

    The healthcare sector depends heavily on the informal care provided by families and friends of those who are ill. Informal caregivers may experience significant burden as well as health and well-being effects. Resource allocation decisions, in particular from a societal perspective, should account explicitly for these effects in the social environment of patients. This is not only important to make a complete welfare economic assessment of treatments, but also to ensure the lasting involvement of informal caregivers in the care-giving process. Measurement and valuation techniques for the costs and effects of informal care have been developed and their use is becoming more common. Decision-makers in healthcare - and eventually families and patients - would be helped by more uniformity in methods. PMID:20528366

  18. Patient-Held Maternal and/or Child Health Records: Meeting the Information Needs of Patients and Healthcare Providers in Developing Countries?

    PubMed

    Turner, Kathleen E; Fuller, Sherrilynne

    2011-01-01

    Though improvements in infant and maternal mortality rates have occurred over time, women and children still die every hour from preventable causes. Various regional, social and economic factors are involved in the ability of women and children to receive adequate care and prevention services. Patient-held maternal and/or child health records have been used for a number of years in many countries to help track health risks, vaccinations and other preventative health measures performed. Though these records are primarily designed to record patient histories and healthcare information and guide healthcare workers providing care, because the records are patient-held, they also allow families a greater ability to track their own health and prevention strategies. A LITERATURE SEARCH WAS PERFORMED TO ANSWER THESE QUESTIONS: (1) What are maternal information needs regarding pregnancy, post-natal and infant healthcare, especially in developing countries? (2) What is known about maternal information seeking behavior in developing countries? (3) What is the history and current state of maternal and/or child patient-held healthcare records, do they provide for the information needs of the healthcare provider and what are the effects and outcomes of patient-held records in general and for maternal and/or child health in particular? Specific information needs of pregnant women and mothers are rarely studied. The small numbers of maternal information behavior results available indicate that mothers, in general, prefer to receive health information directly from their healthcare provider as opposed to from other sources (written, etc.) Overall, in developing countries, patient-held maternal and/or child healthcare records have a mostly positive effect for both patient and care provider. Mothers and children with records tend to have better outcomes in healthcare and preventative measures. Further research into the information behaviors of pregnant women and mothers to determine the extent of reliance on interpersonal information seeking is recommended before expending significant resources on enhanced patient-held maternal and/or child healthcare records including storage on mobile devices. In particular, research is needed to explore the utility of providing targeted health messages to mothers regarding their own health and that of their children; this might best be accomplished through mobile technologies. PMID:23569604

  19. Informal rural healthcare providers in North and South India

    PubMed Central

    Gautham, Meenakshi; Shyamprasad, K M; Singh, Rajesh; Zachariah, Anshi; Singh, Rajkumari; Bloom, Gerald

    2014-01-01

    Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. Their numbers far exceed those of formal providers. Our study reports on the education, knowledge, practices and relationships of informal providers (IPs) in two very different districts: Tehri Garhwal in Uttarakhand (north) and Guntur in Andhra Pradesh (south). We mapped and interviewed IPs in all nine blocks of Tehri and in nine out of 57 blocks in Guntur, and then interviewed a smaller sample in depth (90 IPs in Tehri, 100 in Guntur) about market practices, relationships with the formal sector, and their knowledge of protocol-based management of fever, diarrhoea and respiratory conditions. We evaluated IPs performance by observing their interactions with three patients per condition; nine patients per provider. IPs in the two districts had very different educational backgroundsmore years of schooling followed by various informal diplomas in Tehri and more apprenticeships in Guntur, yet their knowledge of management of the three conditions was similar and reasonably high (71% Tehri and 73% Guntur). IPs in Tehri were mostly clinic-based and dispensed a blend of allopathic and indigenous drugs. IPs in Guntur mostly provided door-to-door services and prescribed and dispensed mainly allopathic drugs. In Guntur, formal private doctors were important referral providers (with commissions) and source of new knowledge for IPs. At both sites, IPs prescribed inappropriate drugs, but the use of injections and antibiotics was higher in Guntur. Guntur IPs were well organized in state and block level associations that had successfully lobbied for a state government registration and training for themselves. We find that IPs are firmly established in rural India but their role has grown and evolved differently in different market settings. Interventions need to be tailored differently keeping in view these unique features. PMID:25012795

  20. Informal rural healthcare providers in North and South India.

    PubMed

    Gautham, Meenakshi; Shyamprasad, K M; Singh, Rajesh; Zachariah, Anshi; Singh, Rajkumari; Bloom, Gerald

    2014-07-01

    Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. Their numbers far exceed those of formal providers. Our study reports on the education, knowledge, practices and relationships of informal providers (IPs) in two very different districts: Tehri Garhwal in Uttarakhand (north) and Guntur in Andhra Pradesh (south). We mapped and interviewed IPs in all nine blocks of Tehri and in nine out of 57 blocks in Guntur, and then interviewed a smaller sample in depth (90 IPs in Tehri, 100 in Guntur) about market practices, relationships with the formal sector, and their knowledge of protocol-based management of fever, diarrhoea and respiratory conditions. We evaluated IPs' performance by observing their interactions with three patients per condition; nine patients per provider. IPs in the two districts had very different educational backgrounds-more years of schooling followed by various informal diplomas in Tehri and more apprenticeships in Guntur, yet their knowledge of management of the three conditions was similar and reasonably high (71% Tehri and 73% Guntur). IPs in Tehri were mostly clinic-based and dispensed a blend of allopathic and indigenous drugs. IPs in Guntur mostly provided door-to-door services and prescribed and dispensed mainly allopathic drugs. In Guntur, formal private doctors were important referral providers (with commissions) and source of new knowledge for IPs. At both sites, IPs prescribed inappropriate drugs, but the use of injections and antibiotics was higher in Guntur. Guntur IPs were well organized in state and block level associations that had successfully lobbied for a state government registration and training for themselves. We find that IPs are firmly established in rural India but their role has grown and evolved differently in different market settings. Interventions need to be tailored differently keeping in view these unique features. PMID:25012795

  1. The quality case for information technology in healthcare

    PubMed Central

    Bates, David W

    2002-01-01

    Background As described in the Institute of Medicine's Crossing the Quality Chasm report, the quality of health care in the U.S. today leaves much to be desired. Discussion One major opportunity for improving quality relates to increasing the use of information technology, or IT. Health care organizations currently invest less in IT than in any other information-intensive industry, and not surprisingly current systems are relatively primitive, compared with industries such as banking or aviation. Nonetheless, a number of organizations have demonstrated that quality can be substantially improved in a variety of ways if IT use is increased in ways that improve care. Specifically, computerization of processes that are error-prone and computerized decision support may substantially improve both efficiency and quality, as well as dramatically facilitate quality measurement. This report discusses the current levels of IT and quality in health care, how quality improvement and management are currently done, the evidence that more IT might be helpful, a vision of the future, and the barriers to getting there. Summary This report suggests that there are five key policy domains that need to be addressed: standards, incentives, security and confidentiality, professional involvement, and research, with financial incentives representing the single most important lever. PMID:12396233

  2. Implementation of a patient-centred and physician-oriented healthcare information system.

    PubMed

    Young, S T; Chang, J S

    1997-01-01

    Integration of information has enabled expeditious operation in air transfer, banking, shopping, and stock brokerage, but not in healthcare. Existing health information systems (HIS) are concerned too much with departmental performance and charge billing, and neglect the end users--the patients and the physicians. The resultant HIS then has divergent operation to antagonize the physicians, and has fragmented data to the disadvantage of patients. Recognizing the problems and the trend of HIS, this study proposed and implemented a patient-centred and physician-oriented HIS in a Urology clinic. The proposed HIS had patient care as its core, and accurately coded the patient's diagnoses and therapy information. It also offered a friendly environment and complete function for the physician to administrate medical records and to provide healthcare services. The HIS had client/server structure and an open system to protect the hardware investment and the software implementation. It will be the key to success in complete hospital environments. PMID:9364429

  3. Estimation of the real population and its impact on the utilisation of healthcare services in Mediterranean resort regions: an ecological study

    PubMed Central

    Perea-Milla, Emilio; Pons, Sergi Mari; Rivas-Ruiz, Francisco; Gallofre, Anna; Jurado, Enrique Navarro; Ales, Marco A Navarro; Jimenez-Puente, Alberto; Fernandez-Nieto, Fidel; Cerda, Joan C March; Carrasco, Manuel; Martin, Lydia; Cano, Damian Lopez; Gutierrez, Gonzalo E; Macas, Rafael Cortes; Garcia-Ruiz, Jose A

    2007-01-01

    Background The demographic structure has a significant influence on the use of healthcare services, as does the size of the population denominators. Very few studies have been published on methods for estimating the real population such as tourist resorts. The lack of information about these problems means there is a corresponding lack of information about the behaviour of populational denominators (the floating population or tourist load) and the effect of this on the use of healthcare services. The objectives of the study were: a) To determine the Municipal Solid Waste (MSW) ratio, per person per day, among populations of known size; b) to estimate, by means of this ratio, the real population in an area where tourist numbers are very significant; and c) to determine the impact on the utilisation of hospital emergency healthcare services of the registered population, in comparison to the non-resident population, in two areas where tourist numbers are very significant. Methods An ecological study design was employed. We analysed the Healthcare Districts of the Costa del Sol and the island of Menorca. Both are Spanish territories in the Mediterranean region. Results In the two areas analysed, the correlation coefficient between the MSW ratio and admissions to hospital emergency departments exceeded 0.9, with p < 0.001. On the basis of MSW generation ratios, obtained for a control zone and also measured in neighbouring countries, we estimated the real population. For the summer months, when tourist activity is greatest and demand for emergency healthcare at hospitals is highest, this value was found to be double that of the registered population. Conclusion The MSW indicator, which is both ecological and indirect, can be used to estimate the real population in areas where population levels vary significantly during the year. This parameter is of interest in planning and dimensioning the provision of healthcare services. PMID:17266744

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

    NASA Astrophysics Data System (ADS)

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

    2007-03-01

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

  5. The Promise of Information and Communication Technology in Healthcare: Extracting Value From the Chaos.

    PubMed

    Mamlin, Burke W; Tierney, William M

    2016-01-01

    Healthcare is an information business with expanding use of information and communication technologies (ICTs). Current ICT tools are immature, but a brighter future looms. We examine 7 areas of ICT in healthcare: electronic health records (EHRs), health information exchange (HIE), patient portals, telemedicine, social media, mobile devices and wearable sensors and monitors, and privacy and security. In each of these areas, we examine the current status and future promise, highlighting how each might reach its promise. Steps to better EHRs include a universal programming interface, universal patient identifiers, improved documentation and improved data analysis. HIEs require federal subsidies for sustainability and support from EHR vendors, targeting seamless sharing of EHR data. Patient portals must bring patients into the EHR with better design and training, greater provider engagement and leveraging HIEs. Telemedicine needs sustainable payment models, clear rules of engagement, quality measures and monitoring. Social media needs consensus on rules of engagement for providers, better data mining tools and approaches to counter disinformation. Mobile and wearable devices benefit from a universal programming interface, improved infrastructure, more rigorous research and integration with EHRs and HIEs. Laws for privacy and security need updating to match current technologies, and data stewards should share information on breaches and standardize best practices. ICT tools are evolving quickly in healthcare and require a rational and well-funded national agenda for development, use and assessment. PMID:26802759

  6. Human resource capacity for information management in selected public healthcare facilities in Meru County, Kenya

    PubMed Central

    Kiilu, Elizabeth Mueke; Okero, Dominic Charles; Muiruri, Lillian; Owuondo, Pacific Akinyi

    2015-01-01

    Introduction Reliable health information is essential for decision making in the healthcare system. Information management in Kenya was considered the weakest area under the Health Information System pillar mainly due to inadequate health workers capacity. The study therefore aimed at assessing health workers skills and current training needs for information management in the selected healthcare facilities. Methods Cross-section research design was adopted and both purposive sampling technique and censuses were used to establish the study participants. Analysis was done using SPSS version 20 and results were presented in tables, charts and graphs. Results It was established that capacity building was usually undertaken through on-job trainings i.e. 85.1% (103) health workers had on-job training on filling of data collection tools and only 10% (13) had received formal classroom training on the same. Further, only 9.1% (11) health workers had received information management training while 90.9% (110) had not received such training. Health workers demonstrated below average skills on information management i.e. only 17.4% (21) could check for data accuracy, only 16.5% (20) could compute trends from bar charts and only 16.5% (20) could transform the data they collected into meaningful information for use. Conclusion The researcher recommended that healthcare facilities management teams develop a competency based framework for defining the desired skill mix for information management and have a yearly Training Needs Assessment for assessing training needs for information management among the health workers. PMID:26175824

  7. Do Consumers Use Information to Choose a Health-Care Provider System?

    PubMed Central

    Feldman, Roger; Christianson, Jon; Schultz, Jennifer

    2000-01-01

    This study examines the use of information by employees in the Buyers Health Care Action Group, a purchasing coalition of large employers in Minneapolis. BHCAG employers contract directly with multiple health-care provider systems and attempt to inform employees about those choices. Shortly after the close of the 1998 open-enrollment period, a survey of 927 BHCAG employees with single-coverage health insurance was conducted. Seventy-six percent of the employees relied on information from their employer when selecting their current care system. Use of information from the employer was positively related to education and years of residence in the Twin Cities. Previous experience with doctors and hospitals in the care system also was a common information source. Older and low-income workers were more likely to use information from advertisements. The survey results suggest that employers can predict which information sources their employees will use. PMID:10834081

  8. Systematic Review of Factors Influencing the Adoption of Information and Communication Technologies by Healthcare Professionals

    PubMed Central

    Desmartis, Marie; Labrecque, Michel; Car, Josip; Pagliari, Claudia; Pluye, Pierre; Frmont, Pierre; Gagnon, Johanne; Tremblay, Nadine; Lgar, France

    2014-01-01

    This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices. PMID:20703721

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

    PubMed

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

    2016-01-01

    The objective of this study was gather pilot data from informal caregivers regarding the potential for a training program to assist current or past caregivers in reentering the job market, and thus offering a pathway to economic resilience. In an effort that could foster a sustainable and competent caregiving market to help meet the needs of an aging America, whether training informal caregivers might help them transition into a paid caregiving or other health service role was explored. Caregivers (N = 55) of a chronically or terminally ill family member or friend in a suburban county near Chicago were interviewed. The interview guide addressed household economic effect of illness, emotional burden, and training program interest. Fifty-six percent of caregivers were interested in training to work outside the home, caring for people in other households, 84% indicated a desire to learn more about health care, and 68% reported a desire to explore job possibilities in health care. Eighty-two percent were experienced in working with an individual aged 50 and older. Informal caregivers' interest in a training program to bolster their qualifications for a role in the healthcare workforce, including the option of a formal caregiver position, supports the demand for such a program. Considering the need for healthcare workers to serve the growing elderly population and the desire of informal caregivers to find gainful employment, these informal caregivers could provide the impetus to invest in informal caregiver training. PMID:26782869

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

    ERIC Educational Resources Information Center

    Muglia, Victor O.

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Muglia, Victor O.

    2010-01-01

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

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

    PubMed

    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. PMID:20302435

  13. Investigating potential sources of transmission of healthcare-associated infections in a regional hospital, Ghana

    PubMed Central

    Tagoe, Daniel NA; Desbordes, Kenneth K

    2012-01-01

    Background: Recent research has shown that healthcare-associated infections (HAIs) are on the increase despite education. Aims: The aims of this study were to isolate, quantify, and determine antibiotic susceptibility pattern of bacteria on formites at the Central Regional Hospital, Cape Coast, Ghana. Settings and Design: Purposive sampling of likely areas of contamination and contact by patients and healthcare workers was undertaken. Materials and Methods: A total of 100 swabs were taken from door handles, working surfaces, beds and taps from the various wards, consulting rooms, OPDs, laboratory, and surgical theatre. Serial dilution was used in quantifying bacteria, MacConkey and blood agars were used in isolation, and the Kirby Bauer method applied in antibiotic sensitivity testing. Statistical analysis: Data were statistically analyzed using Statview from SAS Version 5.0. The means were separated using double-tailed paired means comparison. Results: Mean bacterial count ranges from least in wards (9.67 1011), working surfaces (1.64 1012), door handles (1.71 1012), and highest in taps (2.08 1012). Door handles had the highest isolation (23) and highest number of differential isolates were from working surfaces (7). Of the total bacterial isolates, 46.14% were pathogenic, with S. aureus being the highest (14.42%), while 53.86% were nonpathogenic made up of 45.2% of Bacillus spp. Gentamicin was 100% effective, while 6 of the total 12 antibiotics tested (50%) were 100% resistant in either gram-positive or gram-negative bacteria. Conclusion: There was a high potential of bacterial transmission from the studied surfaces requiring hospital management to monitor and enforce cleaning regimen to prevent HAIs. PMID:23776803

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

    PubMed Central

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

    2013-01-01

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

  15. What is the role of informal healthcare providers in developing countries? A systematic review.

    PubMed

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

    2013-01-01

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

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

    PubMed

    Gvozdanović, Darko; Koncar, Miroslav; Kojundzić, Vinko; Jezidzić, Hrvoje

    2007-01-01

    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. PMID:18005567

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

    NASA Astrophysics Data System (ADS)

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

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

  18. Integrative literature review: a review of literature related to geographical information systems, healthcare access, and health outcomes.

    PubMed

    Graves, Barbara Ann

    2008-01-01

    Differences in access to healthcare services and the resulting adverse health outcomes are major public health priorities. The Institute of Medicine and the Department of Health and Human Services have identified the need for strategies to improve access to healthcare services and to support the improvement of health outcomes. The literature documents health disparities associated with healthcare access and health outcomes from a geographic perspective. Place of residence, location of healthcare services, and geography in general are important factors in the analysis of health. Geographical information systems (GISs) are an emerging technology in the analysis of health from a geographical or location context. As a type of information technology, GISs are potentially powerful assessment tools for the investigation of healthcare access, health outcomes, and the possible resulting health disparities. Their ability to integrate health data with mapping functions allows for visualization, exploration, and modeling of health patterns. Application of GIS technology using health data can help in describing and explaining disparities in healthcare access and health outcomes. The studies reviewed demonstrated the use of GISs to investigate various aspects of healthcare access and health outcomes, including environmental variables of Lyme disease, sociodemographic variables and teen pregnancy, geographical disparities in breast cancer mortality by racial groups, PCP and AIDS prevalence, and factors of a leptospirosis disease outbreak. The literature reviewed shows effective integration and analysis of health data using GIS technology. PMID:18698429

  19. Efficacy of a New Medical Information system, Ubiquitous Healthcare Service with Voice Inception Technique in Elderly Diabetic Patients.

    PubMed

    Kim, Kyoung Min; Park, Kyeong Seon; Lee, Hyun Ju; Lee, Yun Hee; Bae, Ji Seon; Lee, Young Joon; Choi, Sung Hee; Jang, Hak Chul; Lim, Soo

    2015-01-01

    We have demonstrated previously that an individualized health management system using advanced medical information technology, named ubiquitous (u)-healthcare, was helpful in achieving better glycemic control than routine care. Recently, we generated a new u-healthcare system using a voice inception technique for elderly diabetic patients to communicate information about their glucose control, physical activity, and diet more easily. In a randomized clinical trial, 70 diabetic patients aged 60-85 years were assigned randomly to a standard care group or u-healthcare group for 6 months. The primary end points were the changes in glycated hemoglobin (HbA1c) and glucose fluctuation assessed by the mean amplitude glycemic excursion (MAGE). Changes in body weight, lifestyle, and knowledge about diabetes were also investigated. After 6 months, the HbA1c levels decreased significantly in the u-healthcare group (from 8.6??1.0% to 7.5??0.6%) compared with the standard care group (from 8.7??0.9% to 8.2??1.1%, P?healthcare group than in the standard care group. Systolic blood pressure and body weight decreased and liver functions improved in the u-healthcare group, but not in the standard care group. The u-healthcare system with voice inception technique was effective in achieving glycemic control without hypoglycemia in elderly diabetic patients (Clinicaltrials.gov: NCT01891474). PMID:26658492

  20. Interventions for promoting information and communication technologies adoption in healthcare professionals

    PubMed Central

    Gagnon, Marie-Pierre; Lgar, France; Labrecque, Michel; Frmont, Pierre; Pluye, Pierre; Gagnon, Johanne; Car, Josip; Pagliari, Claudia; Desmartis, Marie; Turcot, Lucile; Gravel, Karine

    2014-01-01

    Background Information and communication technologies (ICT) are defined as digital and analogue technologies that facilitate the capturing, processing, storage and exchange of information via electronic communication. ICTs have the potential to improve information management, access to health services, quality of care, continuity of services, and cost containment. Knowledge is lacking on conditions for successful ICT integration into practice. Objectives To carry out a systematic review of the effectiveness of interventions to promote the adoption of ICT by healthcare professionals. Search methods Specific strategies, defined with the help of an information specialist, were used to search the Cochrane Effective Practice and Organisation of Care Group (EPOC) register and additional relevant databases. We considered studies published from January 1990 until October 2007. Selection criteria Randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before/after studies (CBAs), and interrupted time series (ITS) that reported objectively measured outcomes concerning the effect of interventions to promote adoption of ICT in healthcare professionals practices. Data collection and analysis Two reviewers independently assessed each potentially relevant study for inclusion. We resolved discrepancies by discussion or a third reviewer. Two teams of two reviewers independently extracted data and assessed the quality of included studies. A meta-analysis of study outcomes was not possible, given the small number of included studies and the heterogeneity of intervention and outcomes measures. We conducted qualitative analyses, and have presented the results in a narrative format. Main results Ten studies met the inclusion criteria. Nine of them were RCTs. All studies involved physicians as participants (including postgraduate trainees), and one study also included other participants. Only two studies measured patient outcomes. Searching skills and/or frequency of use of electronic databases, mainly MEDLINE, were targeted in eight studies. Use of Internet for audit and feedback, and email for provider-patient communication, were targeted in two studies. Four studies showed small to moderate positive effects of the intervention on ICT adoption. Four studies were unable to demonstrate significant positive effects, and the two others showed mixed effects. No studies looked at the long-term effect or sustainability of the intervention. Authors conclusions There is very limited evidence on effective interventions promoting the adoption of ICTs by healthcare professionals. Small effects have been reported for interventions targeting the use of electronic databases and digital libraries. The effectiveness of interventions to promote ICT adoption in healthcare settings remains uncertain, and more well designed trials are needed. PMID:19160265

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

    PubMed

    Kushniruk, Andre W; Borycki, Elizabeth M

    2015-01-01

    Innovations in healthcare information systems promise to revolutionize and streamline healthcare processes worldwide. However, the complexity of these systems and the need to better understand issues related to human-computer interaction have slowed progress in this area. In this chapter the authors describe their work in using methods adapted from usability engineering, video ethnography and analysis of digital log files for improving our understanding of complex real-world healthcare interactions between humans and technology. The approaches taken are cost-effective and practical and can provide detailed ethnographic data on issues health professionals and consumers encounter while using systems as well as potential safety problems. The work is important in that it can be used in techno-anthropology to characterize complex user interactions with technologies and also to provide feedback into redesign and optimization of improved healthcare information systems. PMID:26249198

  2. An intelligent virtual human system for providing healthcare information and support.

    PubMed

    Rizzo, Albert A; Lange, Belinda; Buckwalter, John G; Forbell, Eric; Kim, Julia; Sagae, Kenji; Williams, Josh; Rothbaum, Barbara O; Difede, JoAnn; Reger, Greg; Parsons, Thomas; Kenny, Patrick

    2011-01-01

    Over the last 15 years, a virtual revolution has taken place in the use of Virtual Reality simulation technology for clinical purposes. Shifts in the social and scientific landscape have now set the stage for the next major movement in Clinical Virtual Reality with the "birth" of intelligent virtual humans. Seminal research and development has appeared in the creation of highly interactive, artificially intelligent and natural language capable virtual human agents that can engage real human users in a credible fashion. No longer at the level of a prop to add context or minimal faux interaction in a virtual world, virtual humans can be designed to perceive and act in a 3D virtual world, engage in spoken dialogues with real users and can be capable of exhibiting human-like emotional reactions. This paper will present an overview of the SimCoach project that aims to develop virtual human support agents to serve as online guides for promoting access to psychological healthcare information and for assisting military personnel and family members in breaking down barriers to initiating care. The SimCoach experience is being designed to attract and engage military Service Members, Veterans and their significant others who might not otherwise seek help with a live healthcare provider. It is expected that this experience will motivate users to take the first step--to empower themselves to seek advice and information regarding their healthcare and general personal welfare and encourage them to take the next step towards seeking more formal resources if needed. PMID:21335847

  3. The use of health information technology in saudi primary healthcare centers.

    PubMed

    Almaiman, Ahmad; Bahkali, Salwa; Alfrih, Suha; Househ, Mowafa; El Metwally, Ashraf

    2014-01-01

    The purpose of this exploratory study is to provide an overview of health information technologies (HITs) used in primary healthcare centers (PHCC) in the Kingdom of Saudi Arabia. Data collection methods included key stakeholder interviews and an academic search using a variety of keyword terms. Evidence shows that the use of health information technologies in Saudi PHCCs is growing although is still in its early stages. Despite the numerous steps undertaken in upgrading and operating the Kingdom electronic health information system (EHIS) as a consequence of the national strategic roadmap of alignment with the electronic health (e-Health) Strategic objectives, yet there is still a mounting need to address realistic approaches in implementing e-health services in Saudi PHCCs. Particularly, tackling barriers that hinder the use of EHIS in PHCCs. PMID:25000053

  4. Monitoring diseases across borders: African regional integrative information systems.

    PubMed

    Simbini, Tungamirirai; Foster, Rosemary; Nesara, Paul; Hullin Lucay Cossio, Carola

    2010-01-01

    In African countries, communicable diseases remain the chief cause of a heavy disease burden. Regional economic, political and social integration bring new challenges in the management of these diseases, many of which are treatable. Information Communication Technology (ICT) applied through electronic health systems has the potential to strengthen healthcare service delivery and disease surveillance within these countries. This paper discusses the importance of well-defined e-Health strategies within countries and, in addition, proposes that countries within regions collaborate in planning for health information exchange across borders. It is suggested that particular attention be paid to technical and data standards enabling interoperability, and also to issues of security, patient privacy and governance. PMID:20841717

  5. Knowledge Levels Regarding Crimean-Congo Hemorrhagic Fever Among Emergency Healthcare Workers in an Endemic Region

    PubMed Central

    Yolcu, Sadiye; Kader, Cigdem; Kayipmaz, Afsin Emre; Ozbay, Sedat; Erbay, Ayse

    2014-01-01

    Background In this study, we aimed to determine knowledge levels regarding Crimean-Congo hemorrhagic fever (CCHF) among emergency healthcare workers (HCWs) in an endemic region. Methods A questionnaire form consisting of questions about CCHF was applied to the participants. Results The mean age was 29.6 ± 6.5 years (range 19 - 45). Fifty-four (49.5%) participants were physicians, 39 (35.8%) were nurses and 16 (14.7%) were paramedics. All of the participants were aware of CCHF, and 48 (44%) of them had previously followed CCHF patients. Rates of the use of protective equipment (masks and gloves) during interventions for patients who were admitted to the emergency service with active hemorrhage were 100% among paramedics, 76.9% among nurses and 61.1% among physicians (P = 0.003). Among 86 (78.9%) HCWs who believed that their knowledge regarding CCHF was adequate, 62 (56.9%) declared that they would prefer not to care for patients with CCHF (P = 0.608). Conclusions The use of techniques to prevent transmission of this disease, including gloves, face masks, face visors and box coats, should be explained to emergency room HCWs, and encouragement should be provided for using these techniques. PMID:24734146

  6. EPPS: Efficient and Privacy-Preserving Personal Health Information Sharing in Mobile Healthcare Social Networks.

    PubMed

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-01-01

    Mobile healthcare social networks (MHSNs) have emerged as a promising next-generation healthcare system, which will significantly improve the quality of life. However, there are many security and privacy concerns before personal health information (PHI) is shared with other parities. To ensure patients' full control over their PHI, we propose a fine-grained and scalable data access control scheme based on attribute-based encryption (ABE). Besides, policies themselves for PHI sharing may be sensitive and may reveal information about underlying PHI or about data owners or recipients. In our scheme, we let each attribute contain an attribute name and its value and adopt the Bloom filter to efficiently check attributes before decryption. Thus, the data privacy and policy privacy can be preserved in our proposed scheme. Moreover, considering the fact that the computational cost grows with the complexity of the access policy and the limitation of the resource and energy in a smart phone, we outsource ABE decryption to the cloud while preventing the cloud from learning anything about the content and access policy. The security and performance analysis is carried out to demonstrate that our proposed scheme can achieve fine-grained access policies for PHI sharing in MHSNs. PMID:26404300

  7. EPPS: Efficient and Privacy-Preserving Personal Health Information Sharing in Mobile Healthcare Social Networks

    PubMed Central

    Jiang, Shunrong; Zhu, Xiaoyan; Wang, Liangmin

    2015-01-01

    Mobile healthcare social networks (MHSNs) have emerged as a promising next-generation healthcare system, which will significantly improve the quality of life. However, there are many security and privacy concerns before personal health information (PHI) is shared with other parities. To ensure patients’ full control over their PHI, we propose a fine-grained and scalable data access control scheme based on attribute-based encryption (ABE). Besides, policies themselves for PHI sharing may be sensitive and may reveal information about underlying PHI or about data owners or recipients. In our scheme, we let each attribute contain an attribute name and its value and adopt the Bloom filter to efficiently check attributes before decryption. Thus, the data privacy and policy privacy can be preserved in our proposed scheme. Moreover, considering the fact that the computational cost grows with the complexity of the access policy and the limitation of the resource and energy in a smart phone, we outsource ABE decryption to the cloud while preventing the cloud from learning anything about the content and access policy. The security and performance analysis is carried out to demonstrate that our proposed scheme can achieve fine-grained access policies for PHI sharing in MHSNs. PMID:26404300

  8. Cloud-based hospital information system as a service for grassroots healthcare institutions.

    PubMed

    Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

    2014-09-01

    Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance. PMID:25015761

  9. Scatter Matters: Regularities and Implications for the Scatter of Healthcare Information on the Web

    PubMed Central

    Bhavnani, Suresh K.; Peck, Frederick A.

    2015-01-01

    Despite the development of huge healthcare Web sites and powerful search engines, many searchers end their searches prematurely with incomplete information. Recent studies suggest that users often retrieve incomplete information because of the complex scatter of relevant facts about a topic across Web pages. However, little is understood about regularities underlying such information scatter. To probe regularities within the scatter of facts across Web pages, this article presents the results of two analyses: (a) a cluster analysis of Web pages that reveals the existence of three page clusters that vary in information density and (b) a content analysis that suggests the role each of the above-mentioned page clusters play in providing comprehensive information. These results provide implications for the design of Web sites, search tools, and training to help users find comprehensive information about a topic and for a hypothesis describing the underlying mechanisms causing the scatter. We conclude by briefly discussing how the analysis of information scatter, at the granularity of facts, complements existing theories of information-seeking behavior. PMID:26594133

  10. Systems of evidence-based healthcare and personalised health information: some international and national trends.

    PubMed

    Gordon, C; Gray, J A; Toth, B; Veloso, M

    2000-01-01

    In Europe, North America and elsewhere, growing interest has focussed on evidence-based healthcare systems, incorporating the deployment of practice guidelines, as a field of application for health telematics. The clinical benefit and technical feasibility of common European approaches to this task has recently been demonstrated. In Europe it is likely that, building on recent progress in electronic health record architecture (EHRA) standards, a sufficient state of maturity can be reached to justify initiation within CEN TC251 of a prestandards process on guideline content formats during the current 5th Framework of EC RT&D activity. There is now a similar impetus to agree standards for this field in North America. Thanks to fruitful EC-USA contacts during the 4th Framework programme, there is now a chance, given well-planned coordination, to establish a global consensus optimally suited to serve the world-wide delivery and application of evidence-based medicine. This review notes three factors which may accelerate progress to convergence: (1) revolutionary changes in the knowledge basis of professional/patient/public healthcare partnerships, involving the key role of the Web as a health knowledge resource for citizens, and a rapidly growing market for personalised health information and advice; (2) the emergence at national levels of digital warehouses of clinical guidelines and EBM knowledge resources, agencies which are capable of brokering common mark-up and interchange media definitions between knowledge providers, industry and healthcare organizations; (3) the closing gap in knowledge management technology, with the advent of XML and RDF, between approaches and services based respectively on text mark-up and knowledge-base paradigms. A current project in the UK National Health Service (the National electronic Library of Health) is cited as an example of a national initiative designed to harness these trends. PMID:11187548

  11. Information-sharing between healthcare professionals, parents and children with cancer: more than a matter of information exchange.

    PubMed

    Coyne, I; Amory, A; Gibson, F; Kiernan, G

    2016-01-01

    This study examined participants' views on children's participation in information-sharing and communication interactions. A descriptive qualitative approach was taken with individual interviews held with children (The term 'children' is used to denote both children and adolescents and to avoid cumbersome repetition.) aged 7-16years (n=20), their parents (n=22) and healthcare professionals (n=40) at a children's hospital in Ireland. Data were analysed using the constant comparative method and managed with NVivo (version 8). The findings indicate that professionals strongly supported an open and honest approach to information-sharing; however, this viewpoint was not shared by all parents. The need to maintain hope and spirit and promote an optimistic identity influenced the amount and type of information shared by parents. Children trusted their parents to share information, and valued their parents' role as interpreters of information, advocates, and communication buffers. Most professionals endorsed parents' primacy as managers of information but experienced difficulty navigating a restricted stance. This study adds important insights into the complexities of information-sharing in triadic encounters. Professionals need to maintain an open mind about information-sharing strategies families may choose, remain sensitive to parents and children's information requirements and adopt a flexible approach to information provision. PMID:26537295

  12. Nested Quantization Index Modulation for Reversible Watermarking and Its Application to Healthcare Information Management Systems

    PubMed Central

    Ko, Lu-Ting; Chen, Jwu-E.; Shieh, Yaw-Shih; Hsin, Hsi-Chin; Sung, Tze-Yun

    2012-01-01

    Digital watermarking has attracted lots of researches to healthcare information management systems for access control, patients' data protection, and information retrieval. The well-known quantization index modulation-(QIM-) based watermarking has its limitations as the host image will be destroyed; however, the recovery of medical images is essential to avoid misdiagnosis. In this paper, we propose the nested QIM-based watermarking, which is preferable to the QIM-based watermarking for the medical image applications. As the host image can be exactly reconstructed by the nested QIM-based watermarking. The capacity of the embedded watermark can be increased by taking advantage of the proposed nest structure. The algorithm and mathematical model of the nested QIM-based watermarking including forward and inverse model is presented. Due to algorithms and architectures of forward and inverse nested QIM, the concurrent programs and special processors for the nested QIM-based watermarking are easily implemented. PMID:22194776

  13. Nested quantization index modulation for reversible watermarking and its application to healthcare information management systems.

    PubMed

    Ko, Lu-Ting; Chen, Jwu-E; Shieh, Yaw-Shih; Hsin, Hsi-Chin; Sung, Tze-Yun

    2012-01-01

    Digital watermarking has attracted lots of researches to healthcare information management systems for access control, patients' data protection, and information retrieval. The well-known quantization index modulation-(QIM-) based watermarking has its limitations as the host image will be destroyed; however, the recovery of medical images is essential to avoid misdiagnosis. In this paper, we propose the nested QIM-based watermarking, which is preferable to the QIM-based watermarking for the medical image applications. As the host image can be exactly reconstructed by the nested QIM-based watermarking. The capacity of the embedded watermark can be increased by taking advantage of the proposed nest structure. The algorithm and mathematical model of the nested QIM-based watermarking including forward and inverse model is presented. Due to algorithms and architectures of forward and inverse nested QIM, the concurrent programs and special processors for the nested QIM-based watermarking are easily implemented. PMID:22194776

  14. Systematic review of the types of methods and approaches used to assess the effectiveness of healthcare information websites.

    PubMed

    Tieman, Jennifer; Bradley, Sandra L

    2013-01-01

    The aim of this systematic review was to identify types of approaches and methods used to evaluate the effectiveness of healthcare information websites. Simple usage data may not be sufficient to assess whether desired healthcare outcomes were achieved or to determine the relative effectiveness of different web resources on the same health topic. To establish the state of the knowledge base on assessment methods used to determine the effectiveness of healthcare websites, a structured search of the literature was conducted in Ovid Medline, resulting in the retrieval of 1611 articles, of which 240 met the inclusion criteria for the present review. The present review found that diverse evaluation methods were used to measure the effectiveness of healthcare websites. These evaluation methods were used during development, before release and after release. Economic assessment was rare and most evaluations looked at content issues, such as readability scores. Several studies did try to assess the usefulness of websites, but few studies looked at behaviour change or knowledge transfer following engagement with the designated health website. To assess the effectiveness of the knowledge transfer of healthcare information through the online environment, multiple methods may need to be used to evaluate healthcare websites and may need to be undertaken at all stages of the website development process. PMID:24004691

  15. 77 FR 2299 - Agency Information Collection Activities; Proposed Collection; Comment Request; Healthcare...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-17

    ... Collection; Comment Request; Healthcare Professional Survey of Prescription Drug Promotion AGENCY: Food and... public comment in response to the notice. This notice solicits comments on the Healthcare Professional... to consumers and healthcare providers. DATES: Submit either electronic or written comments on...

  16. Informal Payments in Healthcare: A Case Study of Kerman Province in Iran

    PubMed Central

    Nekoeimoghadam, Mahmood; Esfandiari, Atefeh; Ramezani, Fatemeh; Amiresmaili, Mohammadreza

    2013-01-01

    Background: Informal payments for health care, which are common in many countries, can have negative effects on health care access, equity and health status as they lead people to forgo or delay seeking care, or to sell assets to pay for care. Many countries are putting reforms in place with the aim of reducing informal payments. In order to be successful, such policies should be informed by the underlying causes of such payments. This study attempts to explore why, how, and in what ways informal payments occur. Methods: We conducted face-to-face interviews with a purposeful sample of 45 participants, including patients, healthcare providers and officials, in Kerman province in Iran, in 2010. The research participants were asked about the nature of informal payments, the reasons behind both asking and making those payments. We analysed the data using content analysis. Results: We found that people make informal payments for several reasons, namely cultural, quality-related and legal. Providers ask for informal payments because of tariffs, structural and moral reasons, and to demonstrate their competence. Informal payments were found to be more prevalent for complex procedures and are usually asked for directly. Conclusion: Informal payments are present in Iran’s health system as in other countries. What makes Iran’s condition slightly different from other countries is the peculiarity of reasons behind asking informal payments and the disadvantages associated with these kinds of payments. Iran could overcome this dilemma by precise investigation of the reasons to inform appropriate policy formulation. Some policies such as raising salaries, justifying the tariffs and cost-sharing, defining a benefits package of services, and improving accountability and transparency in the health system could be taken by the government to alleviate the problem. PMID:24596856

  17. Geographic Information Systems for healthcare organizations: a primer for nursing professions.

    PubMed

    Endacott, Ruth; Kamel Boulos, Maged N; Manning, Bryan R M; Maramba, Inocencio

    2009-01-01

    The sharing of spatial information among members of the health sector can have vast strategic and operational benefits. Geographic Information Systems, or GIS, can be a key technology in optimally using this information. There are two types of applications under GIS: (1) studying health outcomes and epidemiology and (2) studying and informing healthcare delivery. With the advent of GIS that can be used over the Internet, a wider audience of decision makers and stakeholders now has the opportunity to use these technologies through something as simple as a Web browser. There is a small but growing number of published articles giving examples of using GIS for nursing practice and research. However, increased efforts are needed to make nurses, other health professionals, and health organizations aware of the possibilities of these information products for empowering their decision making. An incremental "capacity building" approach is proposed as the best way forward for sustainable and sustained nursing GIS development. The aims of this article are (1) to provide a brief nontechnical overview for readers not familiar with GIS, (2) to provide a framework for the adoption of GIS in health service organizations, and (3) to identify ways in which GIS can impact on the nursing management of patients. PMID:19060622

  18. The Five W's for Information Visualization with Application to Healthcare Informatics.

    PubMed

    Zhang, Zhiyuan; Wang, Bing; Ahmed, Faisal; Ramakrishnan, Iv; Zhao, Rong; Viccellio, Asa; Mueller, Klaus

    2013-06-01

    The Five W's is a popular concept for information gathering in journalistic reporting. It captures all aspects of a story or incidence: who, when, what, where, and why. We propose a framework composed of a suite of cooperating visual information displays to represent the Five W's and demonstrate its use within a healthcare informatics application. Here, the who is the patient, the where is the patient's body, and the when, what, why is a reasoning chain which can be interactively sorted and brushed. The patient is represented as a radial sunburst visualization integrated with a stylized body map. This display captures all health conditions of the past and present to serve as a quick overview to the interrogating physician. The reasoning chain is represented as a multi-stage flow chart, composed of date, symptom, data, diagnosis, treatment, and outcome. Our system seeks to improve the usability of information captured in the electronic medical record (EMR) and makes ample use of popular hierarchical medical codes, such as ICD9 and CPT, for information organization. We show via multiple examples that our framework can significantly lower the time and effort needed to access the medical patient information required to arrive at a diagnostic conclusion. PMID:23751321

  19. Integrating a Federated Healthcare Data Query Platform With Electronic IRB Information Systems.

    PubMed

    He, Shan; Hurdle, John F; Botkin, Jeffrey R; Narus, Scott P

    2010-01-01

    Human subjects are indispensable for clinical and translational research. Federal and local agencies issue regulations governing the conduct of research involving human subjects in order to properly protect study participants. Institutional Review Boards (IRBs) have the authority to review human subject research to ensure concordance with these regulations. One of the primary goals of the IRB oversight is to protect research participants' privacy by carefully reviewing the data used and disclosed during a study. However, there are major challenges for IRBs in the typical research process. Due to the information disconnect between the data providers (e.g., a clinical data warehouse) and the IRB, it is often impossible to tell exactly what data has been disclosed to investigators. This causes time-consuming, inefficient, and often ineffective monitoring of clinical studies. This paper proposes an integrated architecture that interconnects a federated healthcare data query platform with an electronic IRB system. PMID:21346987

  20. A Comparison of Usability Factors of Four Mobile Devices for Accessing Healthcare Information by Adolescents

    PubMed Central

    Sheehan, B.; Lee, Y.; Rodriguez, M.; Tiase, V.; Schnall, R.

    2012-01-01

    Background Mobile health (mHealth) is a growing field aimed at developing mobile information and communication technologies for healthcare. Adolescents are known for their ubiquitous use of mobile technologies in everyday life. However, the use of mHealth tools among adolescents is not well described. Objective We examined the usability of four commonly used mobile devices (an iPhone, an Android with touchscreen keyboard, an Android with built-in keyboard, and an iPad) for accessing healthcare information among a group of urban-dwelling adolescents. Methods Guided by the FITT (Fit between Individuals, Task, and Technology) framework, a think-aloud protocol was combined with a questionnaire to describe usability on three dimensions: 1) task-technology fit; 2) individual-technology fit; and 3) individual-task fit. Results For task-technology fit, we compared the efficiency, and effectiveness of each of the devices tested and found that the iPhone was the most usable had the fewest errors and prompts and had the lowest mean overall task time For individual-task fit, we compared efficiency and learnability measures by website tasks and found no statistically significant effect on tasks steps, task time and number of errors. Following our comparison of success rates by website tasks, we compared the difference between two mobile applications which were used for diet tracking and found statistically significant effect on tasks steps, task time and number of errors. For individual-technology fit, interface quality was significantly different across devices indicating that this is an important factor to be considered in developing future mobile devices. Conclusions All of our users were able to complete all of the tasks, however the time needed to complete the tasks was significantly different by mobile device and mHealth application. Future design of mobile technology and mHealth applications should place particular importance on interface quality. PMID:23227134

  1. An overview of methods and applications to value informal care in economic evaluations of healthcare.

    PubMed

    Koopmanschap, Marc A; van Exel, Job N A; van den Berg, Bernard; Brouwer, Werner B F

    2008-01-01

    This paper compares several applied valuation methods for including informal care in economic evaluations of healthcare programmes: the proxy good method; the opportunity cost method; the contingent valuation method (CVM); conjoint measurement (CM); and valuation of health effects in terms of health-related quality of life (HR-QOL) and well-being. The comparison focuses on three questions: what outcome measures are available for including informal care in economic evaluations of healthcare programmes; whether these measures are compatible with the common types of economic evaluation; and, when applying these measures, whether all relevant aspects of informal care are incorporated. All types of economic evaluation can incorporate a monetary value of informal care (using the opportunity cost method, the proxy good method, CVM and CM) on the cost side of an analysis, but only when the relevant aspects of time costs have been valued. On the effect side of a cost-effectiveness or cost-utility analysis, the health effects (for the patient and/or caregiver) measured in natural units or QALYs can be combined with cost estimates based on the opportunity cost method or the proxy good method. One should be careful when incorporating CVM and CM in cost-minimization, cost-effectiveness and cost-utility analyses, as the health effects of patients receiving informal care and the carers themselves may also have been valued separately. One should determine whether the caregiver valuation exercise allows combination with other valuation techniques. In cost-benefit analyses, CVM and CM appear to be the best tools for the valuation of informal care. When researchers decide to use the well-being method, we recommend applying it in a cost-benefit analysis framework. This method values overall QOL (happiness); hence it is broader than just HR-QOL, which complicates inclusion in traditional health economic evaluations that normally define outcomes more narrowly. Using broader, non-monetary valuation techniques, such as the CarerQol instrument, requires a broader evaluation framework than cost-effectiveness/cost-utility analysis, such as cost-consequence or multi-criteria analysis. PMID:18370563

  2. Summary of Information and Resources Related to Energy Use in Healthcare Facilities - Version 1

    SciTech Connect

    Singer, Brett C.; Coughlin, Jennifer L.; Mathew, Paul A.

    2009-09-08

    This document presents the results of a review of publicly available information on energy use in health care facilities. The information contained in this document and in the sources cited herein provides the background and context for efforts to reduce energy use and costs in health care. Recognizing the breadth and diversity of relevant information, the author acknowledges that the report is likely not comprehensive. It is intended only to present a broad picture of what is currently known about health care energy use. This review was conducted as part of a 'High Performance Health Care Buildings' research study funded by the California Energy Commission. The study was motivated by the recognition that health care facilities collectively account for a substantial fraction of total commercial building energy use, due in large part to the very high energy intensity of hospitals and other inpatient care facilities. The goal of the study was to develop a roadmap of research, development and deployment (RD&D) needs for the health care industry. In addition to this information review, the road map development process included interviews with industry experts and a full-day workshop at LBNL in March 2009. This report is described as 'Version 1' with the intent that it will be expanded and updated as part of an ongoing LBNL program in healthcare energy efficiency. The document is being released in this form with the hope that it can assist others in finding and accessing the resources described within.

  3. The five Ws for information visualization with application to healthcare informatics.

    PubMed

    Zhang, Zhiyuan; Wang, Bing; Ahmed, Faisal; Ramakrishnan, I V; Zhao, Rong; Viccellio, Asa; Mueller, Klaus

    2013-11-01

    The Five Ws is a popular concept for information gathering in journalistic reporting. It captures all aspects of a story or incidence: who, when, what, where, and why. We propose a framework composed of a suite of cooperating visual information displays to represent the Five Ws and demonstrate its use within a healthcare informatics application. Here, the who is the patient, the where is the patient's body, and the when, what, why is a reasoning chain which can be interactively sorted and brushed. The patient is represented as a radial sunburst visualization integrated with a stylized body map. This display captures all health conditions of the past and present to serve as a quick overview to the interrogating physician. The reasoning chain is represented as a multistage flow chart, composed of date, symptom, data, diagnosis, treatment, and outcome. Our system seeks to improve the usability of information captured in the electronic medical record (EMR) and we show via multiple examples that our framework can significantly lower the time and effort needed to access the medical patient information required to arrive at a diagnostic conclusion. PMID:24029909

  4. Efficacy of a New Medical Information system, Ubiquitous Healthcare Service with Voice Inception Technique in Elderly Diabetic Patients

    PubMed Central

    Kim, Kyoung Min; Park, Kyeong Seon; Lee, Hyun Ju; Lee, Yun Hee; Bae, Ji Seon; Lee, Young Joon; Choi, Sung Hee; Jang, Hak Chul; Lim, Soo

    2015-01-01

    We have demonstrated previously that an individualized health management system using advanced medical information technology, named ubiquitous (u)-healthcare, was helpful in achieving better glycemic control than routine care. Recently, we generated a new u-healthcare system using a voice inception technique for elderly diabetic patients to communicate information about their glucose control, physical activity, and diet more easily. In a randomized clinical trial, 70 diabetic patients aged 60–85 years were assigned randomly to a standard care group or u-healthcare group for 6 months. The primary end points were the changes in glycated hemoglobin (HbA1c) and glucose fluctuation assessed by the mean amplitude glycemic excursion (MAGE). Changes in body weight, lifestyle, and knowledge about diabetes were also investigated. After 6 months, the HbA1c levels decreased significantly in the u-healthcare group (from 8.6 ± 1.0% to 7.5 ± 0.6%) compared with the standard care group (from 8.7 ± 0.9% to 8.2 ± 1.1%, P < 0.01). The MAGE decreased more in the u-healthcare group than in the standard care group. Systolic blood pressure and body weight decreased and liver functions improved in the u-healthcare group, but not in the standard care group. The u-healthcare system with voice inception technique was effective in achieving glycemic control without hypoglycemia in elderly diabetic patients (Clinicaltrials.gov: NCT01891474). PMID:26658492

  5. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    PubMed Central

    Ahiabu, Mary-Anne; Tersbøl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-01-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and ‘no malaria drug’ on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support of rational drug use. PMID:26045328

  6. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana.

    PubMed

    Ahiabu, Mary-Anne; Tersbøl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-03-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and 'no malaria drug' on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support of rational drug use. PMID:26045328

  7. Portal of medical data models: information infrastructure for medical research and healthcare

    PubMed Central

    Dugas, Martin; Neuhaus, Philipp; Meidt, Alexandra; Doods, Justin; Storck, Michael; Bruland, Philipp; Varghese, Julian

    2016-01-01

    Introduction: Information systems are a key success factor for medical research and healthcare. Currently, most of these systems apply heterogeneous and proprietary data models, which impede data exchange and integrated data analysis for scientific purposes. Due to the complexity of medical terminology, the overall number of medical data models is very high. At present, the vast majority of these models are not available to the scientific community. The objective of the Portal of Medical Data Models (MDM, https://medical-data-models.org) is to foster sharing of medical data models. Methods: MDM is a registered European information infrastructure. It provides a multilingual platform for exchange and discussion of data models in medicine, both for medical research and healthcare. The system is developed in collaboration with the University Library of Münster to ensure sustainability. A web front-end enables users to search, view, download and discuss data models. Eleven different export formats are available (ODM, PDF, CDA, CSV, MACRO-XML, REDCap, SQL, SPSS, ADL, R, XLSX). MDM contents were analysed with descriptive statistics. Results: MDM contains 4387 current versions of data models (in total 10 963 versions). 2475 of these models belong to oncology trials. The most common keyword (n = 3826) is ‘Clinical Trial’; most frequent diseases are breast cancer, leukemia, lung and colorectal neoplasms. Most common languages of data elements are English (n = 328 557) and German (n = 68 738). Semantic annotations (UMLS codes) are available for 108 412 data items, 2453 item groups and 35 361 code list items. Overall 335 087 UMLS codes are assigned with 21 847 unique codes. Few UMLS codes are used several thousand times, but there is a long tail of rarely used codes in the frequency distribution. Discussion: Expected benefits of the MDM portal are improved and accelerated design of medical data models by sharing best practice, more standardised data models with semantic annotation and better information exchange between information systems, in particular Electronic Data Capture (EDC) and Electronic Health Records (EHR) systems. Contents of the MDM portal need to be further expanded to reach broad coverage of all relevant medical domains. Database URL: https://medical-data-models.org PMID:26868052

  8. Healthcare Lean.

    PubMed

    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. PMID:12886662

  9. Composition Matters: Multi-Context Informal Mentoring Networks for Low-Income Urban Adolescent Girls Pursuing Healthcare Careers

    ERIC Educational Resources Information Center

    Packard, Becky Wai-Ling; Kim, Grace June; Sicley, Marissa; Piontkowski, Sarah

    2009-01-01

    In the career research literature focused on adults, diversely composed mentoring networks are advocated due to their effectiveness in providing a wide range of mentoring functions. This study investigates the composition of informal mentoring networks utilized by low-income urban adolescent girls with healthcare college and career aspirations. In…

  10. Competencies Required for Healthcare Information Technology to Be an Effective Strategic Business Change Partner

    ERIC Educational Resources Information Center

    Davalos, Eugenia

    2013-01-01

    One of the core strategies to transform the United States national healthcare system is the implementation of key technologies such as the electronic patient medical record. Such key technologies improve patient care and help the organization gain competitive advantage. With a high demand for strategic and operational change, healthcare providers…

  11. Competencies Required for Healthcare Information Technology to Be an Effective Strategic Business Change Partner

    ERIC Educational Resources Information Center

    Davalos, Eugenia

    2013-01-01

    One of the core strategies to transform the United States national healthcare system is the implementation of key technologies such as the electronic patient medical record. Such key technologies improve patient care and help the organization gain competitive advantage. With a high demand for strategic and operational change, healthcare providers

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

    PubMed

    Korukonda, Appa Rao; Korukonda, Saritha

    2006-01-01

    Although electronic healthcare can boast of a remarkable origin in modern-day e-commerce in the form of Electronic Data Interchange (EDI), its mission-critical nature in information-based strategising is yet to be realised. Restricting the scope of e-healthcare management to product advertisements and website management reflects an unfortunate trend of underutilisation of the scope of electronic decision support systems in pricing and other business strategies. This paper aims to illustrate how this trend can be corrected by transforming e-healthcare into a full-fledged business strategy for strategic positioning and corporate profitability. This argument is illustrated with the aid of a business example related to transfer pricing. PMID:18048255

  13. Quality of service provision assessment in the healthcare information and telecommunications infrastructures.

    PubMed

    Babulak, Eduard

    2006-01-01

    The continuous increase in the complexity and the heterogeneity of corporate and healthcare telecommunications infrastructures will require new assessment methods of quality of service (QoS) provision that are capable of addressing all engineering and social issues with much faster speeds. Speed and accessibility to any information at any time from anywhere will create global communications infrastructures with great performance bottlenecks that may put in danger human lives, power supplies, national economy and security. Regardless of the technology supporting the information flows, the final verdict on the QoS is made by the end user. The users' perception of telecommunications' network infrastructure QoS provision is critical to the successful business management operation of any organization. As a result, it is essential to assess the QoS Provision in the light of user's perception. This article presents a cost effective methodology to assess the user's perception of quality of service provision utilizing the existing Staffordshire University Network (SUN) by adding a component of measurement to the existing model presented by Walker. This paper presents the real examples of CISCO Networking Solutions for Health Care givers and offers a cost effective approach to assess the QoS provision within the campus network, which could be easily adapted to any health care organization or campus network in the world. PMID:16137920

  14. A semantic model for multimodal data mining in healthcare information systems.

    PubMed

    Iakovidis, Dimitris; Smailis, Christos

    2012-01-01

    Electronic health records (EHRs) are representative examples of multimodal/multisource data collections; including measurements, images and free texts. The diversity of such information sources and the increasing amounts of medical data produced by healthcare institutes annually, pose significant challenges in data mining. In this paper we present a novel semantic model that describes knowledge extracted from the lowest-level of a data mining process, where information is represented by multiple features i.e. measurements or numerical descriptors extracted from measurements, images, texts or other medical data, forming multidimensional feature spaces. Knowledge collected by manual annotation or extracted by unsupervised data mining from one or more feature spaces is modeled through generalized qualitative spatial semantics. This model enables a unified representation of knowledge across multimodal data repositories. It contributes to bridging the semantic gap, by enabling direct links between low-level features and higher-level concepts e.g. describing body parts, anatomies and pathological findings. The proposed model has been developed in web ontology language based on description logics (OWL-DL) and can be applied to a variety of data mining tasks in medical informatics. It utility is demonstrated for automatic annotation of medical data. PMID:22874256

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

    PubMed

    Namo?lu, Nihan; Ulgen, Yekta

    2013-01-01

    Healthcare industry has become widely dependent on information technology and internet as it moves from paper to electronic records. Healthcare Information System has to provide a high quality service to patients and a productive knowledge share between healthcare staff by means of patient data. With the internet being commonly used across hospitals, healthcare industry got its own share from cyber threats like other industries in the world. The challenge is allowing knowledge transfer to hospital staff while still ensuring compliance with security mandates. Working in collaboration with a private hospital in Turkey; this study aims to reveal the essential elements of a 21st century business continuity plan for hospitals while presenting the security vulnerabilities in the current hospital information systems and personal privacy auditing standards proposed by regulations and laws. We will survey the accreditation criteria in Turkey and counterparts in US and EU. We will also interview with medical staff in the hospital to understand the needs for personal privacy and the technical staff to perceive the technical requirements in terms of network security configuration and deployment. As hospitals are adopting electronic transactions, it should be considered a must to protect these electronic health records in terms of personal privacy aspects. PMID:23823398

  16. A scoping review on the experiences and preferences in accessing diabetes-related healthcare information and services by British Bangladeshis.

    PubMed

    Alam, Rahul; Speed, Shaun; Beaver, Kinta

    2012-03-01

    Diabetes is a chronic condition requiring lifelong self-management. Patients are encouraged to access appropriate services to facilitate optimum management of diabetes. Although equitable access to healthcare in the United Kingdom is a legal right, not all groups and individuals in the community experience equity. Despite various equality laws and numerous efforts to minimise health inequalities related to access, particular community groups are more likely to experience inequitable access than others. The Bangladeshi community are one such community who experience some of the worst diabetes-related health outcomes in the United Kingdom. Little is known about their experiences and preferences in accessing diabetes healthcare information and services. Consequently, we undertook a scoping review of the literature by following the York Scoping Reviews Framework to identify the experiences and preferences of Bangladeshi patients and carers when gaining access to diabetes-related healthcare information and services. We identified eight articles and reported our results in relation to four domains of access: health service availability, health service utilisation, health service outcomes and the notion of equity. The review identified that language and literacy issues were the most common barriers hindering access to information and services. Patient knowledge regarding diabetes and its management was generally low, and friends and family were frequently being used as information sources and as informal interpreters. Additionally, there were feelings of isolation from mainstream information and services possibly resulting in the high prevalence of depression in the Bangladeshi community with women more affected than men. Social networks combined with religious and cultural beliefs as well as wider societal duties played a crucial role in accessing information and services for this population, and the identification of these issues merit further research and are possible avenues towards improved access to healthcare information and services for the Bangladeshi population. PMID:21883609

  17. Designing the Regional College Management Information System.

    ERIC Educational Resources Information Center

    Kin Maung Kywe; And Others

    Beginning in 1976, Regional Colleges were formed in Burma to implement career and technical education at the post-secondary level. This paper describes the Regional Colleges and explores the possible use of a systemic management information process that could assist in the complex planning required to develop second-year vocational and technical

  18. Conceptual Design of a Regional Information System.

    ERIC Educational Resources Information Center

    Denver Regional Council of Governments, CO.

    This report describes the conceptual design of a regional information system, developed in support of the Denver Regional Council of Government's established comprehensive planning work program. It includes a discussion of system objectives, available data sources, recommended system content, software and system maintenance requirements,…

  19. A long time coming: primary healthcare renewal in Canada.

    PubMed

    Hutchison, Brian

    2008-01-01

    Following decades of stagnation, potentially transformative changes in primary healthcare are proceeding in several Canadian provinces. These changes - primarily collaborative and interdisciplinary models of care delivery and quality improvement programs - have been impelled by an improved fiscal climate, increased federal transfers (some earmarked for primary healthcare), pressure generated by the recommendations of the Romanow Commission and the Kirby Committee and growing political and public concern about healthcare access and quality. Transformation has begun, but much remains to be done to address Canada's poor primary healthcare performance relative to other wealthy industrialized countries. Processes are needed at the regional and provincial levels to collectively engage the full range of key stakeholders in providing policy advice and informing the articulation of clear policy direction for primary healthcare. Critical areas for investment include integrated health information systems, quality improvement processes, interdisciplinary primary healthcare teams and group practices, and systematic evaluation of primary healthcare innovations and ongoing system performance. PMID:18453816

  20. Design and development of a tele-healthcare information system based on web services and HL7 standards.

    PubMed

    Huang, Ean-Wen; Hung, Rui-Suan; Chiou, Shwu-Fen; Liu, Fei-Ying; Liou, Der-Ming

    2011-01-01

    Information and communication technologies progress rapidly and many novel applications have been developed in many domains of human life. In recent years, the demand for healthcare services has been growing because of the increase in the elderly population. Consequently, a number of healthcare institutions have focused on creating technologies to reduce extraneous work and improve the quality of service. In this study, an information platform for tele- healthcare services was implemented. The architecture of the platform included a web-based application server and client system. The client system was able to retrieve the blood pressure and glucose levels of a patient stored in measurement instruments through Bluetooth wireless transmission. The web application server assisted the staffs and clients in analyzing the health conditions of patients. In addition, the server provided face-to-face communications and instructions through remote video devices. The platform deployed a service-oriented architecture, which consisted of HL7 standard messages and web service components. The platform could transfer health records into HL7 standard clinical document architecture for data exchange with other organizations. The prototyping system was pretested and evaluated in a homecare department of hospital and a community management center for chronic disease monitoring. Based on the results of this study, this system is expected to improve the quality of healthcare services. PMID:21431601

  1. [INFORMATION ABOUT HOSPITALS AND THE ORGANISATION OF THE HEALTHCARE SYSTEM: EVALUATION OR CLASSIFICATION? THE USERS' POINT OF VIEW].

    PubMed

    Brun, Nicolas

    2015-03-01

    Until recently users felt that the French healthcare system was the best in the world and consequently all of the actors, structures and organisations were of a similar level of excellence and competence. Patients were often directed by their general practitioner or by the opinion of their friends and family. This feeling of homogenity of the quality of the hospitals or healthcare professionals has disappeared. Nowadays users want to have information which is useful for them and allows them to find their way in an organisation of healthcare that is very complex, and therefore a source of inequality. This informaion may come from institutional sites, league tables in newspapers or Internet sites. But, if it is to be useful, this information must be accessible and understandable by all, both in form and content. This is not always the case. It is in the interest of the healthcare system to be as transparent as possible, so it must resolutely go in this direction. PMID:26606771

  2. Professional and geographical network effects on healthcare information exchange growth: does proximity really matter?

    PubMed Central

    Yaraghi, Niam; Du, Anna Ye; Sharman, Raj; Gopal, Ram D; Ramesh, R; Singh, Ranjit; Singh, Gurdev

    2014-01-01

    Background and objective We postulate that professional proximity due to common patients and geographical proximity among practice locations are significant factors influencing the adoption of health information exchange (HIE) services by healthcare providers. The objective of this study is to investigate the direct and indirect network effects of these drivers on HIE diffusion. Design Multi-dimensional scaling and clustering are first used to create different clusters of physicians based on their professional and geographical proximities. Extending the Bass diffusion model to capture direct and indirect network effects among groups, the growth of HIE among these clusters is modeled and studied. The network effects among the clusters are investigated using adoption data over a 3-year period for an HIE based in Western New York. Measurement HIE adoption parameters—external sources of influence as well as direct and indirect network coefficients—are estimated by the extended version of the Bass diffusion model. Results Direct network effects caused by common patients among physicians are much more influential on HIE adoption as compared with previously investigated social contagion and external factors. Professional proximity due to common patients does influence adoption decisions; geographical proximity is also influential, but its effect is more on rural than urban physicians. Conclusions Flow of patients among different groups of physicians is a powerful factor in HIE adoption. Rather than merely following the market trend, physicians appear to be influenced by other physicians with whom they interact with and have common patients. PMID:24287171

  3. Information and communication technologies for approaching smokers: a descriptive study in primary healthcare.

    TOXLINE Toxicology Bibliographic Information

    Puigdomnech E; Trujillo-Gmez JM; Martn-Cantera C; Daz-Gete L; Manzano-Montero M; Snchez-Fondevila J; Gonzalez-Fernandez Y; Garcia-Rueda B; Briones-Carrió EM; Clemente-Jimnez ML; Castao C; Biruls-Muntané J; Grupo Estudio TABATIC

    2015-01-01

    BACKGROUND: Common interventions for smoking cessation are based on medical advice and pharmacological aid. Information and communication technologies may be helpful as interventions by themselves or as complementary tools to quit smoking. The objective of the study was to determine the use of information and communication technologies (ICTs) in the smoking population attended in primary care, and describe the major factors associated with its use.METHODS: Descriptive observational study in 84 health centres in Catalua, Aragon and Salamanca. We included by simple random sampling 1725 primary healthcare smokers (any amount of tobacco) aged 18-85. Through personal interview professionals collected Socio-demographic data and variables related with tobacco consumption and ICTs use were collected through face to face interviews Factors associated with the use of ICTs were analyzed by logistic regression.RESULTS: Users of at least one ICT were predominantly male, young (18-45 years), from most favoured social classes and of higher education. Compared with non-ICTs users, users declared lower consumption of tobacco, younger onset age, and lower nicotine dependence. The percentages of use of email, text messages and web pages were 65.3%, 74.0% and 71.5%, respectively. Factors associated with the use of ICTs were age, social class, educational level and nicotine dependence level. The factor most closely associated with the use of all three ICTs was age; mainly individuals aged 18-24.CONCLUSIONS: The use of ICTs to quit smoking is promising, with the technology of mobile phones having a broader potential. Younger and more educated subjects are good targets for ICTs interventions on smoking cessation.

  4. Lessons Learned from Implementation of Information and Communication Technologies in Spain's Healthcare Services

    PubMed Central

    Carnicero, J.; Rojas, D.

    2010-01-01

    Background Spain’s health services have undertaken a number of important projects aimed at the creation of Electronic Health Records (EHR) through the incorporation of Information and Communication Technologies (ICT) into patient care practices. The objective of this endeavor is to improve care quality and efficiency and increase responsiveness to the population's needs and demands. Between 2006-2009 over 300 million Euro were invested in projects of this type. Objective To better understand the success criteria, the difficulties encountered and certain issues that must be kept in mind to ensure successful implementation of ICT projects in health organizations, based on Spain's experiences in this field. Methods The projects' results are analyzed using the criteria of compliance with the expected scope, cost and time frame. Results The results can be considered satisfactory in primary care facilities, where almost 90% of Spain's general practitioners, pediatricians and primary care nurses are using electronic health record (EHR) systems. In hospitals EHR implementation is more uneven. Over 40% of Spanish primary care centers and 42% of pharmacies are using electronic prescription (the information system that connects the physician to the dispensing pharmacy and the dispensing pharmacy to the payer). Discussion All of Spain’s health services are currently carrying out projects involving ICT application in healthcare, and a priori the benefits of ICT are not questioned. However, the costs and time frames required for these projects are clearly surpassing initial expectations, while the benefits perceived by both professionals and institutions remain limited. This situation may be due in part to the absence of a project management culture in the health services, which has led them to pay insufficient attention to the main difficulties and key issues related to the implementation of EHR. PMID:23616846

  5. Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Qubec province: Montral and Montrgie

    PubMed Central

    2010-01-01

    Background The Canadian healthcare system is currently experiencing important organizational transformations through the reform of primary healthcare (PHC). These reforms vary in scope but share a common feature of proposing the transformation of PHC organizations by implementing new models of PHC organization. These models vary in their performance with respect to client affiliation, utilization of services, experience of care and perceived outcomes of care. Objectives In early 2005 we conducted a study in the two most populous regions of Quebec province (Montreal and Montrgie) which assessed the association between prevailing models of primary healthcare (PHC) and population-level experience of care. The goal of the present research project is to track the evolution of PHC organizational models and their relative performance through the reform process (from 2005 until 2010) and to assess factors at the organizational and contextual levels that are associated with the transformation of PHC organizations and their performance. Methods/Design This study will consist of three interrelated surveys, hierarchically nested. The first survey is a population-based survey of randomly-selected adults from two populous regions in the province of Quebec. This survey will assess the current affiliation of people with PHC organizations, their level of utilization of healthcare services, attributes of their experience of care, reception of preventive and curative services and perception of unmet needs for care. The second survey is an organizational survey of PHC organizations assessing aspects related to their vision, organizational structure, level of resources, and clinical practice characteristics. This information will serve to develop a taxonomy of organizations using a mixed methods approach of factorial analysis and principal component analysis. The third survey is an assessment of the organizational context in which PHC organizations are evolving. The five year prospective period will serve as a natural experiment to assess contextual and organizational factors (in 2005) associated with migration of PHC organizational models into new forms or models (in 2010) and assess the impact of this evolution on the performance of PHC. Discussion The results of this study will shed light on changes brought about in the organization of PHC and on factors associated with these changes. PMID:21122145

  6. Information society in Czech healthcare 'starting point' to prognosis for the year 2013.

    PubMed

    Zvrov, Jana; Pribk, Vladimr

    2002-11-20

    A prognosis of how the information society in health care will look like in 2013 must start from the current state of affairs at the given locality regarding healthcare management by public authorities including legislative, ICT technological levels and accessibility of professional knowledge in individual fields of medicine. It is presumed that after 10 years the influence of this 'starting point' will still persist and knowledge of the current state of affairs will be needed to positively but also negatively differentiates the prognosis [Health Care in the Information Society: A Prognosis for the Year 2013, in this issue] for individual localities, e.g. Germany versus neighbouring the Czech Republic. The present article focuses on aims of Czech health care and the measures that are taken in Czech health care that are carried out and which have been already initiated. Their significance towards the future prognosis according to [Health Care in the Information Society: A Prognosis for the Year 2013, in this issue] is clear. The first measure is legalisation of conditions, which allow health care administration only be carried out with electronic forms and the protection of these sensitive personal data when they are placed in a centralised data depository where they are prepared for physicians who use them while providing health care in health institutions. In the Czech Republic an information system is developed called Internet Access to Health Patient Information (IHPI). The second measure is creating a unified central system of health information together with methodologies for data collection, data standards and protocols. In the Czech Republic there is the National Health Information System (NHIS) governed by the Institute for Health Information and Statistics (IHIS CR). The NHIS enables care providers to get information about the health state of citizens, about health institutions, about their activities and economics, it enables to regulate the provision of health care, to define conceptions of state health politics and to administrate public health. The third measure is legalisation of possibilities to establish centralised health care registers that are designated for recording and following of patients with chosen socially serious diseases. These registers help with diagnosis and therapy and reveal consequences of diseases for the patients. It helps to evaluate accessibility and quality of provided health care in the country. An important goal of the use of health care registers and information systems is for educational purposes and as causal expert systems for physicians. The National Health Registers have been introduced to the whole of the Czech Republic; some of them are accessible on-line in a countrywide data network. The last part of the paper focuses on research and education for developing the information society in Czech health care and on co-operation with EU countries in selected projects and initiatives. PMID:12453559

  7. An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats.

    PubMed

    Trigo, Jess Daniel; Martnez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Gnter; Garca, Jos

    2012-07-01

    This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility. PMID:22453644

  8. Healthcare fundamentals.

    PubMed

    Kauk, Justin; Hill, Austin D; Althausen, Peter L

    2014-07-01

    In order for a trauma surgeon to have an intelligent discussion with hospital administrators, healthcare plans, policymakers, or any other physicians, a basic understanding of the fundamentals of healthcare is paramount. It is truly shocking how many surgeons are unable to describe the difference between Medicare and Medicaid or describe how hospitals and physicians get paid. These topics may seem burdensome but they are vital to all business decision making in the healthcare field. The following chapter provides further insight about what we call "the basics" of providing medical care today. Most of the topics presented can be applied to all specialties of medicine. It is broken down into 5 sections. The first section is a brief overview of government programs, their influence on care delivery and reimbursement, and past and future legislation. Section 2 focuses on the compliance, care provision, and privacy statutes that regulate physicians who care for Medicare/Medicaid patient populations. With a better understanding of these obligations, section 3 discusses avenues by which physicians can stay informed of current and pending health policy and provides ways that they can become involved in shaping future legislation. The fourth section changes gears slightly by explaining how the concepts of trade restraint, libel, antitrust legislation, and indemnity relate to physician practice. The fifth, and final, section ties all of components together by describing how physician-hospital alignment can be mutually beneficial in providing patient care under current healthcare policy legislation. PMID:24918828

  9. 'Don't get caught out': pragmatic and discourse features of informational and promotional texts in international healthcare insurance.

    PubMed

    Solly, Martin

    2007-01-01

    This paper examines the pragmatic and discourse features of a number of multimodal international healthcare insurance texts. The texts contain specialized language related to the provision and treatment of healthcare and to insurance coverage and are aimed at a fairly well-defined target readership, many of them actual or potential expatriates. They thus serve a useful function, that of providing the readership with an informed and comprehensible guide to the services and products available. Some of them have a more strictly promotional aspect, that of advertising specific insurance policies. In particular, the paper focuses on the language choices favored by these texts and the strategies they serve, noting that the distinction between their informative and promotional dimensions is not always clear-cut. It further suggests that the writers of these texts make a specific use of discourse features and languaging strategies in order to achieve their rhetorical purposes. PMID:17714041

  10. Quantifying the Validity of Routine Neonatal Healthcare Data in the Greater Accra Region, Ghana

    PubMed Central

    Kayode, Gbenga A.; Amoakoh-Coleman, Mary; Brown-Davies, Charles; Grobbee, Diederick E.; Agyepong, Irene Akua; Ansah, Evelyn; Klipstein-Grobusch, Kerstin

    2014-01-01

    Objectives The District Health Information Management System2 (DHIMS2) is the database for storing health service data in Ghana, and similar to other low and middle income countries, paper-based data collection is being used by the Ghana Health Service. As the DHIMS-2 database has not been validated before this study aimed to evaluate its validity. Methods Seven out of ten districts in the Greater Accra Region were randomly sampled; the district hospital and a polyclinic in each district were recruited for validation. Seven pre-specified neonatal health indicators were considered for validation: antenatal registrants, deliveries, total births, live birth, stillbirth, low birthweight, and neonatal death. Data were extracted on these health indicators from the primary data (hospital paper-registers) recorded from January to March 2012. We examined all the data captured during this period as these data have been uploaded to the DHIMS-2 database. The differences between the values of the health indicators obtained from the primary data and that of the facility and DHIMS2 database were used to assess the accuracy of the database while its completeness was estimated by the percentage of missing data in the primary data. Results About 41,000 data were assessed and in almost all the districts, the error rates of the DHIMS-2 data were less than 2.1% while the percentages of missing data were below 2%. At the regional level, almost all the health indicators had an error rate below 1% while the overall error rate of the DHIMS-2 database was 0.68% (95% C I?=?0.610.75) and the percentage of missing data was 3.1% (95% C I?=?2.963.24). Conclusion This study demonstrated that the percentage of missing data in the DHIMS-2 database was negligible while its accuracy was close to the acceptable range for high quality data. PMID:25144222

  11. A rapid assessment of the quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania

    PubMed Central

    2012-01-01

    Background While child mortality is declining in Africa there has been no evidence of a comparable reduction in neonatal mortality. The quality of inpatient neonatal care is likely a contributing factor but data from resource limited settings are few. The objective of this study was to assess the quality of neonatal care in the district hospitals of the Kilimanjaro region of Tanzania. Methods Clinical records were reviewed for ill or premature neonates admitted to 13 inpatient health facilities in the Kilimanjaro region; staffing and equipment levels were also assessed. Results Among the 82 neonates reviewed, key health information was missing from a substantial proportion of records: on maternal antenatal cards, blood group was recorded for 52 (63.4%) mothers, Rhesus (Rh) factor for 39 (47.6%), VDRL for 59 (71.9%) and HIV status for 77 (93.1%). From neonatal clinical records, heart rate was recorded for3 (3.7%) neonates, respiratory rate in 14, (17.1%) and temperature in 33 (40.2%). None of 13 facilities had a functioning premature unit despite calculated gestational age <36 weeks in 45.6% of evaluated neonates. Intravenous fluids and oxygen were available in 9 out of 13 of facilities, while antibiotics and essential basic equipment were available in more than two thirds. Medication dosing errors were common; under-dosage for ampicillin, gentamicin and cloxacillin was found in 44.0%, 37.9% and 50% of cases, respectively, while over-dosage was found in 20.0%, 24.2% and 19.9%, respectively. Physician or assistant physician staffing levels by the WHO indicator levels (WISN) were generally low. Conclusion Key aspects of neonatal care were found to be poorly documented or incorrectly implemented in this appraisal of neonatal care in Kilimanjaro. Efforts towards quality assurance and enhanced motivation of staff may improve outcomes for this vulnerable group. PMID:23171226

  12. Can Italian Healthcare Administrative Databases Be Used to Compare Regions with Respect to Compliance with Standards of Care for Chronic Diseases?

    PubMed Central

    Gini, Rosa; Schuemie, Martijn J.; Francesconi, Paolo; Lapi, Francesco; Cricelli, Iacopo; Pasqua, Alessandro; Gallina, Pietro; Donato, Daniele; Brugaletta, Salvatore; Donatini, Andrea; Marini, Alessandro; Cricelli, Claudio; Damiani, Gianfranco; Bellentani, Mariadonata; van der Lei, Johan; Sturkenboom, Miriam C. J. M.; Klazinga, Niek S.

    2014-01-01

    Background Italy has a population of 60 million and a universal coverage single-payer healthcare system, which mandates collection of healthcare administrative data in a uniform fashion throughout the country. On the other hand, organization of the health system takes place at the regional level, and local initiatives generate natural experiments. This is happening in particular in primary care, due to the need to face the growing burden of chronic diseases. Health services research can compare and evaluate local initiatives on the basis of the common healthcare administrative data.However reliability of such data in this context needs to be assessed, especially when comparing different regions of the country. In this paper we investigated the validity of healthcare administrative databases to compute indicators of compliance with standards of care for diabetes, ischaemic heart disease (IHD) and heart failure (HF). Methods We compared indicators estimated from healthcare administrative data collected by Local Health Authorities in five Italian regions with corresponding estimates from clinical data collected by General Practitioners (GPs). Four indicators of diagnostic follow-up (two for diabetes, one for IHD and one for HF) and four indicators of appropriate therapy (two each for IHD and HF) were considered. Results Agreement between the two data sources was very good, except for indicators of laboratory diagnostic follow-up in one region and for the indicator of bioimaging diagnostic follow-up in all regions, where measurement with administrative data underestimated quality. Conclusion According to evidence presented in this study, estimating compliance with standards of care for diabetes, ischaemic heart disease and heart failure from healthcare databases is likely to produce reliable results, even though completeness of data on diagnostic procedures should be assessed first. Performing studies comparing regions using such indicators as outcomes is a promising development with potential to improve quality governance in the Italian healthcare system. PMID:24816637

  13. A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems

    PubMed Central

    Sittig, Dean F.; Singh, Hardeep

    2011-01-01

    Conceptual models have been developed to address challenges inherent in studying health information technology (HIT). This manuscript introduces an 8-dimensional model specifically designed to address the socio-technical challenges involved in design, development, implementation, use, and evaluation of HIT within complex adaptive healthcare systems. The 8 dimensions are not independent, sequential, or hierarchical, but rather are interdependent and interrelated concepts similar to compositions of other complex adaptive systems. Hardware and software computing infrastructure refers to equipment and software used to power, support, and operate clinical applications and devices. Clinical content refers to textual or numeric data and images that constitute the “language” of clinical applications. The human computer interface includes all aspects of the computer that users can see, touch, or hear as they interact with it. People refers to everyone who interacts in some way with the system, from developer to end-user, including potential patient-users. Workflow and communication are the processes or steps involved in assuring that patient care tasks are carried out effectively. Two additional dimensions of the model are internal organizational features (e.g., policies, procedures, and culture) and external rules and regulations, both of which may facilitate or constrain many aspects of the preceding dimensions. The final dimension is measurement and monitoring, which refers to the process of measuring and evaluating both intended and unintended consequences of HIT implementation and use. We illustrate how our model has been successfully applied in real-world complex adaptive settings to understand and improve HIT applications at various stages of development and implementation. PMID:20959322

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

    PubMed

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

    2014-08-11

    Direct out-of-pocket payments for healthcare continue to be a major source of health financing in low-income and middle-income countries. Some of these direct payments take the form of informal charges paid by patients to access the needed healthcare services. Remarkably, however, little is known about the extent to which these payments are exercised and their determinants in the context of Sub-Saharan Africa. This study attempts therefore to shed light on the role of supply-side factors in the occurrence of informal payments while accounting for the demand-side factors. The study relies on data taken from a nationally representative survey conducted among people living with HIV/AIDS in Cameroon. A multilevel mixed-effect logistic model is employed to identify the factors associated with the incidence of informal payments. Results reveal that circa 3.05% of the surveyed patients incurred informal payments for the consultations made on the day of the survey. The amount paid informally represents up to four times the official tariff. Factors related to the following: (i) human resource management of the health facilities (e.g., task shifting); (ii) health professionals' perceptions vis--vis the remunerations of HIV care provision; and (iii) reception of patients (e.g., waiting time) significantly influence the probability of incurring informal payments. Also of note, the type of healthcare facilities is found to play a role: informal payments appear to be significantly lower in private non-profit facilities compared with those belonging to public sector. Our findings allude to some policy recommendations that can help reduce the incidence of informal payments. Copyright 2014 John Wiley & Sons, Ltd. PMID:25130179

  15. Regional Information System: Feasibility Report. Final Report.

    ERIC Educational Resources Information Center

    Lower Pioneer Valley Regional Planning Commission, West Springfield, MA.

    A study was made of the feasibility of establishing a computerized regional information system. Existing systems were reviewed, and the location of the system was discussed. The system's structure was described. A cost benefit analysis looked into capital costs and operating costs. A cooperative system was found to be feasible, based on

  16. Tailoring Healthy Workplace Interventions to Local Healthcare Settings: A Complexity Theory-Informed Workplace of Well-Being Framework

    PubMed Central

    Brand, Sarah L.; Fleming, Lora E.; Wyatt, Katrina M.

    2015-01-01

    Many healthy workplace interventions have been developed for healthcare settings to address the consistently low scores of healthcare professionals on assessments of mental and physical well-being. Complex healthcare settings present challenges for the scale-up and spread of successful interventions from one setting to another. Despite general agreement regarding the importance of the local setting in affecting intervention success across different settings, there is no consensus on what it is about a local setting that needs to be taken into account to design healthy workplace interventions appropriate for different local settings. Complexity theory principles were used to understand a workplace as a complex adaptive system and to create a framework of eight domains (system characteristics) that affect the emergence of system-level behaviour. This Workplace of Well-being (WoW) framework is responsive and adaptive to local settings and allows a shared understanding of the enablers and barriers to behaviour change by capturing local information for each of the eight domains. We use the results of applying the WoW framework to one workplace, a UK National Health Service ward, to describe the utility of this approach in informing design of setting-appropriate healthy workplace interventions that create workplaces conducive to healthy behaviour change. PMID:26380358

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

    PubMed Central

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

    2016-01-01

    The integration of behavioral health services in primary care has been referred to in many ways, but ultimately refers to common structures and processes. Behavioral health is integrated into primary care because it increases the effectiveness and efficiency of providing care and reduces costs in the care of primary care patients. Reimbursement is one factor, if not the main factor, that determines the level of integration that can be achieved. The federal health reform agenda supports changes that will eventually permit behavioral health to be fully integrated and will allow the health of the population to be the primary target of intervention. In an effort to develop more integrated services at Baylor Scott and White Healthcare, models of integration are reviewed and the advantages and disadvantages of each model are discussed. Recommendations to increase integration include adopting a disease management model with care management, planned guideline-based stepped care, follow-up, and treatment monitoring. Population-based interventions can be completed at the pace of the development of alternative reimbursement methods. The program should be based upon patient-centered medical home standards, and research is needed throughout the program development process.

  18. [Centralized immunization schedules and regional equity of access: an audit among Apulian healthcare workers].

    PubMed

    Tafuri, S; Martinelli, D; Caputi, G; Fortunato, F; Germinario, C; Prato, R

    2009-01-01

    The reform of the Vth Title of the Italian Constitution has given the Regions autonomous power over planning of their immunization programme and immunization calendar. This amendment has federalized Italy's vaccination system and, is justified by epidemiological evidence however casts doubt on its provision of equal rights to health care. The objective of this current study is to gain insight into the opinion of vaccine services officers in the Apulia region on federal immunization and the regional immunization programme. Research was conducted using an anonymous standardized questionnaire to which 302 vaccines services staff responded. 67.4% of respondents believe that the current federal vaccination programme should be maintained, whilst 20.2% believe that the current system should be eradicated and 12.4% believe it should be phased out gradually. The current apulian vaccination calendar provides free and active immunizations for all newborns for the pneumococcal, meningitis C, chickenpox and hepatitis A vaccines. The interviewees believe that the vaccinations provided in the regional immunization programme are very important (average importance out of 10 = 6.1/7). The positive response to the regional vaccination plan given by the health officers explains, at least in part, the conservative attitude tewards federal vaccination plans. It cannot be excluded that sacrificing regional autonomy over vaccination programmes might be considered by the vaccination officers as being responsible for the abandonment of the Region's long established immunization practices. The success of these practices is evident in the case of the Region's Hepatitis A immunization programme where the active provision of this vaccine has drastically reduced the endemicity of the illness in Apulia. These experiences of good practice should be adequately considered in before opting to phase out the current immunisation programme. PMID:19653444

  19. Performance Comparison among the Major Healthcare Financing Systems in Six Cities of the Pearl River Delta Region, Mainland China

    PubMed Central

    Wong, Martin C. S.; Wang, Harry H. X.; Wong, Samuel Y. S.; Wei, Xiaolin; Yang, Nan; Zhang, Zhenzhen; Li, Haitao; Gao, Yang; Li, Donald K. T.; Tang, JinLing; Wang, Jiaji; Griffiths, Sian M.

    2012-01-01

    Background The healthcare system of mainland China is undergoing drastic reform and the optimal models for healthcare financing for provision of primary care will need to be identified. This study compared the performance indicators of the community health centres (CHCs) under different healthcare financing systems in the six cities of the Pearl River Delta region. Methods Approximately 300 hypertensive patients were randomly recruited from the computerized chronic disease management records provided by one CHC in each of the six cities in 2011 using a multi-stage cluster random sampling method. The major outcome measures included the treatment rate of hypertension, defined as prescription of ? one antihypertensive agent; and the control rate of hypertension, defined as systolic blood pressure levels <140 mmHg and diastolic blood pressure levels <90 mmHg in patients without diabetes mellitus, or <130/80 mmHg among patients with concomitant diabetes. Binary logistic regression analyses were conducted with these two measures as outcome variables, respectively, controlling for patients socio-demographic variables. The financing system (Hospital- vs. Government- vs. private-funded) was the independent variable tested for association with the outcomes. Results From 1,830 patients with an average age of 65.9 years (SD 12.8), the overall treatment and control rates were 75.4% and 20.2%, respectively. When compared with hospital-funded CHCs, patients seen in the Government-funded (adjusted odds ratio [AOR] 0.462, 95% C.I. 0.3250.656) and private-funded CHCs (AOR 0.031, 95% C.I. 0.0190.052) were significantly less likely to be prescribed antihypertensive medication. However, the Government-funded CHC was more likely to have optimal BP control (AOR 1.628, 95% C.I. 1.1572.291) whilst the privately-funded CHC was less likely to achieve BP control (AOR 0.146, 95% C.I. 0.0690.310), irrespective of whether antihypertensive drugs were prescribed. Conclusions Privately-funded CHCs had the lowest rates of BP treatment and control due to a variety of potential factors as discussed. PMID:23029474

  20. Improving quality of service of home healthcare units with health information technologies.

    PubMed

    Cegarra-Navarro, Juan Gabriel; Wensley, Anthony K P; Snchez-Polo, Maria Teresa

    2011-01-01

    Deployment of health information technologies (HITs) provides home care units with the means to generate improvements in accuracy and timeliness of information required to meet dynamic patient demands and provide high quality patient care. Increasing availability of information can also facilitate organisational learning, which leads to the invocation of processes that result in improved responses and decisions. This study examined crucial links between HITs and quality of service provided through an empirical investigation of 252 patients in a hospital-in-the-home unit (HHU) in a Spanish regional hospital. The study sought to test the relationship between HITs and the quality of service using factor analysis and structural equation modeling (SEM) to investigate how HITs mediate effects of organisational learning on quality of service. Findings support the notion that the relationship between organisational learning and quality of service can be mediated by HITs. This study provides HHU managers with guidelines for understanding the role of organisational learning processes with respect to HITs and quality of service. PMID:21712559

  1. Rural Veteran Access to Healthcare Services: Investigating the Role of Information and Communication Technologies in Overcoming Spatial Barriers

    PubMed Central

    Schooley, Benjamin L; Horan, Thomas A; Lee, Pamela W; West, Priscilla A

    2010-01-01

    This multimethod pilot study examined patient and practitioner perspectives on the influence of spatial barriers to healthcare access and the role of health information technology in overcoming these barriers. The study included a survey administered to patients attending a Department of Veterans Affairs (VA) health visit, and a focus group with VA care providers. Descriptive results and focus group findings are presented. Spatial distance is a significant factor for many rural veterans when seeking healthcare. For this sample of rural veterans, a range of telephone, computer, and Internet technologies may become more important for accessing care as Internet access becomes more ubiquitous and as younger veterans begin using the VA health system. The focus group highlighted the negative impact of distance, economic considerations, geographic barriers, and specific medical conditions on access to care. Lack of adequate technology infrastructure was seen as an obstacle to utilization. This study discusses the need to consider distance, travel modes, age, and information technology infrastructure and adoption when designing health information technology to care for rural patients. PMID:20697468

  2. Recommended Vaccines for Healthcare Workers

    MedlinePLUS

    ... or visit Healthmap Vaccine Finder . Recommended Vaccines for Healthcare Workers Recommend on Facebook Tweet Share Compartir On ... for More Information Resources for Those Vaccinating HCWs Healthcare workers (HCWs) are at risk for exposure to ...

  3. [How should health and healthcare priorities be set and evaluated? Prioritization methods and regional disparities. 2008 SESPAS Report].

    PubMed

    Snchez Martnez, Fernando I; Abelln Perpin, Jos Mara; Martnez Prez, Jorge E

    2008-04-01

    The conflict between scarce resources and unlimited needs is perhaps more prominent in the healthcare sector than in any other areas. Thus, setting priorities in health care emerges as an unavoidable task. The laudable aim of adopting any health technology that improves the population's health is impossible when confronted by budgetary constraints. Therefore, the outstanding health problems of a society and the most efficient health technologies in terms of their cost-effectiveness must be identified and patients must be prioritized, bearing in mind aspects of equity and efficiency. The present article reviews the issue of setting health care priorities by examining the experiences that have been put into practice in Spain and abroad. The problem is analyzed at three levels: the "macro" level (strategic planning, identification of higher priority areas and the selection of health care interventions); the "meso" level (incorporation of cost-effectiveness analyses into clinical practice guidelines), and the "micro" level (how to design priority systems for patients on waiting lists based on clinical and social criteria). In all these levels, there is substantial heterogeneity between Spanish regional health services, the steps that need to be taken and the ground that needs to be covered. Thus, we suggest that the first steps that some regional health services have made, together with international initiatives, could serve as a reference for the definitive incorporation of new approaches in priority setting in the Spanish health system as a whole. PMID:18405562

  4. The Views of Healthcare Professionals, Drug Developers and Regulators on Information about Older People Needed for Rational Drug Prescription

    PubMed Central

    Beers, Erna; Egberts, Toine C. G.; Leufkens, Hubert G. M.; Jansen, Paul A. F.

    2013-01-01

    Background The ICH E7 guideline intends to improve the knowledge about medicines in geriatric patients. As a legislative document, it might not reflect the needs of healthcare professionals. This study investigated what information healthcare professionals, regulatory agencies and pharmaceutical industries consider necessary for rational drug prescribing to older individuals. Methods and Findings A 29-item-questionnaire was composed, considering the representation in trials, pharmacokinetics, efficacy, safety, and convenience of use in older individuals, with space for additions. Forty-three European professionals with an interest in medication for older individuals were included. In order to investigate their relevance, five items were included in a second questionnaire, with 11 control items. Median scores, differences between clinical and non-clinical respondents and response consistency were analysed. Consistency was present in 10 control items. Therefore, all items of the first questionnaire and the five additional items were analysed. Thirty-seven (86%) respondents returned the first questionnaire; 31/37 (84%) the second. Information about age-related differences in adverse events, locomotor effects, drug-disease interactions, dosing instructions, and information about the proportion of included 65+ patients was considered necessary by most respondents. Clinicians considered information significantly more important than the non-clinical respondents about the inclusion of 75+, time-until-benefit in older people, anticholinergic effects, drug-disease interactions, and convenience of use. Main study limitations are the focus on information for daily practice, while the ICH E7 guideline is a legislative document focused on market approval of a new medicine. Also, a questionnaire with a Likert scale has its limitations; this was addressed by providing space for comments. Conclusions This study reveals that items considered necessary are currently not included in the ICH E7 guideline. Also, clinicians and non-clinicians opinions differed significantly in 15% of the items. Therefore, all stakeholders should collaborate to improve the availability of information for the rational prescribing to older individuals. PMID:23977208

  5. Healthcare decision-tools a growing Web trend: three-pronged public relations campaign heightens presence, recognition for online healthcare information provider.

    PubMed

    2006-01-01

    Schwartz Communications, LLC, executes a successful PR campaign to position Subimo, a provider of online healthcare decision tools, as a leader in the industry that touts names such as WebMD.com and HealthGrades.com. Through a three-pronged media relations strategy, Schwartz and Subimo together branded the company as an industry thought-leader. PMID:16509388

  6. Indigenous traditional medicine and intercultural healthcare in Bolivia: a case study from the Potosi region.

    PubMed

    Torri, Maria Costanza; Hollenberg, Daniel

    2013-01-01

    Indigenous peoples have the worst socio-demographic indicators and the largest inequalities in terms of access to social services and health in the Latin American region, Bolivia included. In the last few years, attempts to implement policies that support indigenous people's health rights led to the development of intercultural health approaches. Yet, acceptance and integration of indigenous medicine into the biomedical health system presents a major challenge to intercultural health in Latin America. The objective of this article is to analyze the case of a health center in Tinguipaya, one of the first and few examples of intercultural health initiatives in Bolivia. This intercultural health project, which represents a pioneer experience with regard to the creation of intercultural health services in Bolivia, aims to create a network between local communities, traditional healers, and biomedical staff and offer a more culturally sensitive and holistic health service for indigenous people living in the area. The aim of this article is to critically assess this initiative and to analyze the main challenges met in the creation of a more effective intercultural health policy. The extent to which this initiative succeeded in promoting the integration between indigenous health practitioners and biomedical staff as well as in improving access to health care for local indigenous patients will also be examined. PMID:24219641

  7. The contribution of interventional cardiology procedures to the population radiation dose in a 'health-care level I' representative region.

    PubMed

    Peruzzo Cornetto, Andrea; Aimonetto, Stefania; Pisano, Francesco; Giudice, Marcello; Sicuro, Marco; Meloni, Teodoro; Tofani, Santi

    2016-02-01

    This study evaluates per-procedure, collective and per capita effective dose to the population by interventional cardiology (IC) procedures performed during 2002-11 at the main hospital of Aosta Valley Region that can be considered as representative of the health-care level I countries, as defined by the UNSCEAR, based on its socio-demographic characteristics. IC procedures investigated were often multiple procedures in patients older than 60 y. The median extreme dose-area product values of 300 and 22 908 cGycm(2) were found for standard pacemaker implantation and coronary angioplasty, respectively, while the relative mean per-procedure effective dose ranged from 0.7 to 47 mSv. A 3-fold increase in frequency has been observed together with a correlated increase in the delivered per capita dose (0.05-0.27 mSv y(-1)) and the collective dose (5.8-35 man Sv y(-1)). Doses increased particularly from 2008 onwards mainly because of the introduction of coronary angioplasty procedures in the authors' institution. IC practice contributed remarkably in terms of effective dose to the population, delivering ?10 % of the total dose by medical ionising radiation examination categories. PMID:26012484

  8. Lean healthcare.

    PubMed

    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. PMID:18615998

  9. Patient views of adverse events: comparisons of self-reported healthcare staff attitudes with disclosure of accident information.

    PubMed

    Itoh, Kenji; Andersen, Henning Boje; Madsen, Marlene Dyrlv; stergaard, Doris; Ikeno, Masaaki

    2006-07-01

    In the present paper, we report results of surveys in 2003 in Japan and Denmark about patients' views about adverse events, focusing on the actions of healthcare staff involved in a medical accident. Results show that patients were more likely to indicate negative expectations to a doctor's reactions after a medical accident when asked in general terms than when asked in relation to concrete case stories. When asked in general terms, 66% (47%) of Japanese (Danish) respondents expected that doctors sometimes hold back on providing information to patients about a medical accident, while 37% (7%) did so when asked about a concrete, mild-outcome case. We examine some possible reasons for the relatively high level of distrust of Japanese patients, and we discuss whether the seemingly lower level of disclosure in Japan than in Denmark and the negative stories in the Japanese press may have an impact. We also suggest some implications for introducing a patient-centred or customer-centred approach to risk management in healthcare and other domains. PMID:16759631

  10. Primary health-care nurses and Internet health information-seeking: Access, barriers and quality checks.

    PubMed

    Gilmour, Jean; Strong, Alison; Chan, Helen; Hanna, Sue; Huntington, Annette

    2016-02-01

    Online information is a critical resource for evidence-based practice and patient education. This study aimed to establish New Zealand nurses' access and evaluation of online health information in the primary care context using a postal questionnaire survey; there were 630 respondents from a random sample of 931 nurses. The majority of respondents were satisfied with work access to online information (84.5%, n = 501) and searched for online information at least several times a week (57.5%, n = 343). The major barrier to online information seeking was insufficient time, but 68 respondents had no work online information access. The level of nursing qualification was significantly correlated with computer confidence and information quality checking. A range of information evaluation approaches was used. Most nurses in study accessed and evaluated Internet information in contrast to the findings of earlier studies, but there were barriers preventing universal integration into practice. PMID:25355072

  11. Characterization of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae from a healthcare region in Hong Kong.

    PubMed

    Ho, P L; Cheung, Y Y; Wang, Y; Lo, W U; Lai, E L Y; Chow, K H; Cheng, V C C

    2016-03-01

    Carbapenem-resistant Enterobacteriaceae represents a major public health issue. This study investigated the clonality and resistance mechanisms of 92 carbapenem-resistant E. coli (n = 21) and K. pneumoniae (n = 71) isolates collected consecutively from clinical specimens and patients at high risk of carriage between 2010 and 2012 in a healthcare region in Hong Kong. Combined disk tests (CDTs) and the Carba NP test were used for phenotypic detection of carbapenemases. PCR assays were used to detect carbapenemase genes. All isolates were intermediate or resistant to at least one carbapenem. Nine (9.8 %) isolates were genotypic carbapenemase producers and included six K. pneumoniae (one ST1306/bla IMP-4, one ST889/bla IMP-4, two ST11/bla KPC-2, one ST258/bla KPC-2, one ST483/bla NDM-1) and three E. coli (one ST131/bla IMP-4, two ST744/ bla NDM-1) isolates. All nine isolates carrying carbapenemase genes could be detected by the CDTs and the Carba NP test. PCR identified bla CTX-M and bla AmpC alone or in combination in 77.8 % (7/9) and 96.4 % (80/83) of the carbapenemase-producers and non-producers, respectively. Porin loss was detected in 22.2 % (2/9) and 59.0 % (49/83) of the carbapenemase-producers and non-producers, respectively. Overall, the E. coli clones were diverse (14 different STs), but 36.6 % (26/71) of the K. pneumoniae isolates belonged to ST11. In conclusion, the prevalence of carbapenemases among carbapenem-nonsusceptible E. coli and K. pneumoniae remained low in Hong Kong. Porin loss combined with AmpC and/or CTX-M type ESBL was the major mechanism of carbapenem resistance in the study population. PMID:26740321

  12. Training in Information Systems for Local and Regional Planning.

    ERIC Educational Resources Information Center

    Regional Development Dialogue, 1987

    1987-01-01

    This issue of Regional Development Dialogue contains selected papers presented at an expert meeting sponsored by the United Nations Centre for Regional Development on training in information systems for local and regional planning in developing countries. The following papers are included: (1) "Information System for Local and Regional Planning in

  13. Regional Logistics Information Resources Integration Patterns and Countermeasures

    NASA Astrophysics Data System (ADS)

    Wu, Hui; Shangguan, Xu-ming

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

  14. Assessment of impact of information booklets on use of healthcare services: randomised controlled trial

    PubMed Central

    Heaney, David; Wyke, Sally; Wilson, Philip; Elton, Rob; Rutledge, Philip

    2001-01-01

    Objectives To investigate the effect of patient information booklets on overall use of health services, on particular types of use, and on possible interactions between use, deprivation category of the area in which respondents live, and age. To investigate the possibility of a differential effect on health service use between two information booklets. Design Randomised controlled trial of two patient information booklets (covering the management and treatment of minor illness). Setting 20 general practices in Lothian, Scotland. Participants Random sample of patients from the community health index (n=4878) and of those contacting out of hours services (n=4530) in the previous 12 months in each of the study general practices. Intervention Booklets were posted to participants in intervention groups (3288 were sent What Should I Do?; 3127 were sent Health Care Manual). Patients randomised to control group (2993) did not receive a booklet. Main outcome measures Use of health services audited from patients' general practice notes in 12 months after receipt of booklet. Results Receipt of either booklet had no significant effect on health service use compared with a control group. However, nine out of ten matched practices allocated to receive Health Care Manual had reduced consultation rates compared with matched practices allocated to What Should I Do? Conclusion Widespread distribution of information booklets about the management of minor illness is unlikely to reduce demand for health services. What is already known on this topicOne view of help seeking behaviour is that increasing demand for health services is associated with a lack of knowledge in the self management of minor illnessAn alternative view sees individuals responding reflexively to symptoms on the basis of information and advice from a wide range of sources and using their own experiencesWhat this study addsThe lack of effect on health service use indicates that widespread postal distribution of information booklets about the management of minor illness is unlikely to reduce demand for health services PMID:11358776

  15. A Collaborative Knowledge Management Process for Implementing Healthcare Enterprise Information Systems

    NASA Astrophysics Data System (ADS)

    Cheng, Po-Hsun; Chen, Sao-Jie; Lai, Jin-Shin; Lai, Feipei

    This paper illustrates a feasible health informatics domain knowledge management process which helps gather useful technology information and reduce many knowledge misunderstandings among engineers who have participated in the IBM mainframe rightsizing project at National Taiwan University (NTU) Hospital. We design an asynchronously sharing mechanism to facilitate the knowledge transfer and our health informatics domain knowledge management process can be used to publish and retrieve documents dynamically. It effectively creates an acceptable discussion environment and even lessens the traditional meeting burden among development engineers. An overall description on the current software development status is presented. Then, the knowledge management implementation of health information systems is proposed.

  16. Regional Information System for Educators: Installation and Evaluation.

    ERIC Educational Resources Information Center

    Kromer, Charles

    This document describes the installation and evaluation of the Regional Information System within the Michigan-Ohio Regional Educational Laboratory (MOREL). MOREL is an agency established to develop and test alternatives to current educational practice under Title IV of ESEA. The Regional Information System was established to provide referrals to

  17. Embedding patients confidential data in ECG signal for healthcare information systems.

    PubMed

    Ibaida, Ayman; Khalil, Ibrahim; Al-Shammary, Dhiah

    2010-01-01

    In Wireless tele-cardiology applications, ECG signal is widely used to monitor cardiac activities of patients. Accordingly, in most e-health applications, ECG signals need to be combined with patient confidential information. Data hiding and watermarking techniques can play a crucial role in ECG wireless tele-monitoring systems by combining the confidential information with the ECG signal since digital ECG data is huge enough to act as host to carry tiny amount of additional secret data. In this paper, a new steganography technique is proposed that helps embed confidential information of patients into specific locations (called special range numbers) of digital ECG host signal that will cause minimal distortion to ECG, and at the same time, any secret information embedded is completely extractable. We show that there are 2.1475 10(9) possible special range numbers making it extremely difficult for intruders to identify locations of secret bits. Experiments show that percentage residual difference (PRD) of watermarked ECGs can be as low as 0.0247% and 0.0678% for normal and abnormal ECG segments (taken from MIT-BIH Arrhythmia database) respectively. PMID:21097076

  18. Incorporating Edge Information into Best Merge Region-Growing Segmentation

    NASA Technical Reports Server (NTRS)

    Tilton, James C.; Pasolli, Edoardo

    2014-01-01

    We have previously developed a best merge region-growing approach that integrates nonadjacent region object aggregation with the neighboring region merge process usually employed in region growing segmentation approaches. This approach has been named HSeg, because it provides a hierarchical set of image segmentation results. Up to this point, HSeg considered only global region feature information in the region growing decision process. We present here three new versions of HSeg that include local edge information into the region growing decision process at different levels of rigor. We then compare the effectiveness and processing times of these new versions HSeg with each other and with the original version of HSeg.

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

    PubMed

    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. PMID:23099762

  20. The ASTUTE Health study protocol: Deliberative stakeholder engagements to inform implementation approaches to healthcare disinvestment

    PubMed Central

    2012-01-01

    Background Governments and other payers are yet to determine optimal processes by which to review the safety, effectiveness, and cost-effectiveness of technologies and procedures that are in active use within health systems, and rescind funding (partially or fully) from those that display poor profiles against these parameters. To further progress a disinvestment agenda, a model is required to support payers in implementing disinvestment in a transparent manner that may withstand challenge from vested interests and concerned citizens. Combining approaches from health technology assessment and deliberative democratic theory, this project seeks to determine if and how wide stakeholder engagement can contribute to improved decision-making processes, wherein the views of both vested and non-vested stakeholders are seen to contribute to informing policy implementation within a disinvestment context. Methods/design Systematic reviews pertaining to illustrative case studies were developed and formed the evidence base for discussion. Review findings were presented at a series of deliberative, evidence-informed stakeholder engagements, including partisan (clinicians and consumers) and non-partisan (representative community members) stakeholders. Participants were actively facilitated towards identifying shared and dissenting perspectives regarding public funding policy for each of the case studies and developing their own funding models in response to the evidence presented. Policy advisors will subsequently be invited to evaluate disinvestment options based on the scientific and colloquial evidence presented to them, and to explore the value of this information to their decision-making processes with reference to disinvestment. Discussion Analysis of the varied outputs of the deliberative engagements will contribute to the methodological development around how to best integrate scientific and colloquial evidence for consideration by policy advisors. It may contribute to the legitimization of broad and transparent stakeholder engagement in this context. It is anticipated that decision making will benefit from the knowledge delivered through informed deliberation with engaged stakeholders, and this will be explored through interviews with key decision makers. PMID:23088222

  1. Wearable Sensors in Healthcare and Sensor-Enhanced Health Information Systems: All Our Tomorrows?

    PubMed Central

    Gietzelt, Matthias; Schulze, Mareike; Kohlmann, Martin; Song, Bianying; Wolf, Klaus-Hendrik

    2012-01-01

    Wearable sensor systems which allow for remote or self-monitoring of health-related parameters are regarded as one means to alleviate the consequences of demographic change. This paper aims to summarize current research in wearable sensors as well as in sensor-enhanced health information systems. Wearable sensor technologies are already advanced in terms of their technical capabilities and are frequently used for cardio-vascular monitoring. Epidemiologic predictions suggest that neuropsychiatric diseases will have a growing impact on our health systems and thus should be addressed more intensively. Two current project examples demonstrate the benefit of wearable sensor technologies: long-term, objective measurement under daily-life, unsupervised conditions. Finally, up-to-date approaches for the implementation of sensor-enhanced health information systems are outlined. Wearable sensors are an integral part of future pervasive, ubiquitous and person-centered health care delivery. Future challenges include their integration into sensor-enhanced health information systems and sound evaluation studies involving measures of workload reduction and costs. PMID:22844645

  2. Detailed Clinical Models: Representing Knowledge, Data and Semantics in Healthcare Information Technology

    PubMed Central

    2014-01-01

    Objectives This paper will present an overview of the developmental effort in harmonizing clinical knowledge modeling using the Detailed Clinical Models (DCMs), and will explain how it can contribute to the preservation of Electronic Health Records (EHR) data. Methods Clinical knowledge modeling is vital for the management and preservation of EHR and data. Such modeling provides common data elements and terminology binding with the intention of capturing and managing clinical information over time and location independent from technology. Any EHR data exchange without an agreed clinical knowledge modeling will potentially result in loss of information. Results Many attempts exist from the past to model clinical knowledge for the benefits of semantic interoperability using standardized data representation and common terminologies. The objective of each project is similar with respect to consistent representation of clinical data, using standardized terminologies, and an overall logical approach. However, the conceptual, logical, and the technical expressions are quite different in one clinical knowledge modeling approach versus another. There currently are synergies under the Clinical Information Modeling Initiative (CIMI) in order to create a harmonized reference model for clinical knowledge models. Conclusions The goal for the CIMI is to create a reference model and formalisms based on for instance the DCM (ISO/TS 13972), among other work. A global repository of DCMs may potentially be established in the future. PMID:25152829

  3. Implementation and management of a biomedical observation dictionary in a large healthcare information system

    PubMed Central

    Vandenbussche, Pierre-Yves; Cormont, Sylvie; André, Christophe; Daniel, Christel; Delahousse, Jean; Charlet, Jean; Lepage, Eric

    2013-01-01

    Objective This study shows the evolution of a biomedical observation dictionary within the Assistance Publique Hôpitaux Paris (AP-HP), the largest European university hospital group. The different steps are detailed as follows: the dictionary creation, the mapping to logical observation identifier names and codes (LOINC), the integration into a multiterminological management platform and, finally, the implementation in the health information system. Methods AP-HP decided to create a biomedical observation dictionary named AnaBio, to map it to LOINC and to maintain the mapping. A management platform based on methods used for knowledge engineering has been put in place. It aims at integrating AnaBio within the health information system and improving both the quality and stability of the dictionary. Results This new management platform is now active in AP-HP. The AnaBio dictionary is shared by 120 laboratories and currently includes 50 000 codes. The mapping implementation to LOINC reaches 40% of the AnaBio entries and uses 26% of LOINC records. The results of our work validate the choice made to develop a local dictionary aligned with LOINC. Discussion and Conclusions This work constitutes a first step towards a wider use of the platform. The next step will support the entire biomedical production chain, from the clinician prescription, through laboratory tests tracking in the laboratory information system to the communication of results and the use for decision support and biomedical research. In addition, the increase in the mapping implementation to LOINC ensures the interoperability allowing communication with other international health institutions. PMID:23635601

  4. Geographic information system-based healthcare waste management planning for treatment site location and optimal transportation routeing.

    PubMed

    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. PMID:22128092

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

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

    As VLSI technology has been improved, a smart card employing 32-bit processors has been released, and more personal information such as medical, financial data can be stored in the card. Thus, it becomes important to protect personal information stored in the card. Verification of the card holder's identity using a fingerprint has advantages over the present practices of Personal Identification Numbers (PINs) and passwords. However, the computational workload of fingerprint verification is much heavier than that of the typical PIN-based solution. In this paper, we consider three strategies to implement fingerprint verification in a smart card environment and how to distribute the modules of fingerprint verification between the smart card and the card reader. We first evaluate the number of instructions of each step of a typical fingerprint verification algorithm, and estimate the execution time of several cryptographic algorithms to guarantee the security/privacy of the fingerprint data transmitted in the smart card with the client-server environment. Based on the evaluation results, we analyze each scenario with respect to the security level and the real-time execution requirements in order to implement fingerprint verification in the smart card with the client-server environment.

  6. Improving healthcare practice behaviors.

    PubMed

    Van Fleet, David D; Peterson, Tim O

    2016-03-14

    Purpose - The purpose of this paper is to present the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients. Design/methodology/approach - The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups. Findings - The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities. Research limitations/implications - The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners' instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1997). Practical implications - With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers. Social implications - The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider. Originality/value - Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as to what are effective and ineffective behaviors in healthcare. PMID:26959895

  7. Listening to Those at the Frontline: Patient and Healthcare Personnel Perspectives on Tuberculosis Treatment Barriers and Facilitators in High TB Burden Regions of Argentina

    PubMed Central

    Iribarren, Sarah J.; Rubinstein, Fernando; Discacciati, Vilda; Pearce, Patricia F.

    2014-01-01

    Purpose. In Argentina, tuberculosis (TB) control measures have not achieved key treatment targets. The purpose of this study was to identify modes of treatment delivery and explore patient and healthcare personnel perceptions of barriers and facilitators to treatment success. Methods. We used semistructured group and individual interviews for this descriptive qualitative study. Eight high burden municipalities were purposively selected. Patients in treatment for active TB (n = 16), multidisciplinary TB team members (n = 26), and TB program directors (n = 12) at local, municipal, regional, and national levels were interviewed. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. Results. Modes of treatment delivery varied across municipalities and types of healthcare facility and were highly negotiated with patients. Self-administration of treatment was common in hospital-based and some community clinics. Barriers to TB treatment success were concentrated at the system level. This level relied heavily on individual personal commitment, and many system facilitators were operating in isolation or in limited settings. Conclusions. We outline experiences and perspectives of the facilitating and challenging factors at the individual, structural, social, and organizational levels. Establishing strong patient-healthcare personnel relationships, responding to patient needs, capitalizing on community resources, and maximizing established decentralized system could mitigate some of the barriers. PMID:25328701

  8. Service for the Pseudonymization of Electronic Healthcare Records Based on ISO/EN 13606 for the Secondary Use of Information.

    PubMed

    Somolinos, Roberto; Muoz, Adolfo; Hernando, M Elena; Pascual, Mario; Cceres, Jess; Snchez-de-Madariaga, Ricardo; Fragua, Juan A; Serrano, Pablo; Salvador, Carlos H

    2015-11-01

    The availability of electronic health data favors scientific advance through the creation of repositories for secondary use. Data anonymization is a mandatory step to comply with current legislation. A service for the pseudonymization of electronic healthcare record (EHR) extracts aimed at facilitating the exchange of clinical information for secondary use in compliance with legislation on data protection is presented. According to ISO/TS 25237, pseudonymization is a particular type of anonymization. This tool performs the anonymizations by maintaining three quasi-identifiers (gender, date of birth, and place of residence) with a degree of specification selected by the user. The developed system is based on the ISO/EN 13606 norm using its characteristics specifically favorable for anonymization. The service is made up of two independent modules: the demographic server and the pseudonymizing module. The demographic server supports the permanent storage of the demographic entities and the management of the identifiers. The pseudonymizing module anonymizes the ISO/EN 13606 extracts. The pseudonymizing process consists of four phases: the storage of the demographic information included in the extract, the substitution of the identifiers, the elimination of the demographic information of the extract, and the elimination of key data in free-text fields. The described pseudonymizing system was used in three telemedicine research projects with satisfactory results. A problem was detected with the type of data in a demographic data field and a proposal for modification was prepared for the group in charge of the drawing up and revision of the ISO/EN 13606 norm. PMID:25265637

  9. Can the right to health inform public health planning in developing countries? A case study for maternal healthcare from Indonesia

    PubMed Central

    D'Ambruoso, Lucia; Byass, Peter; Nurul Qomariyah, Siti

    2008-01-01

    Background Maternal mortality remains unacceptably high in developing countries despite international advocacy, development targets, and simple, affordable and effective interventions. In recent years, regard for maternal mortality as a human rights issue as well as one that pertains to health, has emerged. Objective We study a case of maternal death using a theoretical framework derived from the right to health to examine access to and quality of maternal healthcare. Our objective was to explore the potential of rights-based frameworks to inform public health planning from a human rights perspective. Design Information was elicited as part of a verbal autopsy survey investigating maternal deaths in rural settings in Indonesia. The deceased's relatives were interviewed to collect information on medical signs, symptoms and the social, cultural and health systems circumstances surrounding the death. Results In this case, a prolonged, severe fever and a complicated series of referrals culminated in the death of a 19-year-old primagravida at 7 months gestation. The cause of death was acute infection. The woman encountered a range of barriers to access; behavioural, socio-cultural, geographic and economic. Several serious health system failures were also apparent. The theoretical framework derived from the right to health identified that none of the essential elements of the right were upheld. Conclusion The rights-based approach could identify how and where to improve services. However, there are fundamental and inherent conflicts between the public health tradition (collective and preventative) and the right to health (individualistic and curative). As a result, and in practice, the right to health is likely to be ineffective for public health planning from a human rights perspective. Collective rights such as the right to development may provide a more suitable means to achieve equity and social justice in health planning. PMID:20027244

  10. Development and implementation of an information management and information technology strategy for improving healthcare services: a case study.

    PubMed

    Memel, D S; Scott, J P; McMillan, D R; Easton, S M; Donelson, S M; Campbell, G; Sheehan, M; Ewing, T N

    2001-01-01

    PeaceHealth is a multistate, not-for-profit integrated delivery network that owns and operates five acute care hospitals, one critical access hospital, and twenty-five outpatient clinics. PeaceHealth employs approximately two hundred physicians and seventy allied health professionals; it has relationships with one thousand affiliated physicians. In 1990, PeaceHealth developed a set of strategic priorities for delivering seamless care across the continuum, and creating partnerships between caregivers and patient-consumers. A major component of these strategies was development and implementation of the technology, knowledge, organizational, and community infrastructures that would support delivering and using high-quality, timely information when and where it is needed for effective clinical, operational, and financial decision making. Executing this strategy has resulted in implementation of standard enterprisewide information systems, including a computer-based patient record system in inpatient and outpatient settings, tactical and strategic decision support systems, a well-developed intranet and access to the Internet, and a knowledgeable workforce that have enabled PeaceHealth to support and improve its services and business by bringing interactive information directly to patients, caregivers, managers, directors, and executives. This case study discusses the drivers behind the development of this strategy, specific components of the information management and information technology infrastructure, examples of the impact they have had on patients, caregivers, and the organization, and lessons learned. PMID:11642144

  11. Original approach to the individual characteristics associated with forgone healthcare: a study in underprivileged areas, Paris region, France, 2001-2003.

    PubMed Central

    Chauvin, Pierre; Bazin, Fabienne; Parizot, Isabelle

    2005-01-01

    Background The social inequalities in health have endured or even worsened comparatively throughout different social groups since the 1990s. Our objective was to identify the individual characteristics (socio-economic status, living conditions, individuals social integration, health beliefs, expectations and representation, and psychological characteristics) statistically associated with the fact of stating (or not) that healthcare had been forgone because of cost. Methods In this cross-sectional, multi-centre study we randomly selected a study sample from five underprivileged areas in the Paris region. A multiple logistic regression model was used to calculate the odds ratios (OR) and 95% CI. The validity of the model was assessed by goodness-of-fit tests (Pearson and deviance) and by the study of 100 bootstrap samples. Results After making adjustments for numerous individual socio-economic and health characteristics, we observed a higher occurrence of reported forgone healthcare among people who have had financial worries during adulthood (ORyes/no = 5.47 [1.4420.75]), a life-course experience of physical, sexual or psychological abuse (ORyes/no = 2.86 [1.405.84]); who have experienced childhood difficulties (OR1/never difficulties = 5.28 [1.8115.39], OR24/never = 7.62 [2.6921.57], OR>4/never = 8.57 [2.3930.80]); who have expressed a low degree of sickness orientation ORlows/high = 2.62 [1.335.14]), a high worry/concern about health (ORhigh/low = 2.71 [1.335.50]) and a low self-esteem (ORmedium/high = 8.28 [1.4447.64], ORlow/high = 16.44 [2.8196.24]). Conclusion Aside from purely financial hurdles, other factors play a role in the non-use of healthcare services. Health policies mainly promoting equal financial access to healthcare have little chance of abating health inequalities. PMID:15975951

  12. Enhancements in healthcare information technology systems: customizing vendor-supplied clinical decision support for a high-risk patient population

    PubMed Central

    Tiwari, Ruchi; Tsapepas, Demetra S; Powell, Jaclyn T

    2013-01-01

    Healthcare organizations continue to adopt information technologies with clinical decision support (CDS) to prevent potential medication-related adverse drug events. End-users who are unfamiliar with certain high-risk patient populations are at an increased risk of unknowingly causing medication errors. The following case describes a heart transplant recipient exposed to supra-therapeutic concentrations of tacrolimus during co-administration of ritonavir as a result of vendor supplied CDS tools that omitted an interaction alert. After review of 4692 potential tacrolimus-based DDIs between 329 different drug pairs supplied by vendor CDS, the severity of 20 DDIs were downgraded and the severity of 62 were upgraded. The need for institution-specific customization of vendor-provided CDS is paramount to ensure avoidance of medication errors. Individualized care will become more important as patient populations and institutions become more specialized. In the future, vendors providing integrated CDS tools must be proactive in developing institution-specific and easily customizable CDS tools. PMID:22813760

  13. LIS-lnterlink-connecting laboratory information systems to remote primary health-care centres via the Internet.

    PubMed

    Clark, B; Wachowiak, B; Crawford, E W; Jakubowski, Z; Kabata, J

    1998-01-01

    A pilot study was performed to evaluate the feasibility of using the Internet to securely deliver patient laboratory results, and the system has subsequently gone into routine use in Poland. The system went from design to pilot and then to live implementation within a four-month period, resulting in the LIS-Interlink software product. Test results are retrieved at regular intervals from the BioLink(TM) LIS (Laboratory Information System), encrypted and transferred to a secure area on the Web server. The primary health-care centres dial into the Internet using a local-cell service provided by Polish Telecom (TP), obtain a TCP/IP address using the TP DHCP server, and perform HTTP 'get' and 'post' operations to obtain the files by secure handshaking. The data are then automatically inserted into a local SQL database (with optional printing of incoming reports)for cumulative reporting and searching functions. The local database is fully multi-user and can be accessed from different clinics within the centres by a variety of networking protocols. PMID:18924820

  14. Serving homeless Veterans in the VA Desert Pacific Healthcare Network: A needs assessment to inform quality improvement endeavors

    PubMed Central

    Gabrielian, Sonya; Yuan, Anita; Rubenstein, Lisa; Andersen, Ronald M.; Gelberg, Lillian

    2016-01-01

    This report describes a needs assessment of VA programs for homeless Veterans in Southern California and Nevada, the geographic region with the most homeless Veterans in the nation. The assessment was formulated through key informant interviews. Current service provisions are discussed, along with salient unmet needs for this vulnerable population. PMID:23974403

  15. Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide

    PubMed Central

    2013-01-01

    Background Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse analytic approaches, but there has been very little systematic reviewing of this evidence. Methods We developed an approach to reviewing evidence from conversation analytic and related discursive research through the following procedures: • reviewing existing systematic review methods and our own prior experience of applying these • clarifying distinctive features of conversation analytic and related discursive work which must be taken into account when reviewing • holding discussions within a review advisory team that included members with expertise in healthcare research, conversation analytic research, and systematic reviewing • attempting and then refining procedures through conducting an actual review which examined evidence about how people talk about difficult future issues including illness progression and dying Results We produced a step-by-step guide which we describe here in terms of eight stages, and which we illustrate from our ‘Review of Future Talk’. The guide incorporates both established procedures for systematic reviewing, and new techniques designed for working with conversation analytic evidence. Conclusions The guide is designed to inform systematic reviews of conversation analytic and related discursive evidence on specific domains and topics. Whilst we designed it for reviews that aim at informing healthcare practice and policy, it is flexible and could be used for reviews with other aims, for instance those aiming to underpin research programmes and projects. We advocate systematically reviewing conversation analytic and related discursive findings using this approach in order to translate them into a form that is credible and useful to healthcare practitioners, educators and policy-makers. PMID:23721181

  16. The need for consistency in healthcare reporting.

    PubMed

    Duis, T E

    1993-07-01

    Different authoritative accounting and reporting guidelines apply within the healthcare industry. The issue at hand is whether or not the current accounting and reporting framework adequately addresses the needs of those with interests in healthcare financial information. PMID:10145838

  17. Informal m-health: How are young people using mobile phones to bridge healthcare gaps in Sub-Saharan Africa?

    PubMed

    Hampshire, Kate; Porter, Gina; Owusu, Samuel Asiedu; Mariwah, Simon; Abane, Albert; Robson, Elsbeth; Munthali, Alister; DeLannoy, Ariane; Bango, Andisiwe; Gunguluza, Nwabisa; Milner, James

    2015-10-01

    The African communications 'revolution' has generated optimism that mobile phones might help overcome infrastructural barriers to healthcare provision in resource-poor contexts. However, while formal m-health programmes remain limited in coverage and scope, young people are using mobile phones creatively and strategically in an attempt to secure effective healthcare. Drawing on qualitative and quantitative data collected in 2012-2014 from over 4500 young people (aged 8-25 y) in Ghana, Malawi and South Africa, this paper documents these practices and the new therapeutic opportunities they create, alongside the constraints, contingencies and risks. We argue that young people are endeavouring to lay claim to a digitally-mediated form of therapeutic citizenship, but that a lack of appropriate resources, social networks and skills ('digital capital'), combined with ongoing shortcomings in healthcare delivery, can compromise their ability to do this effectively. The paper concludes by offering tentative suggestions for remedying this situation. PMID:26298645

  18. Characteristics of healthcare wastes

    SciTech Connect

    Diaz, L.F. Eggerth, L.L.; Enkhtsetseg, Sh.; Savage, G.M.

    2008-07-01

    A comprehensive understanding of the quantities and characteristics of the material that needs to be managed is one of the most basic steps in the development of a plan for solid waste management. In this case, the material under consideration is the solid waste generated in healthcare facilities, also known as healthcare waste. Unfortunately, limited reliable information is available in the open literature on the quantities and characteristics of the various types of wastes that are generated in healthcare facilities. Thus, sound management of these wastes, particularly in developing countries, often is problematic. This article provides information on the quantities and properties of healthcare wastes in various types of facilities located in developing countries, as well as in some industrialized countries. Most of the information has been obtained from the open literature, although some information has been collected by the authors and from reports available to the authors. Only data collected within approximately the last 15 years and using prescribed methodologies are presented. The range of hospital waste generation (both infectious and mixed solid waste fractions) varies from 0.016 to 3.23 kg/bed-day. The relatively wide variation is due to the fact that some of the facilities surveyed in Ulaanbaatar include out-patient services and district health clinics; these facilities essentially provide very basic services and thus the quantities of waste generated are relatively small. On the other hand, the reported amount of infectious (clinical, yellow bag) waste varied from 0.01 to 0.65 kg/bed-day. The characteristics of the components of healthcare wastes, such as the bulk density and the calorific value, have substantial variability. This literature review and the associated attempt at a comparative analysis point to the need for worldwide consensus on the terms and characteristics that describe wastes from healthcare facilities. Such a consensus would greatly facilitate comparative analyses among different facilities, studies and countries.

  19. Characteristics of healthcare wastes.

    PubMed

    Diaz, L F; Eggerth, L L; Enkhtsetseg, Sh; Savage, G M

    2008-01-01

    A comprehensive understanding of the quantities and characteristics of the material that needs to be managed is one of the most basic steps in the development of a plan for solid waste management. In this case, the material under consideration is the solid waste generated in healthcare facilities, also known as healthcare waste. Unfortunately, limited reliable information is available in the open literature on the quantities and characteristics of the various types of wastes that are generated in healthcare facilities. Thus, sound management of these wastes, particularly in developing countries, often is problematic. This article provides information on the quantities and properties of healthcare wastes in various types of facilities located in developing countries, as well as in some industrialized countries. Most of the information has been obtained from the open literature, although some information has been collected by the authors and from reports available to the authors. Only data collected within approximately the last 15 years and using prescribed methodologies are presented. The range of hospital waste generation (both infectious and mixed solid waste fractions) varies from 0.016 to 3.23kg/bed-day. The relatively wide variation is due to the fact that some of the facilities surveyed in Ulaanbaatar include out-patient services and district health clinics; these facilities essentially provide very basic services and thus the quantities of waste generated are relatively small. On the other hand, the reported amount of infectious (clinical, yellow bag) waste varied from 0.01 to 0.65kg/bed-day. The characteristics of the components of healthcare wastes, such as the bulk density and the calorific value, have substantial variability. This literature review and the associated attempt at a comparative analysis point to the need for worldwide consensus on the terms and characteristics that describe wastes from healthcare facilities. Such a consensus would greatly facilitate comparative analyses among different facilities, studies and countries. PMID:17651963

  20. Applying GIS technology to the Regional Information Sharing Systems database

    NASA Astrophysics Data System (ADS)

    Aumond, Karen L.

    1997-02-01

    The Regional Information Sharing Systems (RISS) program was formed as a partnership for information exchange between the federal government and state and local law enforcement. The six regional projects provide member law enforcement agencies in all 50 states with a broad range of intelligence and investigative support services. Recently, the existing RISS databases were redesigned to allow for connectivity among projects and the capability of a nationwide search of over 450,000 suspects. This relational database of intelligence information, along with a photographic imaging system, an operational `critical event' database, and GIS mapping are integrated components of RISSNET. The Geographical-Regional Information Sharing System (G-RISS) application is being prototypes by Graphic Data Systems Corporation at one RISS site, the Western States Information Network in Sacramento, California. G-RISS is a tool that will combine information from various law enforcement resources, map criminal activities to detect trends and assist agencies by being proactive to combat these activities.

  1. Information Resources; A Searcher's Manual. MOREL Regional Information System for Educators.

    ERIC Educational Resources Information Center

    Grimes, George; Doyle, James

    This document is one of a series describing the background, functions, and utilization of the Regional Information System (RIS) developed by the Michigan-Ohio Regional Educational Laboratory (MOREL). The purpose of this manual is to detail a procedure for performing a productive search of information resources which can satisfy the informational

  2. Building the Partners HealthCare Biobank at Partners Personalized Medicine: Informed Consent, Return of Research Results, Recruitment Lessons and Operational Considerations.

    PubMed

    Karlson, Elizabeth W; Boutin, Natalie T; Hoffnagle, Alison G; Allen, Nicole L

    2016-01-01

    The Partners HealthCare Biobank is a Partners HealthCare enterprise-wide initiative whose goal is to provide a foundation for the next generation of translational research studies of genotype, environment, gene-environment interaction, biomarker and family history associations with disease phenotypes. The Biobank has leveraged in-person and electronic recruitment methods to enroll >30,000 subjects as of October 2015 at two academic medical centers in Partners HealthCare since launching in 2010. Through a close collaboration with the Partners Human Research Committee, the Biobank has developed a comprehensive informed consent process that addresses key patient concerns, including privacy and the return of research results. Lessons learned include the need for careful consideration of ethical issues, attention to the educational content of electronic media, the importance of patient authentication in electronic informed consent, the need for highly secure IT infrastructure and management of communications and the importance of flexible recruitment modalities and processes dependent on the clinical setting for recruitment. PMID:26784234

  3. Open source clinical portals: a model for healthcare information systems to support care processes and feed clinical research. An Italian case of design, development, reuse, and exploitation.

    PubMed

    Locatelli, Paolo; Baj, Emanuele; Restifo, Nicola; Origgi, Gianni; Bragagia, Silvia

    2011-01-01

    Open source is a still unexploited chance for healthcare organizations and technology providers to answer to a growing demand for innovation and to join economical benefits with a new way of managing hospital information systems. This chapter will present the case of the web enterprise clinical portal developed in Italy by Niguarda Hospital in Milan with the support of Fondazione Politecnico di Milano, to enable a paperless environment for clinical and administrative activities in the ward. This represents also one rare case of open source technology and reuse in the healthcare sector, as the system's porting is now taking place at Besta Neurological Institute in Milan. This institute is customizing the portal to feed researchers with structured clinical data collected in its portal's patient records, so that they can be analyzed, e.g., through business intelligence tools. Both organizational and clinical advantages are investigated, from process monitoring, to semantic data structuring, to recognition of common patterns in care processes. PMID:21431608

  4. RHIOs--build in healthcare fraud management from the beginning.

    PubMed

    Hanson, Susan P; Cassidy, Bonnie S

    2006-01-01

    This article presents the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology's field-based research on the use of Health Information Technology to Advance and Expand Healthcare Anti-Fraud Activities.' The authors of this article directed and performed this research under contract to the Foundation of Research and Education of AHIMA. There is a tremendous potential to reduce healthcare fraud and achieve substantial financial benefits using a nationwide health information network with interoperable electronic health records. To achieve these benefits, there must be interoperability among providers and between providers and payers. The article will provide recommendations for regional health information organizations to incorporate healthcare fraud management in their early designs. PMID:16903660

  5. Healthcare Software Assurance

    PubMed Central

    Cooper, Jason G.; Pauley, Keith A.

    2006-01-01

    Software assurance is a rigorous, lifecycle phase-independent set of activities which ensure completeness, safety, and reliability of software processes and products. This is accomplished by guaranteeing conformance to all requirements, standards, procedures, and regulations. These assurance processes are even more important when coupled with healthcare software systems, embedded software in medical instrumentation, and other healthcare-oriented life-critical systems. The current Food and Drug Administration (FDA) regulatory requirements and guidance documentation do not address certain aspects of complete software assurance activities. In addition, the FDAs software oversight processes require enhancement to include increasingly complex healthcare systems such as Hospital Information Systems (HIS). The importance of complete software assurance is introduced, current regulatory requirements and guidance discussed, and the necessity for enhancements to the current processes shall be highlighted. PMID:17238324

  6. NASIC: A Regional Experiment in the Brokerage of Information Services.

    ERIC Educational Resources Information Center

    Wax, David M.; Morrison, R. D., Jr.

    The Northeast Academic Science Information Center (NASIC), a program of the New England Board of Higher Education which was initially funded by the National Science Foundation, represents an attempt to apply on a regional basis the concept of brokerage or wholesaling to the provision of computer-based information services. The center expects to be…

  7. CARETS: An experimental regional information system using ERTS data

    NASA Technical Reports Server (NTRS)

    Alexander, R. H.

    1974-01-01

    The U. S. Geological Survey CARETS (Central Atlantic Regional Ecological Test Site)/ERTS investigation is testing the applicability of ERTS data as input to an environmental information system for a multi-state mid-Atlantic region surrounding the Chesapeake and Delaware Bays. The information system framework encompasses a flow of information through several stages from sensor to user, and involving evaluation and feedback from several potential users. Basic assumptions of the CARETS project model are that there is a measurable environmental impact associated with land use and land use change as determined with remote sensor data, and that the ERTS derived land use data sets, when properly calibrated, may thus provide regional planners and administrators with a shortcut to an understanding of the environmental changes that are going on in their regions.

  8. Design of surface-water data networks for regional information

    USGS Publications Warehouse

    Moss, Marshall E.; Gilroy, E.J.; Tasker, Gary D.; Karlinger, M.R.

    1982-01-01

    This report describes a technique, Network Analysis of Regional Information (NARI), and the existing computer procedures that have been developed for the specification of the regional information-cost relation for several statistical parameters of streamflow. The measure of information used is the true standard error of estimate of a regional logarithmic regression. The cost is a function of the number of stations at which hydrologic data are collected and the number of years for which the data are collected. The technique can be used to obtain either (1) a minimum cost network that will attain a prespecified accuracy and reliability or (2) a network that maximizes information given a set of budgetary and time constraints.

  9. Scaling Health and Healthcare: Re-Presenting Thailand's HIV/AIDS Epidemic with World Regional Geography Students

    ERIC Educational Resources Information Center

    Del Casino Jr, Vincent

    2004-01-01

    Authors of world regional geography textbooks have recently become more interested in the broader theoretical changes that have emerged in human geography. Relying on feminist and other critical perspectives, concepts such as space, place and scale are being re-imagined in this 'new world regional geography'. This paper intervenes on behalf of a

  10. Role of data warehousing in healthcare epidemiology.

    PubMed

    Wyllie, D; Davies, J

    2015-04-01

    Electronic storage of healthcare data, including individual-level risk factors for both infectious and other diseases, is increasing. These data can be integrated at hospital, regional and national levels. Data sources that contain risk factor and outcome information for a wide range of conditions offer the potential for efficient epidemiological analysis of multiple diseases. Opportunities may also arise for monitoring healthcare processes. Integrating diverse data sources presents epidemiological, practical, and ethical challenges. For example, diagnostic criteria, outcome definitions, and ascertainment methods may differ across the data sources. Data volumes may be very large, requiring sophisticated computing technology. Given the large populations involved, perhaps the most challenging aspect is how informed consent can be obtained for the development of integrated databases, particularly when it is not easy to demonstrate their potential. In this article, we discuss some of the ups and downs of recent projects as well as the potential of data warehousing for antimicrobial resistance monitoring. PMID:25737091

  11. Addressing healthcare.

    PubMed

    Daly, Rich

    2013-02-11

    Though President Barack Obama has rarely made healthcare references in his State of the Union addresses, health policy experts are hoping he changes that strategy this year. "The question is: Will he say anything? You would hope that he would, given that that was the major issue he started his presidency with," says Dr. James Weinstein, left, of the Dartmouth-Hitchcock health system. PMID:23487896

  12. Objective identification of informative wavelength regions in galaxy spectra

    SciTech Connect

    Yip, Ching-Wa; Szalay, Alexander S.; Budavri, Tams; Wyse, Rosemary F. G.; Mahoney, Michael W.; Csabai, Istvn; Dobos, Laszlo E-mail: szalay@jhu.edu

    2014-05-01

    Understanding the diversity in spectra is the key to determining the physical parameters of galaxies. The optical spectra of galaxies are highly convoluted with continuum and lines that are potentially sensitive to different physical parameters. Defining the wavelength regions of interest is therefore an important question. In this work, we identify informative wavelength regions in a single-burst stellar population model using the CUR Matrix Decomposition. Simulating the Lick/IDS spectrograph configuration, we recover the widely used D {sub n}(4000), H?, and H? {sub A} to be most informative. Simulating the Sloan Digital Sky Survey spectrograph configuration with a wavelength range 3450-8350 and a model-limited spectral resolution of 3 , the most informative regions are: first regionthe 4000 break and the H? line; second regionthe Fe-like indices; third regionthe H? line; and fourth regionthe G band and the H? line. A principal component analysis on the first region shows that the first eigenspectrum tells primarily the stellar age, the second eigenspectrum is related to the age-metallicity degeneracy, and the third eigenspectrum shows an anti-correlation between the strengths of the Balmer and the Ca K and H absorptions. The regions can be used to determine the stellar age and metallicity in early-type galaxies that have solar abundance ratios, no dust, and a single-burst star formation history. The region identification method can be applied to any set of spectra of the user's interest, so that we eliminate the need for a common, fixed-resolution index system. We discuss future directions in extending the current analysis to late-type galaxies. ASCII formatted tables of the regional eigenspectra are available.

  13. Establishing the Information System: An Operational Handbook. MOREL Regional Information System for Educators.

    ERIC Educational Resources Information Center

    Kromer, Charles; Doyle, James

    This document is one of a series describing the background, functions, and utilization of the Regional Information System (RIS), developed by the Michigan-Ohio Regional Educational Laboratory (MOREL). RIS, which was developed to improve the accessibility of information for the educational practitioner, is described in this handbook. The handbook

  14. Economic evaluations of healthcare programmes and decision making: the influence of economic evaluations on different healthcare decision-making levels.

    PubMed

    van Velden, Marieke E; Severens, Johan L; Novak, Annoesjka

    2005-01-01

    Given the potential role of economic information in healthcare decision making, it is of interest to assess its influence on decisions at a national or regional level (macro level), at a healthcare facility level (meso level) and at the healthcare provider level (micro level). This literature review summarises 36 empirical studies that examined the influence of economic evaluations on these three healthcare decision-making levels. Economic evaluations are considered useful and important; however, their direct influence on decision making (instrumental use) is moderate, especially at the macro and micro levels. A major influence was observed at the meso level, leading to the conclusion that economic evaluations have the most pronounced influence on decision making within healthcare organisations. However, unexpectedly, our literature search did not reveal an empirical study analysing the considerable influence of economic evaluations on decisions by the National Institute of Health and Clinical Excellence in the UK. Our findings indicate that results of economic evaluations cannot be considered the dominant decision criterion for healthcare decision makers at either the macro, meso or micro levels. Enlightenment use (where scientific evidence provides a background of information, ideas and concepts that affect the way policy makers view problems and solutions) of economic evaluations in decision making remains to be proven. PMID:16277545

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

    PubMed Central

    Park, Young-Taek

    2015-01-01

    Objectives Many countries try to efficiently deliver high quality healthcare services at lower and manageable costs where healthcare information and communication technologies (ICT) standardisation may play an important role. New Zealand provides a good model of healthcare ICT standardisation. The purpose of this study was to review the current healthcare ICT standardisation and progress in New Zealand. Methods This study reviewed the reports regarding the healthcare ICT standardisation in New Zealand. We also investigated relevant websites related with the healthcare ICT standards, most of which were run by the government. Then, we summarised the governance structure, standardisation processes, and their output regarding the current healthcare ICT standards status of New Zealand. Results New Zealand government bodies have established a set of healthcare ICT standards and clear guidelines and procedures for healthcare ICT standardisation. Government has actively participated in various enactments of healthcare ICT standards from the inception of ideas to their eventual retirement. Great achievements in eHealth have already been realized, and various standards are currently utilised at all levels of healthcare regionally and nationally. Standard clinical terminologies, such as International Classification of Diseases (ICD) and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) have been adopted and Health Level Seven (HL7) standards are actively used in health information exchanges. Conclusions The government to New Zealand has well organised ICT institutions, guidelines, and regulations, as well as various programs, such as e-Medications and integrated care services. Local district health boards directly running hospitals have effectively adopted various new ICT standards. They might already be benefiting from improved efficiency resulting from healthcare ICT standardisation. PMID:26279950

  16. ASIS healthcare security benchmarking study.

    PubMed

    2001-01-01

    Effective security has aligned itself into the everyday operations of a healthcare organization. This is evident in every regional market segment, regardless of size, location, and provider clinical expertise or organizational growth. This research addresses key security issues from an acute care provider to freestanding facilities, from rural hospitals and community hospitals to large urban teaching hospitals. Security issues and concerns are identified and addressed daily by senior and middle management. As provider campuses become larger and more diverse, the hospitals surveyed have identified critical changes and improvements that are proposed or pending. Mitigating liabilities and improving patient, visitor, and/or employee safety are consequential to the performance and viability of all healthcare providers. Healthcare organizations have identified the requirement to compete for patient volume and revenue. The facility that can deliver high-quality healthcare in a comfortable, safe, secure, and efficient atmosphere will have a significant competitive advantage over a facility where patient or visitor security and safety is deficient. Continuing changes in healthcare organizations' operating structure and healthcare geographic layout mean changes in leadership and direction. These changes have led to higher levels of corporate responsibility. As a result, each organization participating in this benchmark study has added value and will derive value for the overall benefit of the healthcare providers throughout the nation. This study provides a better understanding of how the fundamental security needs of security in healthcare organizations are being addressed and its solutions identified and implemented. PMID:11602980

  17. Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory

    PubMed Central

    Smith, Neale; Mitton, Craig; Dowling, Laura; Hiltz, Mary-Ann; Campbell, Matthew; Gujar, Shashi Ashok

    2016-01-01

    Background: In this article, we analyze one case instance of how proposals for change to the priority setting and resource allocation (PSRA) processes at a Canadian healthcare institution reached the decision agenda of the organization’s senior leadership. We adopt key concepts from an established policy studies framework – Kingdon’s multiple streams theory – to inform our analysis. Methods: Twenty-six individual interviews were conducted at the IWK Health Centre in Halifax, NS, Canada. Participants were asked to reflect upon the reasons leading up to the implementation of a formal priority setting process – Program Budgeting and Marginal Analysis (PBMA) – in the 2012/2013 fiscal year. Responses were analyzed qualitatively using Kingdon’s model as a template. Results: The introduction of PBMA can be understood as the opening of a policy window. A problem stream – defined as lack of broad engagement and information sharing across service lines in past practice – converged with a known policy solution, PBMA, which addressed the identified problems and was perceived as easy to use and with an evidence-base from past applications across Canada and elsewhere. Conditions in the political realm allowed for this intervention to proceed, but also constrained its potential outcomes. Conclusion: Understanding in a theoretically-informed way how change occurs in healthcare management practices can provide useful lessons to researchers and decision-makers whose aim is to help health systems achieve the most effective use of available financial resources PMID:26673646

  18. Regional regression of flood characteristics employing historical information

    USGS Publications Warehouse

    Tasker, Gary D.; Stedinger, J.R.

    1987-01-01

    Streamflow gauging networks provide hydrologic information for use in estimating the parameters of regional regression models. The regional regression models can be used to estimate flood statistics, such as the 100 yr peak, at ungauged sites as functions of drainage basin characteristics. A recent innovation in regional regression is the use of a generalized least squares (GLS) estimator that accounts for unequal station record lengths and sample cross correlation among the flows. However, this technique does not account for historical flood information. A method is proposed here to adjust this generalized least squares estimator to account for possible information about historical floods available at some stations in a region. The historical information is assumed to be in the form of observations of all peaks above a threshold during a long period outside the systematic record period. A Monte Carlo simulation experiment was performed to compare the GLS estimator adjusted for historical floods with the unadjusted GLS estimator and the ordinary least squares estimator. Results indicate that using the GLS estimator adjusted for historical information significantly improves the regression model. ?? 1987.

  19. Regional Industry Workforce Development: The Gulf Coast Petrochemical Information Network

    ERIC Educational Resources Information Center

    Hodgin, Johnette; Muha, Susan

    2008-01-01

    The Gulf Coast Petrochemical Information Network (GC-PIN) is a workforce development partnership among industry businesses and area institutions of higher education in the four-county Gulf Coast region. GC-PIN partners develop new industry-specific curricula, foster industry career awareness, and retrain existing employees in new technologies.

  20. Putting E-government to work in healthcare environment: a multiregional project funded by the Italian Innovation & Technology Ministry.

    PubMed

    Ballardini, Luigi; Germagnoli, Fabio; Pagani, Marco; Picchi, Marco; Stoppini, Andrea; Cristiani, Paolo

    2004-01-01

    In 2002, the Italian Ministry of Innovation promoted a national bid for e-government projects. Specifically it allocated a budget of 120 M euro. One of the four project approved in healthcare sector was the "Information, Care ("Assistenza" in Italian) and healthcare Education by the Web" (IAEW), with a global budget of 2580 k euro, partially financed by Ministry with a quota of 830 k euro. The project involves 12 medical structures (both national excellences centers and local regional hospitals) located in two different Region of North Italy, dealing with two different healthcare regional systems (Lombardia and Emilia-Romagna), with potentially 3 millions of users. PMID:15360997

  1. Building an IT healthcare enterprise by taking the standards to the limits and sometimes beyond that

    NASA Astrophysics Data System (ADS)

    Wintell, Mikael; Lindskld, Lars; Gustafsson, Staffan; da Silva, Nino

    2006-03-01

    This paper describes a regional approach to build a healthcare infrastructure beginning with radiology for all radiological information from 17 different radiology clinics in different geographic locations throughout the Vastra Gotalands region in the western part of Sweden. The focus will be to use healthcare standards to make this infrastructure work between different vendors of expert system for the healthcare. Many of the standards and initiatives such as IHE, HL7, DICOM, kith-XML, VG-XML and more are providing solution to part or whole of the different needs and possibilities in healthcare today. One of the key things is that this solution also handles the conversion of reports and other applicable data from proprietary RIS format or HL7 2.5 to XML to SR object, which it stores on the large-scale archive provided by the main contractor. The project tries to achieve an IT Healthcare Enterprise based on the IHE approach. The producers of the healthcare information stored in the central archive are forced to follow the information model, created by the region (technical framework), based on the worldwide standards data models DICOM and HL7. Opportunities for changing in work roles and work practices are also mentioned. These changes influence communication, information and work flow and create new possibilities and new risks for the user of this infrastructure.

  2. 76 FR 41763 - Proposed Information Collection; Comment Request; Alaska Region Logbook Family of Forms

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... Region Logbook Family of Forms AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce... currently approved information collection. National Marine Fisheries Service (NMFS) Alaska Region manages... Alaska Region requests information from participating groundfish participants. This information,...

  3. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

    PubMed

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-02-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

  4. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

    PubMed Central

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-01-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

  5. Development and evaluation of information resources for patients, families, and healthcare providers addressing behavioral and cognitive sequelae among adults with a primary brain tumor.

    PubMed

    Wright, Kylie M; Simpson, Grahame K; Koh, Eng-Siew; Whiting, Diane L; Gillett, Lauren; Simpson, Teresa; Firth, Rochelle

    2015-06-01

    Behavioral and cognitive changes in patients with primary brain tumor (PBT) are common and may be distressing to patients and their family members. Healthcare professionals report a strong need for information, practical strategies, and training to assist consumers and better address management issues. A literature review by the current project found that 53% of the information resources currently available to consumers and health professionals contained minimal or no information about cognitive/behavioral changes after PBT, and 71% of the resources contained minimal or no information on associated strategies to manage these changes. This project aimed to develop an information resource for patients, carers, and health professionals addressing the behavioral and cognitive sequelae of PBT, including strategies to minimize the disabling impact of such behaviors. In consultation with staff and patient groups, 16 key information topics were identified covering cognitive and communication changes and challenging behaviors including executive impairment, behavioral disturbance, and social/emotional dysfunction. Sixteen fact sheets and 11 additional resource sheets were developed and evaluated according to established consumer communication guidelines. Preliminary data show that these resources have been positively received and well utilized. These sheets are the first of their kind addressing challenging behaviors in the neuro-oncology patient group and are a practical and useful information resource for health professionals working with these patients and their families. The new resource assists in reinforcing interventions provided to individual patients and their relatives who are experiencing difficulties in managing challenging behaviors after PBT. PMID:25827649

  6. Reforming healthcare systems on a locally integrated basis: is there a potential for increasing collaborations in primary healthcare?

    PubMed Central

    2013-01-01

    Background Over the past decade, in the province of Quebec, Canada, the government has initiated two consecutive reforms. These have created a new type of primary healthcare family medicine groups (FMGs) and have established 95 geographically defined local health networks (LHNs) across the province. A key goal of these reforms was to improve collaboration among healthcare organizations. The objective of the paper is to analyze the impact of these reforms on the development of collaborations among primary healthcare practices and between these organisations and hospitals both within and outside administrative boundaries of the local health networks. Methods We surveyed 297 primary healthcare practices in 23 LHNs in Quebecs two most populated regions (Montreal & Monteregie) in 2005 and 2010. We characterized collaborations by measuring primary healthcare practices formal or informal arrangements among themselves or with hospitals for different activities. These collaborations were measured based on the percentage of clinics that identified at least one collaborative activity with another organization within or outside of their local health network. We created measures of collaboration for different types of primary healthcare practices: first- and second-generation FMGs, network clinics, local community services centres (CLSCs) and private medical clinics. We compared their situations in 2005 and in 2010 to observe their evolution. Results Our results showed different patterns of evolution in inter-organizational collaboration among different types of primary healthcare practices. The local health network reform appears to have had an impact on territorializing collaborations firstly by significantly reducing collaborations outside LHNs areas for all types of primary healthcare practices, including new type of primary healthcare and CLSCs, and secondly by improving collaborations among healthcare organizations within LHNs areas for all organizations. This is with the exception of private medical clinics, where collaborations decreased both outside and within LHNs. Conclusion Health system reforms aimed at creating geographically based networks influenced primary healthcare practices both among themselves (horizontal collaborations) and with hospitals (vertical collaborations). There is evidence of increased collaborations within defined geographic areas, particularly among new type of primary healthcare. PMID:23835105

  7. Demanding healthcare.

    PubMed

    Mark, A; Pencheon, D; Elliott, R

    2000-01-01

    This paper describes and compares the development of strategies to manage demand in healthcare in the UK and the USA. It suggests that the development is revealing the need to include disciplines other than the traditional ones of economics and public health if its effects are to be understood. Using as an example the growth of telephone help lines and telephone triage, based on computer based decision support systems, it explores the idea of increasing choice and alleviating fear as a way of reducing demand. Organizational behaviour and consumer behaviour can provide wider understanding of these issues, particularly as they relate to the emotional aspects of this activity. Some convergence of the UK and USA approaches and outcomes are identified but demand is revealed as a relatively unexplored territory in the management of health care in both countries. PMID:11184656

  8. Barriers to evidence-based decision making among Polish healthcare managers.

    PubMed

    Niedźwiedzka, B M

    2003-05-01

    The 1999 reform of the Polish healthcare system revealed deficiencies in the research base and a lack of organized systems of information provision. Professionals who most need effective information systems are policymakers and healthcare managers. The main aim of the described study was to obtain data describing the needs, preferences and limitations of healthcare managers as information users, and to identify environmental factors influencing their information behaviour. A national postal survey was conducted and supplemented with information collected during focus groups, semi-structured interviews and through analysis of relevant policy documents. The target population included hospital chief executives, medical directors, head nurses and directors of the institutions responsible for health services planning and purchasing. Target institutions were drawn systematically from official lists, stratified by regions of the country and hospital reference level. The interviews were conducted with primary care unit managers and with Ministry of Health officials. National health strategy and directives, cost-effectiveness analyses of interventions and clinical practice guidelines emerged as information of primary importance to respondents. The main barriers to effective information behaviour were found to be: attitudes towards research activity, lack of appropriately processed data, lack of skills enabling information seeking and appraisal, inappropriate format of publications, ineffective dissemination of information and absence of services facilitating access to evidence. The current information environment of healthcare managers, together with their attitude towards information and deficiencies in information skills, appear to serve as a barrier to evidence-based practice in the Polish healthcare system. PMID:12803950

  9. Information Content of Aerosol Retrievals in the Sunglint Region

    NASA Technical Reports Server (NTRS)

    Ottaviani, M.; Knobelspiesse, K.; Cairns, B.; Mishchenko, M.

    2013-01-01

    We exploit quantitative metrics to investigate the information content in retrievals of atmospheric aerosol parameters (with a focus on single-scattering albedo), contained in multi-angle and multi-spectral measurements with sufficient dynamical range in the sunglint region. The simulations are performed for two classes of maritime aerosols with optical and microphysical properties compiled from measurements of the Aerosol Robotic Network. The information content is assessed using the inverse formalism and is compared to that deriving from observations not affected by sunglint. We find that there indeed is additional information in measurements containing sunglint, not just for single-scattering albedo, but also for aerosol optical thickness and the complex refractive index of the fine aerosol size mode, although the amount of additional information varies with aerosol type.

  10. Web-based Service Portal in Healthcare

    NASA Astrophysics Data System (ADS)

    Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

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

  11. Migrants' access to healthcare.

    PubMed

    Norredam, Marie

    2011-10-01

    There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were used to explore differences: 1) cancer stage at diagnosis as a clinical outcome and 2) emergency room (ER) contacts as a utilisation measure. Both informal and formal barriers to access were studied to explore why possible differences existed including: 1) motivation for using ER; and 2) asylum seekers' healthcare entitlements. Different definitions of migration and ethnicity were investigated including: country of birth and residence status. Substudy I showed a tendency towards more advanced stage at diagnosis or unknown stage among most subgroups of migrant women with a history of cancer compared to non-migrant women. Sub-study II found that some migrants (those born in Somalia, Turkey and Ex-Yugoslavia) use ER services more frequently than do non-migrants whereas others have the same or lower utilisation levels. As a consequence, substudy III was undertaken, which documented that more migrant within all subgroups had considered contacting a primary caregiver before visiting the ER compared to non-migrants, but that migrants experienced communication problems herein. Additionally, more migrants had irrelevant ER visits as evaluated by caregivers. Substudy IV addressed formal and informal barriers to access and screening. According to the law asylum seekers are entitled to emergency care only in 10 out of 24 countries. Medical screening was carried out in all but one of the 24 EU countries; however, the content and extent of screening programmes vary. The thesis aimed to explore if there are differences in migrants' access to healthcare compared to that of non-migrants. Differences in utilisation and clinical outcome were identified between migrants and non-migrants. Reasons why disparities exist were also identified in relation to communication with primary care and on policy level. The thesis shows that various perspectives and scientific problems are important to get a full understanding of the process of access to healthcare for different migrant groups. Moreover, various complementary methodological approaches are needed when studying problems of migrants' access to healthcare. PMID:21975158

  12. Healthcare and the Hospital Chaplain

    PubMed Central

    Loewy, Roberta Springer; Loewy, Erich H.

    2007-01-01

    Many chaplains and most chaplaincy programs in the United States with encouragement from their accrediting organization, the Association for Clinical Pastoral Education (ACPE) have begun to assume a more proactive stance toward patients, healthcare professionals, and healthcare facilities. Some chaplains and chaplaincy programs have begun to engage in activities that have ranged from initiating conversations with and perusing the medical records of patients who have not requested their services to proposing that they be permitted to do spiritual assessments on patients in some instances whether these patients have been explicitly informed and have agreed to this beforehand. Moreover, many chaplains and chaplaincy programs have begun to assume that chaplains are full-fledged members of the healthcare team, complete with access to patients' medical records both to gather information and to make notations of their own. It would appear that such novel activities are being justified by a questionable set of claims and assumptions that includes: (1) the claim that chaplains have a spiritual as opposed to purely religious expertise that entitles them to interact with patients and/or significant others (even those who have not requested a chaplain) presumably without in the least compromising patient autonomy or the confidentiality of the patient/healthcare professional relationship; (2) the assumption that the terms spirituality and religiosity mutually entail one another; (3) the claim that the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) mandates spiritual assessments (which it does not); (4) the assumption that chaplains are full-fledged members of the healthcare team; and (5) the claim that chaplains must, therefore, be permitted access to patients and patients' medical records both to gather information and to make notations of their own. We consider such claims and assumptions disquieting, and suggest that it is high time we revisit the terms chaplaincy, healthcare professional, and member of the healthcare team in reassessing what our professional commitments to respect and protect the bio-psycho-social integrity of patients require. PMID:17435653

  13. Implementing a regional oncology information system: approach and lessons learned

    PubMed Central

    Evans, W.K.; Ashbury, F.D.; Hogue, G.L.; Smith, A.; Pun, J.

    2014-01-01

    Rationale Paper-based medical record systems are known to have major problems of inaccuracy, incomplete data, poor accessibility, and challenges to patient confidentiality. They are also an inefficient mechanism of record-sharing for interdisciplinary patient assessment and management, and represent a major problem for keeping current and monitoring quality control to facilitate improvement. To address those concerns, national, regional, and local health care authorities have increased the pressure on oncology practices to upgrade from paper-based systems to electronic health records. Objectives Here, we describe and discuss the challenges to implementing a region-wide oncology information system across four independent health care organizations, and we describe the lessons learned from the initial phases that are now being applied in subsequent activities of this complex project. Results The need for change must be shared across centres to increase buy-in, adoption, and implementation. It is essential to establish physician leadership, commitment, and engagement in the process. Work processes had to be revised to optimize use of the new system. Culture change must be included in the change management strategy. Furthermore, training and resource requirements must be thoroughly planned, implemented, monitored, and modified as required for effective adoption of new work processes and technology. Interfaces must be established with multiple existing electronic systems across the region to ensure appropriate patient flow. Periodic assessment of the existing project structure is necessary, and adjustments are often required to ensure that the project meets its objectives. Conclusions The implementation of region-wide oncology information systems across different health practice locations has many challenges. Leadership is essential. A strong, collaborative information-sharing strategy across the region and with the supplier is essential to identify, discuss, and resolve implementation problems. A structure that supports project management and accountability contributes to success. PMID:25302031

  14. Occupational deaths among healthcare workers.

    PubMed

    Sepkowitz, Kent A; Eisenberg, Leon

    2005-07-01

    Recent experiences with severe acute respiratory syndrome and the US smallpox vaccination program have demonstrated the vulnerability of healthcare workers to occupationally acquired infectious diseases. However, despite acknowledgment of risk, the occupational death rate for healthcare workers is unknown. In contrast, the death rate for other professions with occupational risk, such as police officer or firefighter, has been well defined. With available information from federal sources and calculating the additional number of deaths from infection by using data on prevalence and natural history, we estimate the annual death rate for healthcare workers from occupational events, including infection, is 17-57 per 1 million workers. However, a much more accurate estimate of risk is needed. Such information could inform future interventions, as was seen with the introduction of safer needle products. This information would also heighten public awareness of this often minimized but essential aspect of patient care. PMID:16022771

  15. Business process modeling in healthcare.

    PubMed

    Ruiz, Francisco; Garcia, Felix; Calahorra, Luis; Llorente, Csar; Gonalves, Luis; Daniel, Christel; Blobel, Bernd

    2012-01-01

    The importance of the process point of view is not restricted to a specific enterprise sector. In the field of health, as a result of the nature of the service offered, health institutions' processes are also the basis for decision making which is focused on achieving their objective of providing quality medical assistance. In this chapter the application of business process modelling - using the Business Process Modelling Notation (BPMN) standard is described. Main challenges of business process modelling in healthcare are the definition of healthcare processes, the multi-disciplinary nature of healthcare, the flexibility and variability of the activities involved in health care processes, the need of interoperability between multiple information systems, and the continuous updating of scientific knowledge in healthcare. PMID:22925789

  16. Region merging techniques using information theory statistical measures.

    PubMed

    Calderero, Felipe; Marques, Ferran

    2010-06-01

    The purpose of the current work is to propose, under a statistical framework, a family of unsupervised region merging techniques providing a set of the most relevant region-based explanations of an image at different levels of analysis. These techniques are characterized by general and nonparametric region models, with neither color nor texture homogeneity assumptions, and a set of innovative merging criteria, based on information theory statistical measures. The scale consistency of the partitions is assured through i) a size regularization term into the merging criteria and a classical merging order, or ii) using a novel scale-based merging order to avoid the region size homogeneity imposed by the use of a size regularization term. Moreover, a partition significance index is defined to automatically determine the subset of most representative partitions from the created hierarchy. Most significant automatically extracted partitions show the ability to represent the semantic content of the image from a human point of view. Finally, a complete and exhaustive evaluation of the proposed techniques is performed, using not only different databases for the two main addressed problems (object-oriented segmentation of generic images and texture image segmentation), but also specific evaluation features in each case: under- and oversegmentation error, and a large set of region-based, pixel-based and error consistency indicators, respectively. Results are promising, outperforming in most indicators both object-oriented and texture state-of-the-art segmentation techniques. PMID:20215082

  17. A qualitative study of healthcare provider awareness and informational needs regarding the nine-valent HPV vaccine.

    PubMed

    Kasting, Monica L; Wilson, Shannon; Dixon, Brian E; Downs, Stephen M; Kulkarni, Amit; Zimet, Gregory D

    2016-03-01

    The 9-valent Human Papillomavirus (HPV) vaccine, 9vHPV, was licensed in the U.S. in December, 2014. We assessed healthcare provider (HCP) awareness of the newly approved vaccine and identified questions HCPs have about the vaccine. As part of a larger study, we used semi-structured interviews to ask 22 pediatric HCPs about their awareness of 9vHPV, questions they have about the vaccine, and questions they anticipate from patients and parents. Interviews were audio-recorded and transcribed then analyzed using inductive content analysis. Over half were aware of the vaccine but few HCPs claimed to be familiar with it. HCPs indicated several questions with common themes pertaining to efficacy, side effects, and cost. Only half of HCPs believed patients or parents would have questions. The results suggest strategies and areas for health systems and public health organizations to target in order to resolve unmet educational needs among HCPs regarding 9vHPV. PMID:26859240

  18. Management demands on information and communication technology in process-oriented health-care organizations: the importance of understanding managers' expectations during early phases of systems design.

    PubMed

    Andersson, Anna; Vimarlund, Vivian; Timpka, Toomas

    2002-01-01

    There are numerous challenges to overcome before information and communication technology (ICT) can achieve its full potential in process-oriented health-care organizations. One of these challenges is designing systems that meet users' needs, while reflecting a continuously changing organizational environment. Another challenge is to develop ICT that supports both the internal and the external stakeholders' demands. In this study a qualitative research strategy was used to explore the demands on ICT expressed by managers from functional and process units at a community hospitaL The results reveal a multitude of partially competing goals that can make the ICT development process confusing, poor in quality, inefficient and unnecessarily costly. Therefore, from the perspective of ICT development, the main task appears to be to coordinate the different visions and in particular clarify them, as well as to establish the impact that these visions would have on the forthcoming ICT application. PMID:12211342

  19. Information support for health information management in regional Sri Lanka: health managers' perspectives.

    PubMed

    Ranasinghe, Kaduruwane Indika; Chan, Taizan; Yaralagadda, Prasad

    2012-01-01

    Good management, supported by accurate, timely and reliable health information, is vital for increasing the effectiveness of Health Information Systems (HIS). When it comes to managing the under-resourced health systems of developing countries, information-based decision making is particularly important. This paper reports findings of a self-report survey that investigated perceptions of local health managers (HMs) of their own regional HIS in Sri Lanka. Data were collected through a validated, pre-tested postal questionnaire, and distributed among a selected group of HMs to elicit their perceptions of the current HIS in relation to information generation, acquisition and use, required reforms to the information system and application of information and communication technology (ICT). Results based on descriptive statistics indicated that the regional HIS was poorly organised and in need of reform; that management support for the system was unsatisfactory in terms of relevance, accuracy, timeliness and accessibility; that political pressure and community and donor requests took precedence over vital health information when management decisions were made; and use of ICT was unsatisfactory. HIS strengths included user-friendly paper formats, a centralised planning system and an efficient disease notification system; weaknesses were lack of comprehensiveness, inaccuracy, and lack of a feedback system. Responses of participants indicated that HIS would be improved by adopting an internationally accepted framework and introducing ICT applications. Perceived barriers to such improvements were high initial cost of educating staff to improve computer literacy, introduction of ICTs, and HIS restructure. We concluded that the regional HIS of Central Province, Sri Lanka had failed to provide much-needed information support to HMs. These findings are consistent with similar research in other developing countries and reinforce the need for further research to verify causes of poor performance and to design strategic reforms to improve HIS in regional Sri Lanka. PMID:23087080

  20. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    PubMed

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications. PMID:18430292

  1. 75 FR 41877 - Insured Healthcare Facilities 232 Loan Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Insured Healthcare Facilities 232 Loan Application AGENCY: Office of the Chief... also lists the following information: Title of Proposal: Insured Healthcare Facilities 232...

  2. Home Healthcare Workers: How to Prevent Latex Allergies

    MedlinePLUS

    ... can help prevent allergic reactions for both home healthcare workers and their clients. LATEX EXPOSURE REACTIONS Three ... being used). • Inform your employer and your personal healthcare professionals that you have latex allergy. • Wear a ...

  3. 75 FR 16821 - Insured Healthcare Facilities 232 Loan Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Insured Healthcare Facilities 232 Loan Application AGENCY: Office of the Chief... lists the following information: Title of Proposal: Insured Healthcare Facilities 232 Loan...

  4. Electronic Health Records and Information Portability: A Pilot Study in a Rural Primary Healthcare Center in India

    PubMed Central

    Radhakrishna, Kedar; Goud, B. Ramakrishna; Kasthuri, Arvind; Waghmare, Abijeet; Raj, Tony

    2014-01-01

    Clinical documentation and health information portability pose unique challenges in urban and rural areas of India. This article presents findings of a pilot study conducted in a primary health center in rural India. In this article, we focus on primary care in rural India and how a portable health record system could facilitate the availability of medical information at the point of care. We followed a geriatric cohort and a maternal cohort of 308 participants over a nine-month period. Physician encounters were entered into a web-based electronic health record. This information was made available to all study participants through a short messaging service (SMS). Additionally, 135 randomly selected participants from the cohort were issued a USB-based memory card that contained their detailed health records and could be viewed on most computers. The dual portability model implemented in the pilot study demonstrates the utility of the concept. PMID:25214819

  5. Central Atlantic Regional Ecological Test Site (CARETS): A prototype regional environmental information system

    NASA Technical Reports Server (NTRS)

    Alexander, R. H. (Principal Investigator)

    1973-01-01

    The author has identified the following significant results. Accomplishments have included: (1) completion of the research design for the USGS/CARETS demonstration project; (2) preparation of photomossics and land use maps at a scale of 1:100,000 for entire area; (3) demonstration of the feasibility of extracting several categories of land use information from ERTS-1 MSS data for a portion of the CARETS region; (4) demonstration of the feasibility of detecting some significant land use changes on ERTS-1 imagery; (5) demonstration of the feasibility of attaching environmental impact significance to the remote sensor-derived land use data; (6) delivery of land use information derived from high altitude aircraft data to the Maryland state planning agency for use in its statewide land use inventory; (7) demonstration of high interest by other use groups in the test region in products and services provided by investigation; and (8) determination of the viability of setting up a computerized geographic information system as part of the CARETS investigation, to facilitate handling of sensor-derived land use data in a variety of formats to suit user requirements.

  6. Regional Information System for Educators. Information Resources; Installation and Evaluation; Information Services; An Operational Handbook; Proceedings of the American Society for Information Science, Vol. 6, 1969. (five documents)

    ERIC Educational Resources Information Center

    Grimes, George; And Others

    A series of four pamphlets which describe the Regional Information System (RIS) of the Michigan-Ohio Regional Educational Laboratory (MOREL), a system designed to provide an effective, systematic methodology for linking users with relevant resources, compose the major portion of this information package. Each publication details an aspect of the

  7. Big Data and Analytics in Healthcare.

    PubMed

    Tan, S S-L; Gao, G; Koch, S

    2015-01-01

    This editorial is part of the Focus Theme of Methods of Information in Medicine on "Big Data and Analytics in Healthcare". The amount of data being generated in the healthcare industry is growing at a rapid rate. This has generated immense interest in leveraging the availability of healthcare data (and "big data") to improve health outcomes and reduce costs. However, the nature of healthcare data, and especially big data, presents unique challenges in processing and analyzing big data in healthcare. This Focus Theme aims to disseminate some novel approaches to address these challenges. More specifically, approaches ranging from efficient methods of processing large clinical data to predictive models that could generate better predictions from healthcare data are presented. PMID:26577624

  8. Integrating Healthcare Ethical Issues into IS Education

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  9. Integrating Healthcare Ethical Issues into IS Education

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  10. Could Mycobacterium leprae Infection Be an Occupational Disease? A Survey in Healthcare Workers From an Endemic Area in the Amazonian Region.

    PubMed

    Pacheco, Sara Eleny; Bhrer-Skula, Samira; de Moura, Rodrigo Scaliante; Stefani, Mariane Martins; Oliveira, Maria Leide W; Saraceni, Valeria; Cordeiro-Santos, Marcelo

    2015-12-01

    A serologic survey was conducted to evaluate the prevalence of Mycobacterium leprae infection among healthcare workers and associated factors. Of 280 workers, 26 (9.3%) were positive using immunoglobulin M serology for PGL-I M. leprae antigen. Exposure to leprosy patients in the workplace was significantly associated with seropositivity (P=.044). PMID:26456726

  11. Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature

    PubMed Central

    2014-01-01

    To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data. PMID:25050084

  12. A wearable context aware system for ubiquitous healthcare.

    PubMed

    Kang, Dong-Oh; Lee, Hyung-Jik; Ko, Eun-Jung; Kang, Kyuchang; Lee, Jeunwoo

    2006-01-01

    Recent developments of information technologies are leading the advent of the era of ubiquitous healthcare, which means healthcare services at any time and at any places. The ubiquitous healthcare service needs a wearable system for more continual measurement of biological signals of a user, which gives information of the user from wearable sensors. In this paper, we propose a wearable context aware system for ubiquitous healthcare, and its systematic design process of a ubiquitous healthcare service. Some wearable sensor systems are introduced with Zigbee communication. We develop a context aware framework to send information from wearable sensors to healthcare service entities as a middleware to solve the interoperability problem between sensor makers and healthcare service providers. And, we propose a systematic process of design of ubiquitous healthcare services with the context aware framework. In order to show the feasibility of the proposed system, some application examples are given, which are applied to remote monitoring, and a self check service. PMID:17947132

  13. GEOHARP Potential Synergies with Region Based Information Retrieval (RBIR)

    NASA Astrophysics Data System (ADS)

    Manunta, P.; Abbattista, C.; Cosmai, M.

    2004-09-01

    This paper describes the new integration platform GEOHARP (Geographic harmonizing Platform) for data interconnectivity. This platform is meant to integrate Geographical Databases, which are located at different operational facilities, and serve different users segments independently. Therefore GEOHARP facilitates an higher level of information sharing and integration, allowing the user to access a broader base of data not necessarily coherent in terms of geographical projection datum, and semantic. The significance of coherent layers of geographical data is particularly important in the context of objects reconnaissance based on high and very high resolution satellite data. The implementation of GEOHARP requires a comprehensive analysis of the existing archiving systems, spanning from commercially available to customized ones. The general architecture of GEOHARP will be shown, together with some key functionalities that allow to generate high quality raster images and vector data overlays. The main features of GEOHARP are online projection conversion algorithms and semantic integration between databases, witch are not invasive while accessing to the different platforms involved in the integration. Part of the discussion will pivot around: a) the quality of this interoperation platform which grant an high integration level; and b) the potential uses in a Region Based Information Retrieving approach.

  14. Communicating with Healthcare Professionals

    MedlinePLUS

    ... People Change See More of Resources Communicating with Healthcare Professionals Updated:Nov 16,2015 Adapted from the ... gained by improving communication between family caregivers and healthcare professionals. Positive outcomes include: Better care for the ...

  15. Fraud Detection in Healthcare

    SciTech Connect

    Chandola, Varun; Schryver, Jack C; Sukumar, Sreenivas R

    2015-01-01

    We discuss the problem of fraud detection in healthcare in this chapter. Given the recent scrutiny of the ineciencies in the US healthcare system, identifying fraud has been on the forefront of the eorts towards reducing the healthcare costs. In this chapter we will focus on understanding the issue of healthcare fraud in detail, and review methods that have been proposed in the literature to combat this issue using data driven approach.

  16. Barriers to knowledge sharing in Chinese healthcare referral services: an emergent theoretical model

    PubMed Central

    Nunes, Miguel Baptista

    2016-01-01

    Background This paper reports on a research study that aims to identify and explain barriers to knowledge sharing (KS) in the provision of healthcare referral services in Chinese healthcare organisations. Design An inductive case study approach was employed, in which 24 healthcare professionals and workers from four healthcare organisations in the province of Hubei, Central China, were interviewed using semi-structured scripts. Results Through data analysis, 14 KS barriers emerged in four main themes: interpersonal trust barriers, communication barriers, management and leadership barriers, and inter-institutional barriers. A cause–consequence analysis of the identified barriers revealed that three of them are at the core of the majority of problems, namely, the absence of national and local policies for inter-hospital KS, lack of a specific hospital KS requirement, and lack of mutual acquaintance. Conclusions To resolve KS problems, it is of great importance that healthcare governance agencies, both at the national and regional levels, take leadership in the process of KS implementation by establishing specific and strong policies for inter-institutional KS in the referral process. This paper raises important issues that exceed academic interests and are important to healthcare professionals, hospital managers, and Information communication technology (ICT) managers in hospitals, as well as healthcare politicians and policy makers. PMID:26895146

  17. A new XML-aware compression technique for improving performance of healthcare information systems over hospital networks.

    PubMed

    Al-Shammary, Dhiah; Khalil, Ibrahim

    2010-01-01

    Most organizations exchange, collect, store and process data over the Internet. Many hospital networks deploy Web services to send and receive patient information. SOAP (Simple Object Access Protocol) is the most usable communication protocol for Web services. XML is the standard encoding language of SOAP messages. However, the major drawback of XML messages is the high network traffic caused by large overheads. In this paper, two XML-aware compressors are suggested to compress patient messages stemming from any data transactions between Web clients and servers. The proposed compression techniques are based on the XML structure concepts and use both fixed-length and Huffman encoding methods for translating the XML message tree. Experiments show that they outperform all the conventional compression methods and can save tremendous amount of network bandwidth. PMID:21095766

  18. Healthcare. Executive Summary

    ERIC Educational Resources Information Center

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

    2012-01-01

    This executive summary highlights several findings about healthcare. These are: (1) Healthcare is 18 percent of the U.S. economy, twice as high as in other countries; (2) There are two labor markets in healthcare: high-skill, high-wage professional and technical jobs and low-skill, low-wage support jobs; (3) Demand for postsecondary education in…

  19. 24 CFR Appendix A to Part 15 - Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Reading Rooms and Contact Information for Regional Counsel A Appendix A to Part 15 Housing and Urban..., App. A Appendix A to Part 15Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel The Department maintains a reading room in Headquarters and in each of...

  20. 24 CFR Appendix A to Part 15 - Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Reading Rooms and Contact Information for Regional Counsel A Appendix A to Part 15 Housing and Urban..., App. A Appendix A to Part 15Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel The Department maintains a reading room in Headquarters and in each of...

  1. Quality of care in a low-income consumer-driven health plan: assessment of healthcare effectiveness data information set (HEDIS) scores for secondary prevention.

    PubMed

    Westover, Chad; Arredondo, Patricia H; Chapa, Griselda; Cole, Evan; Campbell, Claudia R

    2014-01-01

    The passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) may create an estimated 16 million new Medicaid enrollees. This underscores the need to develop innovative strategies to provide efficient care to this population without compromising quality. To address concerns that consumer-driven health plans (CDHPs) and cost sharing discourage individuals from seeking needed care, we examined the Healthcare Effectiveness Data Information Set (HEDIS) measures of secondary prevention for a CDHP offered to uninsured, non-Medicaid eligible adults with incomes under 200% of the federal poverty level and compared them to the National Committee for Quality Assurance (NCQA) benchmarks achieved by national Medicaid and commercially insured health plans. Results suggest that the cost-sharing component in the CDHP plan did not deter these low-income enrollees from pursuing or receiving appropriate care when compared to either Medicaid or commercially insured populations. As these results are only descriptive and not statistical measures, further research is needed with comparable populations and more detailed data for hypothesis testing. PMID:23294023

  2. Networkcentric healthcare: applying the tools, techniques and strategies of knowledge management to create superior healthcare operations.

    PubMed

    von Lubitz, Dag; Wickramasinghe, Nilmini

    2006-01-01

    The proliferation of Information Computer and Communication Technologies (IC2T) throughout the business environment has led to exponentially increasing amounts of data and information. Although these technologies were implemented to enhance and facilitate superior decision-making, the reality is information overload. Knowledge Management (KM) is a recent management technique designed to make sense of this information chaos. Critical to knowledge management is the application of IC2T. This paper discusses how effective and efficient healthcare operations can ensue through the adoption of a networkcentric healthcare perspective that is grounded in process-oriented knowledge generation and enabled through World Healthcare Information Grid (WHIG). PMID:18048258

  3. A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency

    PubMed Central

    2013-01-01

    Background Change agency in its various forms is one intervention aimed at improving the effectiveness of the uptake of evidence. Facilitators, knowledge brokers and opinion leaders are examples of change agency strategies used to promote knowledge utilization. This review adopts a realist approach and addresses the following question: What change agency characteristics work, for whom do they work, in what circumstances and why? Methods The literature reviewed spanned the period 1997-2007. Change agency was operationalized as roles that are aimed at effecting successful change in individuals and organizations. A theoretical framework, developed through stakeholder consultation formed the basis for a search for relevant literature. Team members, working in sub groups, independently themed the data and developed chains of inference to form a series of hypotheses regarding change agency and the role of change agency in knowledge use. Results 24, 478 electronic references were initially returned from search strategies. Preliminary screening of the article titles reduced the list of potentially relevant papers to 196. A review of full document versions of potentially relevant papers resulted in a final list of 52 papers. The findings add to the knowledge of change agency as they raise issues pertaining to how change agents function, how individual change agent characteristics effect evidence-informed health care, the influence of interaction between the change agent and the setting and the overall effect of change agency on knowledge utilization. Particular issues are raised such as how accessibility of the change agent, their cultural compatibility and their attitude mediate overall effectiveness. Findings also indicate the importance of promoting reflection on practice and role modeling. The findings of this study are limited by the complexity and diversity of the change agency literature, poor indexing of literature and a lack of theory-driven approaches. Conclusion This is the first realist review of change agency. Though effectiveness evidence is weak, change agent roles are evolving, as is the literature, which requires more detailed description of interventions, outcomes measures, the context, intensity, and levels at which interventions are implemented in order to understand how change agent interventions effect evidence-informed health care. PMID:24010732

  4. 76 FR 52637 - Proposed Information Collection; Comment Request; Southeast Region Vessel Identification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ..., and Gulf of Mexico under the Fishery Management Plans (FMPs) for each Region. The Regional Fishery... Region Vessel Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... currently approved information collection. The National Marine Fisheries Service (NMFS) Southeast...

  5. Integrating Climate Information and Decision Processes for Regional Climate Resilience

    NASA Astrophysics Data System (ADS)

    Buizer, James; Goddard, Lisa; Guido, Zackry

    2015-04-01

    An integrated multi-disciplinary team of researchers from the University of Arizona and the International Research Institute for Climate and Society at Columbia University have joined forces with communities and institutions in the Caribbean, South Asia and West Africa to develop relevant, usable climate information and connect it to real decisions and development challenges. The overall objective of the "Integrating Climate Information and Decision Processes for Regional Climate Resilience" program is to build community resilience to negative impacts of climate variability and change. We produce and provide science-based climate tools and information to vulnerable peoples and the public, private, and civil society organizations that serve them. We face significant institutional challenges because of the geographical and cultural distance between the locale of climate tool-makers and the locale of climate tool-users and because of the complicated, often-inefficient networks that link them. To use an accepted metaphor, there is great institutional difficulty in coordinating the supply of and the demand for useful climate products that can be put to the task of building local resilience and reducing climate vulnerability. Our program is designed to reduce the information constraint and to initiate a linkage that is more demand driven, and which provides a set of priorities for further climate tool generation. A demand-driven approach to the co-production of appropriate and relevant climate tools seeks to meet the direct needs of vulnerable peoples as these needs have been canvassed empirically and as the benefits of application have been adequately evaluated. We first investigate how climate variability and climate change affect the livelihoods of vulnerable peoples. In so doing we assess the complex institutional web within which these peoples live -- the public agencies that serve them, their forms of access to necessary information, the structural constraints under which they make their decisions, and the non-public institutions of support that are available to them. We then interpret this complex reality in terms of the demand for science-based climate products and analyze the channels through which such climate support must pass, thus linking demand assessment with the scientific capacity to create appropriate decision support tools. In summary, the approach we employ is: 1) Demand-driven, beginning with a knowledge of the impacts of climate variability and change upon targeted populations, 2) Focused on vulnerability and resilience, which requires an understanding of broader networks of institutional actors who contribute to the adaptive capacity of vulnerable peoples, 3) Needs-based in that the climate needs matrix set priorities for the assessment of relevant climate products, 4) Dynamic in that the producers of climate products are involved at the point of demand assessment and can respond directly to stated needs, 5) Reflective in that the impacts of climate product interventions are subject to monitoring and evaluation throughout the process. Methods, approaches and preliminary results of our work in the Caribbean will be presented.

  6. MountainStar Healthcare makes a unique appeal to healthcare brokers. Improves recognition in a competitive market.

    PubMed

    Botvin, J D

    2001-01-01

    MountainStar Healthcare, the Utah segment of HCA (The Healthcare Company), partnered with the health plans that shared a common interest: all were in competition with multi-state Intermountain Health Care. Mountain Star promoted its outstanding record of service--to healthcare brokers! An information kit, including a "Quality Report Card" and cost analysis proved to be an effective tool. PMID:11467200

  7. The Chinese healthcare challenge

    PubMed Central

    Fabre, Guilhem

    2015-01-01

    Investments in the extension of health insurance coverage, the strengthening of public health services, as well as primary care and better hospitals, highlights the emerging role of healthcare as part of China’s new growth regime, based on an expansion of services, and redistributive policies. Such investments, apart from their central role in terms of relief for low-income people, serve to rebalance the Chinese economy away from export-led growth toward the domestic market, particularly in megacity-regions as Shanghai and the Pearl River Delta, which confront the challenge of integrating migrant workers. Based on the paper by Gusmano and colleagues, one would expect improvements in population health for permanent residents of China’s cities. The challenge ahead, however, is how to address the growth of inequalities in income, wealth and the social wage. PMID:25774379

  8. Regional Ocean Products Portal: Transforming Information to Knowledge

    NASA Astrophysics Data System (ADS)

    Howard, M. K.; Kobara, S.; Gayanilo, F. C.; Baum, S. K.; Simoniello, C.; Jochens, A. E.

    2010-12-01

    Scientific visualization of complex fusions of heterogeneous 2, 3, and 4-D data sets is a challenge in most fields of geosciences and oceanography is no exception. Despite increased computing power, dedicated graphic processing units, and more capable software, 30 years of change in the ways that geophysical sciences are conducted continues to challenge our ability to present the data in visually meaningful ways. Oceanography, for example, changed from a science in which a sole researcher studied a single phenomena, e.g. ocean currents to one in which a multidisciplinary collaborative teams study complex coupled systems. In three decades weve moved from a time where a map of mean circulation and a coastline rendered on a pen-plotter would suffice, to one in which we require detailed dynamic views of relationships and change. We now need to visualize multiple parameters of relatively sparse observed data combined with computer generated output on dense numerical model grids. We want parameters within ocean and atmosphere volumes rendered over detailed earth terrains with illumination and infrastructure. We want to see the dynamic relations between the oceans, atmosphere, land, biogeochemistry, biota, and ecosystem all at once and in context. As the computational power increased, the density of the model grid points increased accordingly. The latest challenge has been due to the internet, the notion of sensor webs, and the near real-time availability of high-bandwidth interoperable standards-based data streams. Not only do we want to see it all, we want to see it now, and we want to see it the way we want and that may change from moment to moment. Increasingly this involves 4D visualizations combined with a strong element of traditional Geographic Information System type presentation. The Gulf of Mexico Coastal Ocean Observing System Regional Association (GCOOS-RA) is one of 11 regional observing systems that comprise the non-federal part of the U.S. Integrated Ocean Observing System (IOOS). With IOOS guidance, and cooperation of regional data providers, GCOOS-RA has established a regional interoperable system of systems which has the potential to deliver marine, and coastal marine oceanographic, atmospheric, biogeochemical, and ecosystem related data in an automated and largely unattended way from sensors to products. GCOOS-RA devotes 10% of its funding to Education and Outreach activities and we have a number of modeling partners producing terabytes of output. With the interoperable parts of the data delivery system complete, our current challenge has been producing automated workflows that generate useful interactive graphical representations over the web. We have used a variety of commercial and free software packages. Some are net-enabled and can acquire remote datasets. Several are designed for 3D including ITTVIS IDL, Unidata IDV, and IVSs Fledermaus. This talk will present a survey of software packages weve used, our successes and remaining challenges.

  9. Regional Ocean Data Portal: Transforming Information to Knowledge

    NASA Astrophysics Data System (ADS)

    Howard, M. K.; Gayanilo, F. C.; Jochens, A. E.

    2009-12-01

    The mission of the Gulf of Mexico Coastal Ocean Observing System’s (GCOOS) regional data portal is to aggregate data and model output from distributed providers and to offer these, and derived products, through a single access point in standardized ways to a diverse set of users. The portal evolved under the NOAA-led U.S. Integrated Ocean Observing System (IOOS) program where automated largely-unattended machine-to-machine interoperability has always been a guiding tenet for system design. Initially, the portal focused on aggregating relatively homogeneous oceanographic and marine meteorological data from the principal Gulf of Mexico data providers. Obtaining community agreements from the data providers on data formats, vocabularies, and levels of service was relatively easy because the technical barriers to participation were low and we were able to provide financial support to them to make small additions or changes to their local data systems. Over time, the portal requirements became more complex as new parameters, new providers and heterogeneous data streams were added and the spatial domain increased to include beaches and adjacent wetlands. This began to strain our resources and take us outside our science domains of expertise. During the same period, the Gulf of Mexico Alliance (GOMA), a new environmental quality initiative involving the five Gulf states and Mexico with similar goals and directives as those of our sponsor, gained momentum and demanded both our attention and participation. GOMA is working, mostly among themselves, to discover or establish community standards for various types of data sets - e.g. water quality and nutrients. In addition to aggregation, the portal is also tasked with producing products from the collected information streams. Arriving at a prioritized list of desired products has been a major part of the business conducted by the GCOOS Regional Association (RA). Numerous stakeholder (e.g. emergency responders, oil and gas producers, recreational boaters, etc.) workshops were held to elicit user needs and requirements for observing system products for each group. The GCOOS-RA’s Products and Services Committee and Education and Outreach Council have gone through similar activities aimed at determining what products various users groups want. We have been sensitive to the private sector when deciding which products to produce. While science users want numbers, users of all types mainly want maps. We have tried to develop flexible capabilities within the portal that helps users to create their own fused products, ad hoc, for a variety of output devices, from desktop screens to the smart phones. We will discuss how our data management system has evolved within the backdrop of rapidly changing technologies and diverse community requirements.

  10. Globalization of Healthcare

    PubMed Central

    2012-01-01

    Globalization—the increasing transnational circulation of money, goods, people, ideas, and information worldwide—is generally recognized as one of the most powerful forces shaping our current and future history. How is it affecting healthcare, and in that context, what is the purpose and significance of Global Advances in Health and Medicine (GAHM), publisher of this journal? Our goal is not homogenization but rather to provide an opportunity for integration, convergence, and collaboration across cultures. By respecting and conserving the richness and diversity of each new medicine, we embrace globalization. Globalization is of course not new; it began in the Renaissance and particularly with the 15th- and 16th-century voyages of exploration by Columbus, Magellan, and others. Since the beginning of time, there have been interactions and exchanges among different peoples and cultures. However, the current magnitude of globalization is unprecedented and yet still expanding rapidly. PMID:24278809

  11. An organizational field approach to resource environments in healthcare: comparing entries of hospitals and home health agencies in the San Francisco Bay region.

    PubMed Central

    Ruef, M; Mendel, P; Scott, W R

    1998-01-01

    OBJECTIVE: To draw together insights from three perspectives (health economics, organizational ecology, and institutional theory) in order to clarify the factors that influence entries of providers into healthcare markets. A model centered on the concept of an organizational field is advanced as the level of analysis best suited to examining the assortment and interdependence of organizational populations and the institutional forces that shape this co-evolution. In particular, the model argues that: (1) different populations of healthcare providers partition fiscal, geographic, and demographic resource environments in order to ameliorate competition and introduce service complementarities; and (2) competitive barriers to entry within populations of providers vary systematically with regulatory regimens. DATA SOURCES: County-level entries of hospitals and home health agencies in the San Francisco Bay Area using data from the American Hospital Association (1945-1991) and California's Office of Statewide Health Planning and Development (1976-1991). Characteristics of the resource environment are derived from the Area Resource File (ARF) and selected government censuses. METHODS OF ANALYSIS: A comparative design is applied to contrast influences on hospital and home health agency entries during the post-World War II period. Empirical estimates are obtained using Poisson and negative binomial regression models. RESULTS: Hospital and HHA markets are partitioned primarily by the age and education of consumers and, to a lesser extent, by urbanization levels and public funding expenditures. Such resource partitioning allows independent HHAs to exist comfortably in concentrated hospital markets. For both hospitals and HHAs, the barriers to entry once generated by oligopolistic concentration have declined noticeably with the market-oriented reforms of the past 15 years. CONCLUSION: A field-level perspective demonstrates that characteristics of local resource environments interact with interdependencies of provider populations and broader regulatory regimes to affect significantly the types of provider organizations likely to enter a given healthcare market. PMID:9460486

  12. Developing and evaluating the implementation of a complex intervention: using mixed methods to inform the design of a randomised controlled trial of an oral healthcare intervention after stroke

    PubMed Central

    2011-01-01

    Background Many interventions delivered within the stroke rehabilitation setting could be considered complex, though some are more complex than others. The degree of complexity might be based on the number of and interactions between levels, components and actions targeted within the intervention. The number of (and variation within) participant groups and the contexts in which it is delivered might also reflect the extent of complexity. Similarly, designing the evaluation of a complex intervention can be challenging. Considerations include the necessity for intervention standardisation, the multiplicity of outcome measures employed to capture the impact of a multifaceted intervention and the delivery of the intervention across different clinical settings operating within varying healthcare contexts. Our aim was to develop and evaluate the implementation of a complex, multidimensional oral health care (OHC) intervention for people in stroke rehabilitation settings which would inform the development of a randomised controlled trial. Methods After reviewing the evidence for the provision of OHC following stroke, multi-disciplinary experts informed the development of our intervention. Using both quantitative and qualitative methods we evaluated the implementation of the complex OHC intervention across patients, staff and service levels of care. We also adopted a pragmatic approach to patient recruitment, the completion of assessment tools and delivery of OHC, alongside an attention to the context in which it was delivered. Results We demonstrated the feasibility of implementing a complex OHC intervention across three levels of care. The complementary nature of the mixed methods approach to data gathering provided a complete picture of the implementation of the intervention and a detailed understanding of the variations within and interactions between the components of the intervention. Information on the feasibility of the outcome measures used to capture impact across a range of components was also collected, though some process orientated uncertainties including eligibility and recruitment rates remain to be further explored within a Phase II exploratory trial. Conclusions Complex interventions can be captured and described in a manner which facilitates evaluation in the form of exploratory and subsequently definitive clinical trials. If effective, the evidence captured relating to the intervention context will facilitate translation into clinical practice. PMID:21729277

  13. Information Services; A Survey of the History and Present Status of the Field. MOREL Regional Information System for Educators.

    ERIC Educational Resources Information Center

    Grimes, George

    This document is one of a series describing the background, functions, and utilization of the Regional Information System (RIS) developed by the Michigan-Ohio Regional Educational Laboratory (MOREL). The continuing history of the field of librarianship and information services is reviewed in this report. The first part covers ancient times to the

  14. Healthcare financing in Malaysia.

    PubMed

    Kananatu, K

    2002-01-01

    This paper presents an overview of the Malaysian healthcare system and its method of financing. The development of the healthcare delivery system in Malaysia is commendable. However, the strength and weaknesses of the public healthcare system and the financing problems encountered are also discussed. Cost of healthcare and funding of both the public and private sectors were also revealed. One must optimise the advantages of operating a health financing scheme which is affordable and controllable which contribute towards cost-containment and quality assurance. Thus, there is a need for the establishment of a National Healthcare Financing, a mechanism to sustain the healthcare delivery network and operate it as a viable option. A model of the National Health Financing Scheme (NHFS) was proposed. PMID:12597514

  15. Gang awareness for healthcare professionals.

    PubMed

    Hall-McGee, P

    1999-01-01

    All healthcare facilities--not just urban ones--need to train their staff and be equipped to handle gangs and gang-related crime and violence, says the author. This article discusses the various aspects of the ongoing training program in gang awareness for Durham Regional Hospital's Security Department--including types of gangs, their mindsets and what motivates them, and how to identify them as well as their graffiti, colors, hand signals, and tattoos. PMID:10557439

  16. 78 FR 44147 - Proposed Information Collection; National Capital Region Application for Public Gathering

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    .... Title: National Capital Region Application for Public Gathering, 36 CFR 7.96(g). Service Form Number(s... National Park Service Proposed Information Collection; National Capital Region Application for Public... additional information about this IC, contact Robbin Owen, National Capital Region, National Park...

  17. Why healthcare providers merge.

    PubMed

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities. PMID:26055501

  18. Principles of Information Processing. Curriculum Improvement Project. Region II.

    ERIC Educational Resources Information Center

    Rivera, Gloria

    This course curriculum is intended for community college instructors and administrators to use in implementing a principles of information processing course. A student's course syllabus provides this information: credit hours, catalog description, prerequisites, required texts, instructional process, objectives, student evaluation, and class

  19. Evaluation of a combined strategy directed towards health-care professionals and patients with chronic obstructive pulmonary disease (COPD): Information and health education feedback for improving clinical monitoring and quality-of-life

    PubMed Central

    2009-01-01

    Background Chronic obstructive pulmonary disease (COPD) is a health problem that is becoming increasingly attended-to in Primary Care (PC). However, there is a scarcity of health-care programs and studies exploring the implementation of Clinical Practice Guidelines (CPG). The principal objective of the present study is to evaluate the effectiveness of a combined strategy directed towards health-care professionals and patients to improve the grade of clinical control and the quality-of-life (QoL) of the patients via a feedback on their state-of-health. A training plan for the health-care professionals is based on CPG and health education. Method/Design Multi-centred, before-after, quasi experimental, prospective study involving an intervention group and a control group of individuals followed-up for 12 months. The patients receive attention from urban and semi-urban Primary Care Centres (PCC) within the administrative area of the Costa de Ponent (near Barcelona). All the pacients corresponding to the PCC of one sub-area were assigned to the intervention group and patients from the rest of sub-areas to the group control. The intervention includes providing data to the health-care professionals (clinician/nurse) derived from a clinical history and an interview. A course of training focused on aspects of CPG, motivational interview and health education (tobacco, inhalers, diet, physical exercise, physiotherapy). The sample random includes a total of 801 patients (? 40 years of age), recorded as having COPD, receiving attention in the PCC or at home, who have had at least one clinical visit, and who provided written informed consent to participation in the study. Data collected include socio-demographic characteristics, drug treatment, exacerbations and hospital admissions, evaluation of inhaler use, tobacco consumption and life-style and health-care resources consumed. The main endpoints are dyspnoea, according to the modified scale of the Medical Research Council (MRC) and the QoL, evaluated with the St George's Respiratory Questionnaire (SGRQ). The variables are obtained at the start and the end of the intervention. Information from follow-up visits focuses on the changes in life-style activities of the patient. Discussion This study is conducted with the objective of generating evidence that shows that implementation of awareness programs directed towards health-care professionals as well as patients in the context of PC can produce an increase in the QoL and a decrease in the disease exacerbation, compared to standard clinical practice. Trial Registration Clinical Trials.gov Identifier: NCT00922545; PMID:20128887

  20. Customer privacy on UK healthcare websites.

    PubMed

    Mundy, Darren P

    2006-09-01

    Privacy has been and continues to be one of the key challenges of an age devoted to the accumulation, processing, and mining of electronic information. In particular, privacy of healthcare-related information is seen as a key issue as health organizations move towards the electronic provision of services. The aim of the research detailed in this paper has been to analyse privacy policies on popular UK healthcare-related websites to determine the extent to which consumer privacy is protected. The author has combined approaches (such as approaches focused on usability, policy content, and policy quality) used in studies by other researchers on e-commerce and US healthcare websites to provide a comprehensive analysis of UK healthcare privacy policies. The author identifies a wide range of issues related to the protection of consumer privacy through his research analysis using quantitative results. The main outcomes from the author's research are that only 61% of healthcare-related websites in their sample group posted privacy policies. In addition, most of the posted privacy policies had poor readability standards and included a variety of privacy vulnerability statements. Overall, the author's findings represent significant current issues in relation to healthcare information protection on the Internet. The hope is that raising awareness of these results will drive forward changes in the industry, similar to those experienced with information quality. PMID:16954055

  1. 76 FR 37139 - Notice of Submission of Proposed Information Collection to OMB Sustainable Communities Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Sustainable Communities... regarding the Sustainable Communities Regional Planning Grant Program NOFA applications to ensure that...: Title of Proposal: Sustainable Communities Regional Grant Program. OMB Approval Number: 2501-0024....

  2. How can healthcare standards be standardised?

    PubMed

    Shaw, Charles D

    2015-10-01

    International travel, medical tourism and trade have created a demand for reliable assessment of healthcare provision across borders, and for information which is accessible to patients, insurers and referring institutions. External assessment schemes for healthcare providers may be clustered into three types: statutory regulation and institutional licensing, International Standardization Organisation certification, and voluntary systems such as peer review and healthcare accreditation. Increasing complexity of healthcare provision, pressures for public accountability and expectations of professional self-governance place a burden on the inspectors and the inspected. If only to contain costs of external assessment and to increase access to reliable information for patients and insurers, the three approaches must work together rather than compete. This paper summarises the origins, aims, authority and methods of the three general models, describing current pressures and opportunities for convergence (between systems and across borders) in the UK and in Europe. PMID:26130813

  3. 78 FR 11156 - Proposed Information Collection; Comment Request; Southeast Region Dealer and Interview Family of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... Region Dealer and Interview Family of Forms AGENCY: National Oceanic and Atmospheric Administration (NOAA..., information collection included in this family of forms includes interview with fishermen to...

  4. 78 FR 58286 - Proposed Information Collection; Comment Request; Western Region Vessel Monitoring System and Pre...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ... Region Vessel Monitoring System and Pre-Trip Reporting Requirements AGENCY: National Oceanic and... current information collection). Affected Public: Business or other for-profit organizations....

  5. Healthcare. State Report

    ERIC Educational Resources Information Center

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

    2012-01-01

    This report projects education requirements linked to forecasted job growth in healthcare by state and the District of Columbia from 2010 through 2020. It complements a larger national report which projects educational demand for healthcare for the same time period. The national report shows that with or without Obamacare, the United States will…

  6. Healthcare professionals and the ethics of healthcare marketing.

    PubMed

    Hammond, Kevin L; Jurkus, Anthony F

    1993-01-01

    The article explores marketing ethics considerations in the application of marketing to healthcare. While we realize that acceptance of healthcare marketing by all stakeholders is important for successful marketing, we emphasize its level of acceptance by healthcare professionals. The high levels of resistance to advertising and other forms of healthcare marketing by healthcare professionals has been largely based on the grounds that the practices are unethical. The nature of the resistance thus invites this exploration of healthcare marketing (and the marketing concept), marketing ethics, and the acceptance (rejection) by healthcare professionals of healthcare marketing. PMID:11660180

  7. Downscaled Regional Climate Information for the Southeastern US

    EPA Science Inventory

    The U.S. Environmental Protection Agency’s Office of Research and Development in Research Triangle Park, NC, has been developing regional climate and air quality fields for North America for current and future periods. Research emphasis has been placed on evaluating near-s...

  8. Downscaled Regional Climate Information for the Southeastern US

    EPA Science Inventory

    The U.S. Environmental Protection Agencys Office of Research and Development in Research Triangle Park, NC, has been developing regional climate and air quality fields for North America for current and future periods. Research emphasis has been placed on evaluating near-s...

  9. Healthy Youth/Healthy Regions: Informing Action for the Nine County Capital Region and Its Youth

    ERIC Educational Resources Information Center

    London, Jonathan; Erbstein, Nancy

    2011-01-01

    Will the Sacramento Capital Region prosper, thrive and ultimately grow into its full potential in coming years? To answer this question, the authors have to look carefully at the well-being of young people who now inhabit the Capital Region's nine counties. As go today's young people--tomorrow's workers, parents, neighbors and leaders--so goes the

  10. Transnational healthcare practices of Romanian migrants in Ireland: inequalities of access and the privatisation of healthcare services in Europe.

    PubMed

    Stan, Sabina

    2015-01-01

    This article deals with the transnational healthcare practices of Central and Eastern European migrants in Europe, taking the case of Romanian migrants in Ireland. It explores the implications of migrants' transnational healthcare practices for the transformation of citizenship in Europe, more particularly in terms of access to free public healthcare. The article places these practices in the larger perspective of global care chains, seen as including transnational flows of healthcare seekers and healthcare workers that link distant healthcare systems in an emerging European healthcare assemblage. The study adopted a holistic perspective, taking into account both formal and informal practices, as well as the use of healthcare services in both the host and the origin countries of migrants. These were explored during multi-sited fieldwork in Romania and Ireland, conducted between 2012 and 2013, and combining a variety of sources and methods (semi-structured interviews, informal conversations, documentary analysis, etc.). The article explores the links between migrants' transnational healthcare practices and two other important processes: 1) inequalities in access to healthcare services in migrants' countries of origin and of destination; and 2) the contribution of healthcare privatisation to these inequalities. It shows that Romanian migrants' transnational healthcare practices function as strategies of social mobility for migrants, while also reflecting the increasing privatisation of healthcare services in Ireland and Romania. The article argues that these processes are far from specific to Ireland, Romania, and the migration flows uniting them. Rather, they draw our attention to the rise of an unevenly developed European healthcare assemblage and citizenship regime in which patients' movements across borders are closely interlinked with diminishing and increasingly unequal access to public healthcare services. PMID:24797693

  11. A Comparative Analysis of Five Regional Reference and Information Networks.

    ERIC Educational Resources Information Center

    Spicer, Michael W.

    Increasing demands for more information more quickly has called into serious question the traditionally fragmented nature of library service by creating a need for greater interlibrary cooperation. Libraries have responded to this need by the formation of networks which are nothing more nor less than a formalized tool for interlibrary cooperation.…

  12. A study on knowledge, attitude, and practice towards premarital carrier screening among adults attending primary healthcare centers in a region in Oman

    PubMed Central

    2014-01-01

    Background Despite that hereditary diseases are widespread among the Arab population due to high rates of consanguineous marriages, research regarding community awareness towards premarital carrier screening in some countries such as Oman, is extremely scarce. This study aimed to investigate knowledge and attitude towards premarital carrier screening (PMCS) in Oman. Methods A cross-sectional study was conducted using a self-administered questionnaire which was distributed to 400 Omani adults aged 20–35 who attended primary healthcare institutions at the South Batinah Governorate in Oman. Results The majority of the participants (84.5%) believed that PMCS was necessary, and about half of them (49.5%) supported the view of making PMCS compulsory. On the contrary, approximately one third (30.5%) of the participants reported that they were not in favor of taking the blood screening test. Overall, unwillingness to perform pre-marital testing was associated with female gender, younger age, being single, less education, and increased income. Conclusion Despite the relatively high level of knowledge, about one third of the participants were still reluctant to carry out premarital testing. Such attitude calls for immediate need for community-based campaigns to encourage the public to do premarital testing. PMID:24742222

  13. A Regional Information System Strategy for the Caribbean for the Year 2000.

    ERIC Educational Resources Information Center

    Durrant, Fay

    This document outlines the proposals for a regional information system strategy resulting from a project undertaken by the Caribbean Community Secretariat and the United Nations Economic Commission for Latin America and the Caribbean Sub-regional Headquarters for the Caribbean. The document covers: (1) the role of information in the development

  14. Board Governance: Transformational Approaches Under Healthcare Reform.

    PubMed

    Zastocki, Deborah K

    2015-01-01

    Previous successes of healthcare organizations and effective governance practices in the pre-reform environment are not predictive of future success. Healthcare has been through numerous phases of growth and development using tried-and-true strategies. The challenge is that our toolbox does not contain what is needed to build the future healthcare delivery systems required in the post-reform world. Healthcare has had a parochial focus at the local level, with some broadening of horizons at the state and national levels. But healthcare delivery is now a global issue that requires a totally different perspective, and many countries are confronting similar issues. US healthcare reform initiatives have far-reaching implications. Compounding the reform dynamics are the simultaneously occurring, gamechanging accelerants such as enabling information technologies and mobile health, new providers of healthcare, increased consumer demands, and limited healthcare dollars, to name a few. Operating in this turbulent environment requires transformational board, executive, and physician leadership because traditional ways of planning for incremental change and attempting to time those adjustments can prove disastrous. Creating the legacy healthcare system for tomorrow requires governing boards and executive leadership to act today as they would in the desired future system. Boards need to create a culture that fosters.innovation with a tolerance for risk and some failure. To provide effective governance, boards must essentially develop new skills, expertise, and ways of thinking. The rapid rate of change requires board members to possess certain capabilities, including the ability to deal with ambiguity and uncertainty while demonstrating flexibility and adaptability, all with a driving commitment to metrics and results. This requires development plans for both individual members and the overall board. In short, the board needs to function differently, particularly regarding the types of discussions at and the focus of board meetings. PMID:26495543

  15. Central Atlantic regional ecological test site: A prototype regional environmental information system

    NASA Technical Reports Server (NTRS)

    Alexander, R. H. (Principal Investigator)

    1973-01-01

    The author has identified the following significant results. A comparison of photomorphic regions from an uncontrolled ERTS-1 mosaic of CARETS to land use areas on a map published in the National Atlas revealed close correlations in non-urban regions. Such regional scale analysis of ERTS-1 data has the potential for providing an economical sampling strategy for selecting sites for more detailed field measurements if other environmental variables can be correlated with patterns on ERTS-1 imagery. ERTS-1 imagery has also revealed for the first time the appearance of CARETS during the winter months. Investigators have identified extensive areas of conifers, which have previously been indistinguishable from deciduous vegetation. Imagery has also shown very clearly the extent of snow cover at a particular time over the region. The evaluation of ERTS-1 imagery used for the land use mapping of the shore zone of CARETS, has shown that the presence or absence of elements of an hierarchal system of shoreline landforms can help identify areas of potential rapid change. Changes in land use class distributions on the Barrier Islands signify the environmental response to natural and man-caused processes. Both environmental vulnerability and sensitivity can be estimated from the repetitive ERTS-1 coverage of long reaches of the CARETS coast. Results indicate potential applications to land use planning, management, and regional environmental quality analysis.

  16. The Middle Eastern Regional Irrigation Management Information Systems project-update

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Middle Eastern Regional Irrigation Management Information Systems Project (MERIMIS) was formulated at a meeting of experts from the region in Jordan in 2003. Funded by the U.S. Department of State, it is a cooperative regional project bringing together participants from Israel, Jordan, Palestini...

  17. 77 FR 4862 - Agency Requests for Renewal of a Previously Approved Information Collection: SBTRC Regional Field...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... Information Collection: SBTRC Regional Field Offices Intake Form (DOT F 4500) and SBTRC Regional Field Offices Quarterly Report Form (DOT F 4502) AGENCY: Office of Small and Disadvantaged Business Utilization (OSDBU... Offices Quarterly Report Form, respectively. The Regional Field Offices Intake Form (No. DOT F 4500)...

  18. Safety and Accountability in Healthcare From Past to Present

    SciTech Connect

    Hendee, William R.

    2008-05-01

    Healthcare is transitioning into a new era-an era of accountability. This era demands heightened awareness of the quality, cost, and safety of healthcare, with value (quality/cost) and safety being the watchwords of accountability. Many factors are driving this transition, and it is affecting all healthcare disciplines, including radiation oncology. The transition is accompanied by the transformation of healthcare from a craft-based culture to an information-age culture in which patient needs and information are given top priority. These changes call for new measures to quantify and document the value and safety of procedures in radiation oncology.

  19. A virtual intranet and data-warehousing for healthcare co-operation.

    PubMed

    Kerkri, E M; Quantin, C; Grison, T; Allaert, F A; Tchounikine, A; Ytongnon, K

    2001-01-01

    As patient's medical data is disseminated in different health structures, developing a medical or epidemiological patient-oriented data warehouse has some specific requirements compared to intra healthcare structure data-warehousing projects. The difference is that the healthcare structures implicated in a patient-oriented data warehouse project require some considerations about the confidentiality of the patient data and of the activities of healthcare structures. Building a data-warehousing system at a regional level, for example in cancerology, requires the participation of all concerned health structures, as well as different health professionals. The heterogeneity of sources medical data of has to be taken into account for choosing between several organizational configurations of the data warehousing system. In top of data warehousing, we propose a concept of Virtual Intranet, which provides a solution to the problem of medical information security arising from heterogeneous sources. PMID:11604699

  20. Executive directors and community health centers--facing the healthcare transition.

    PubMed

    Fields, T; Welborn, R B

    1999-01-01

    This paper examines the impressions and experiences of administrators who manage Community Health Centers (CHCs) in Region VI, US Department of Health and Human Services, with the goal of identifying leadership skills and intrinsic values that are needed to run integrated service delivery sites. As the delivery of healthcare service shifts to health promotion and disease prevention, Community Health Centers are well positioned to assume major roles in this transition. However, some CHC administrators may need additional skills in order to address the changing healthcare environment. A survey of CHC Executive Directors was conducted to identify their impressions and experiences. Information obtained from this exploratory study should be beneficial in educating the next generation of healthcare administrators. PMID:11184902

  1. Active X based standards for healthcare integration.

    PubMed

    Greenberg, D S; Welcker, B

    1998-02-01

    With cost pressures brought to the forefront by the growth of managed care, the integration of healthcare information systems is more important than ever. Providers of healthcare information are under increasing pressure to provide timely information to end users in a cost effective manner. Organizations have had to decide between the strong functionality that a multi-vendor 'best of breed' architecture provides and the strong integration provided by a single-vendor solution. As connectivity between systems increased, these interfaces were migrated to work across serial and eventually, network, connections. In addition, the content of the information became standardized through efforts like HL7 and ANSI X12 and Edifact. Although content-based standards go a long way towards facilitating interoperability, there is also quite a bit of work required to connect two systems even when they both adhere to the standard. A key to accomplishing this goal is increasing the connectivity between disparate systems in the healthcare environment. Microsoft is working with healthcare organizations and independent software vendors to bring Microsoft's powerful enterprise object technology, ActiveX, to the healthcare industry. Whilst object orientation has been heralded as the 'next big thing' in computer applications development, Microsoft believe that, in fact, component software is the technology which will provide the greatest benefit to end users. PMID:9600418

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

    PubMed

    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. PMID:23823404

  3. Healthcare technology and technology assessment

    PubMed Central

    Hwang, Raymond; Bozic, K. H.

    2007-01-01

    New technology is one of the primary drivers for increased healthcare costs in the United States. Both physician and industry play important roles in the development, adoption, utilization and choice of new technologies. The Federal Drug Administration regulates new drugs and new medical devices, but healthcare technology assessment remains limited. Healthcare technology assessment originated in federal agencies; today it is decentralized with increasing private sector efforts. Innovation is left to free market forces, including direct to consumer marketing and consumer choice. But to be fair to the consumer, he/she must have free knowledge of all the risks and benefits of a new technology in order to make an informed choice. Physicians, institutions and industry need to work together by providing proven, safe, clinically effective and cost effective new technologies, which require valid pre-market clinical trials and post-market continued surveillance with national and international registries allowing full transparency of new products to the consumer—the patient. PMID:17426985

  4. Evaluating the sustainability of a regional system using Fisher information in the San Luis Basin, Colorado

    EPA Science Inventory

    This paper describes the theory, data, and methodology necessary for using Fisher information to assess the sustainability of the San Luis Basin (SLB) regional system over time. Fisher information was originally developed as a measure of the information content in data and is an ...

  5. The Effectiveness and Feasibility of a TRISNET Regional Center in Information Transfer. Final Report.

    ERIC Educational Resources Information Center

    Rath, Gustave J.; And Others

    A study was conducted to assess the feasibility of establishing a regional information transfer center within the context of the National Network of Transportation Research Information Services (TRISNET). The principle areas of investigation were: (1) the transportation information needs of the public and private sectors; (2) the utility of

  6. 76 FR 38374 - Applications for New Awards; Literacy Information and Communication System Regional Professional...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Applications for New Awards; Literacy Information and Communication System Regional Professional Development Centers AGENCY: Office of Vocational and Adult Education, Department of Education. ACTION: Notice. Overview Information Literacy Information...

  7. Uncovering middle managers' role in healthcare innovation implementation

    PubMed Central

    2012-01-01

    Background Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations. Discussion Extant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation. Summary Teamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation. PMID:22472001

  8. Precise regional baseline estimation using a priori orbital information

    NASA Technical Reports Server (NTRS)

    Lindqwister, Ulf J.; Lichten, Stephen M.; Blewitt, Geoffrey

    1990-01-01

    A solution using GPS measurements acquired during the CASA Uno campaign has resulted in 3-4 mm horizontal daily baseline repeatability and 13 mm vertical repeatability for a 729 km baseline, located in North America. The agreement with VLBI is at the level of 10-20 mm for all components. The results were obtained with the GIPSY orbit determination and baseline estimation software and are based on five single-day data arcs spanning the 20, 21, 25, 26, and 27 of January, 1988. The estimation strategy included resolving the carrier phase integer ambiguities, utilizing an optial set of fixed reference stations, and constraining GPS orbit parameters by applying a priori information. A multiday GPS orbit and baseline solution has yielded similar 2-4 mm horizontal daily repeatabilities for the same baseline, consistent with the constrained single-day arc solutions. The application of weak constraints to the orbital state for single-day data arcs produces solutions which approach the precise orbits obtained with unconstrained multiday arc solutions.

  9. EDIM - Earthquake Disaster Information System for the Marmara Region, Turkey

    NASA Astrophysics Data System (ADS)

    Wenzel, Friedemann; Erdik, Mustafa; Zschau, Jochen; Fischer, Joachim; Christ, Ingrid; Kiehle, Christian

    2010-05-01

    The main objectives of EDIM (www.cedim.de/EDIM.php) are to enhance the Istanbul earthquake early warning (EEW) system with a number of scientific and technological developments that - in the end - provide a tool set for EEW with wide applicability. Innovations focus on three areas. (1) Analysis and options for improvement of the current system; (2) development of a new type of self-organising sensor system and its application to early warning; (3) development of a geoinformation infrastructure and geoinformation system tuned to early warning purposes. Development in the frame of the Istanbul system, set up and operated by KOERI, allows testing our novel methods and techniques in an operational system environment and working in a partnership with a long-standing traditon of success. EDIM is a consortium of Karlsruhe University (TH), GeoForschungsZentrum (GFZ) Potsdam, Humboldt University (HU) Berlin, lat/lon GmbH Bonn, DELPHI Informations Muster Management GmbH Potsdam, and Kandilli Observatory and Earthquake Research Institute (KOERI) of the Bogazici University in Istanbul. The integration of strong motion seismology, sensor system hard- and software development, and geoinformation real-time management tools prove a successful concept in making seismic early warning a novel technology with high potential for scientific and technological innovation, disaster mitigation, and many spin-offs for other fields. EDIM can serve as a model for further developments in the field of early warning on a global scale.

  10. Interventions for physical activity promotion applied to the primary healthcare settings for people living in regions of low socioeconomic level: study protocol for a non-randomized controlled trial

    PubMed Central

    2014-01-01

    Background Regular physical activity practice has been widely recommended for promoting health, but the physical activity levels remain low in the population. Therefore, the study of interventions to promote physical activity is essential. Objective: To present the methodology of two physical activity interventions from the “Ambiente Ativo” (“Active Environment”) project. Methods 12-month non-randomized controlled intervention trial. 157 healthy and physically inactive individuals were selected: health education (n = 54) supervised exercise (n = 54) and control (n = 49). Intervention based on health education: a multidisciplinary team of health professionals organized the intervention in group discussions, phone calls, SMS and educational material. Intervention based on supervised exercise program: consisted of offering an exercise program in groups supervised by physical education professionals involving strength, endurance and flexibility exercises. The physical activity level was assessed by the International Physical Activity Questionnaire (long version), physical activities recalls, pedometers and accelerometers over a seven-day period. Result This study described two different proposals for promoting physical activity that were applied to adults attended through the public healthcare settings. The participants were living in a region of low socioeconomic level, while respecting the characteristics and organization of the system and its professionals, and also adapting the interventions to the realities of the individuals attended. Conclusion Both interventions are applicable in regions of low socioeconomic level, while respecting the social and economic characteristics of each region. Trial registration ClinicalTrials.gov NCT01852981 PMID:24624930

  11. Integrated secure solution for electronic healthcare records sharing

    NASA Astrophysics Data System (ADS)

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

    2007-03-01

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

  12. Applications of Business Analytics in Healthcare

    PubMed Central

    Ward, Michael J.; Marsolo, Keith A.

    2014-01-01

    The American healthcare system is at a crossroads, and analytics, as an organizational skill, figures to play a pivotal role in its future. As more healthcare systems capture information electronically and as they begin to collect more novel forms of data, such as human DNA, how will we leverage these resources and use them to improve human health at a manageable cost? In this article, we argue that analytics will play a fundamental role in the transformation of the American healthcare system. However, there are numerous challenges to the application and use of analytics, namely the lack of data standards, barriers to the collection of high-quality data, and a shortage of qualified personnel to conduct such analyses. There are also multiple managerial issues, such as how to get end users of electronic data to employ it consistently for improving healthcare delivery, and how to manage the public reporting and sharing of data. In this article, we explore applications of analytics in healthcare, barriers and facilitators to its widespread adoption, and how analytics can help us achieve the goals of the modern healthcare system: high-quality, responsive, affordable, and efficient care. PMID:25429161

  13. Asthma Outcomes: Healthcare Utilization and Costs

    PubMed Central

    Akinbami, Lara J.; Sullivan, Sean D.; Campbell, Jonathan D.; Grundmeier, Robert W.; Hartert, Tina V.; Lee, Todd A.; Smith, Robert A.

    2014-01-01

    Background Measures of healthcare utilization and indirect impact of asthma morbidity are used to assess clinical interventions and estimate cost. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to propose standardized measurement, collection, analysis, and reporting of healthcare utilization and cost outcomes in future asthma studies. Methods We used comprehensive literature reviews and expert opinion to compile a list of asthma healthcare utilization outcomes that we classified as core (required in future studies), supplemental (used according to study aims and standardized) and emerging (requiring validation and standardization). We also have identified methodology to assign cost to these outcomes. This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results We identified 3 ways to promote comparability across clinical trials for measures of healthcare utilization, resource use, and cost: (1) specify the study perspective (patient, clinician, payer, society), (2) standardize the measurement period (ideally, 12 months), and (3) use standard units to measure healthcare utilization and other asthma-related events. Conclusions Large clinical trials and observational studies should collect and report detailed information on healthcare utilization, intervention resources, and indirect impact of asthma, so that costs can be calculated and cost-effectiveness analyses can be conducted across several studies. Additional research is needed to develop standard, validated survey instruments for collection of provider-reported and participant-reported data regarding asthma-related health care. PMID:22386509

  14. Advanced networks and computing in healthcare

    PubMed Central

    Ackerman, Michael

    2011-01-01

    As computing and network capabilities continue to rise, it becomes increasingly important to understand the varied applications for using them to provide healthcare. The objective of this review is to identify key characteristics and attributes of healthcare applications involving the use of advanced computing and communication technologies, drawing upon 45 research and development projects in telemedicine and other aspects of healthcare funded by the National Library of Medicine over the past 12?years. Only projects publishing in the professional literature were included in the review. Four projects did not publish beyond their final reports. In addition, the authors drew on their first-hand experience as project officers, reviewers and monitors of the work. Major themes in the corpus of work were identified, characterizing key attributes of advanced computing and network applications in healthcare. Advanced computing and network applications are relevant to a range of healthcare settings and specialties, but they are most appropriate for solving a narrower range of problems in each. Healthcare projects undertaken primarily to explore potential have also demonstrated effectiveness and depend on the quality of network service as much as bandwidth. Many applications are enabling, making it possible to provide service or conduct research that previously was not possible or to achieve outcomes in addition to those for which projects were undertaken. Most notable are advances in imaging and visualization, collaboration and sense of presence, and mobility in communication and information-resource use. PMID:21486877

  15. Comparison of the Five Danish Regions Regarding Demographic Characteristics, Healthcare Utilization, and Medication UseA Descriptive Cross-Sectional Study

    PubMed Central

    Henriksen, Daniel Pilsgaard; Rasmussen, Lotte; Hansen, Morten Rix; Hallas, Jesper; Pottegrd, Anton

    2015-01-01

    Background While Denmark is well known for its plethora of registers. Many studies are conducted on research databases that only cover parts of Denmark, and regional differences could potentially threaten these studies external validity. The aim of this study was to assess sociodemographic and health related homogeneity of the five Danish regions. Methods We obtained descriptive data for the five Danish regions, using publicly available data sources: Statbank Denmark, the Danish Ministry of Economic Affairs, and Medstat.dk. These data sources comprise aggregate data from four different nationwide registers: The Danish National Patient Register, The Danish Civil Registration System, The Danish Register of Medicinal Product Statistics, and The Danish National Health Service Register for Primary Care. We compared the Danish regions regarding demographic and socioeconomic characteristics, health care utilization, and use of medication. For each characteristic, one-year prevalence was obtained and analyses were performed for 2013 and 2008 to account for possible change over time. Results In 2013, 5,602,628 persons were living in Denmark. The mean age was 40.7 years in the entire Danish population and ranged between 39.6 to 42.4 years in the five regions (coefficient of variation between regions [CV] = 0.028). The proportion of women in Denmark was 50.4% (CV = 0.009). The proportion of residents with low education level was 28.7% (CV = 0.051). The annual number of GP contacts was 7.1 (range: 6.77.4, CV = 0.040), and 114 per 1,000 residents were admitted to the hospital (range: 101131, CV = 0.107). The annual number of persons redeeming a prescription of any medication was 723 per 1,000 residents (range: 718743, CV = 0.016). Analyses for 2008 showed comparable levels of homogeneity as for 2013. Conclusions We found substantial homogeneity between all of the five Danish regions with regard to sociodemographic and health related characteristics. Epidemiologic studies conducted on regional subsets of Danish citizens have a high degree of generalizability. PMID:26439627

  16. Cloud Image Data Center for Healthcare Network in Taiwan.

    PubMed

    Weng, Shao-Jen; Lai, Lai-Shiun; Gotcher, Donald; Wu, Hsin-Hung; Xu, Yeong-Yuh; Yang, Ching-Wen

    2016-04-01

    This paper investigates how a healthcare network in Taiwan uses a practical cloud image data center (CIDC) to communicate with its constituent hospital branches. A case study approach was used. The study was carried out in the central region of Taiwan, with four hospitals belonging to the Veterans Hospital healthcare network. The CIDC provides synchronous and asynchronous consultation among these branches. It provides storage, platforms, and services on demand to the hospitals. Any branch-client can pull up the patient's medical images from any hospital off this cloud. Patients can be examined at the branches, and the images and reports can be further evaluated by physicians in the main Taichung Veterans General Hospital (TVGH) to enhance the usage and efficiency of equipment in the various branches, thereby shortening the waiting time of patients. The performance of the CIDC over 5 years shows: (1) the total number of cross-hospital images accessed with CDC in the branches was 132,712; and (2) TVGH assisted the branches in keying in image reports using the CIDC 4,424 times; and (3) Implementation of the system has improved management, efficiency, speed and quality of care. Therefore, the results lead to the recommendation of continuing and expanding the cloud computing architecture to improve information sharing among branches in the healthcare network. PMID:26846750

  17. Healthcare in Equatorial Guinea, West Africa: obstacles and barriers to care

    PubMed Central

    Reuter, Kim Eleanor; Geysimonyan, Aurora; Molina, Gabriela; Reuter, Peter Robert

    2014-01-01

    Introduction The provision of healthcare services in developing countries has received increasing attention, but inequalities persist. One nation with potential inequalities in healthcare services is Equatorial Guinea (Central-West Africa). Mitigating these inequalities is difficult, as the Equatoguinean healthcare system remains relatively understudied. Methods In this study, we interviewed members of the healthcare community in order to: 1) learn which diseases are most common and the most common cause of death from the perspective of healthcare workers; and 2) gain an understanding of the healthcare community in Equatorial Guinea by describing how: a) healthcare workers gain their professional knowledge; b) summarizing ongoing healthcare programs aimed at the general public; c) discussing conflicts within the healthcare community and between the public and healthcare providers; d) and addressing opportunities to improve healthcare delivery. Results We found that some causes of death, such as serious injuries, may not be currently treatable in country, potentially due to a lack of resources and trauma care facilities. In addition, training and informational programs for both healthcare workers and the general public may not be effectively transmitting information to the intended recipients. This presents hurdles to the healthcare community, both in terms of having professional competence in healthcare delivery and in having a community that is receptive to medical care. Conclusion Our data also highlight government-facility communication as an opportunity for improvement. Our research is an important first step in understanding the context of healthcare delivery in Equatorial Guinea, a country that is relatively data poor. PMID:25932082

  18. Wearable technologies – future challenges for implementation in healthcare services

    PubMed Central

    2015-01-01

    The growing use of wearable technologies increases the ability to have more information from the patient including clinical, behavioural and self-monitored data. The availability and large amounts of data that did not exist before brings an opportunity to develop new tools with intelligent analyses and decision support tools for use in clinical practice. It also opens new possibilities for the patients by providing them with more information and decision support tools specially designed for them, and empowers them in managing their own health conditions, keeping their autonomy. These new developments drive a change in healthcare delivery models and the relationship between patients and healthcare providers. It raises challenges for the healthcare systems in how to implement these new technologies and the growing amount of information in clinical practice, integrate it into the clinical workflows of the various healthcare providers. The future challenge for healthcare will be how to use the developing knowledge in a way that will bring added value to healthcare professionals, healthcare organisations and patients without increasing the workload and cost of the healthcare services. For wearable technology developers, the challenge is to develop solutions that can be easily integrated and used by healthcare professionals considering the existing constraints. PMID:26609396

  19. 75 FR 60461 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ...This notice announces the intention of the Agency for Healthcare Research and Quality (AHRQ) to request that the Office of Management and Budget (OMB) approve the proposed information collection project: ``Reduction of Clostridium difficile Infections in a Regional Collaborative of Inpatient Healthcare Settings through Implementation of Antimicrobial Stewardship.'' In accordance with the......

  20. Healthcare is primary.

    PubMed

    Kumar, Raman

    2015-01-01

    India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2(nd) National Conference on Family Medicine and Primary Care 2015 (FMPC) brought a focus on "healthcare" in India. The theme of this conference was "Healthcare is Primary." The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the "general health system" instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, "family medicine" (academic primary care), the unfinished agenda of National Health Policy 2002, remains a priority area of implementation. PMID:26985402

  1. 76 FR 16236 - Prohibition Against Certain Flights Within the Tripoli (HLLL) Flight Information Region (FIR)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-23

    ... Federal Aviation Administration 14 CFR Part 91 RIN 2120-AJ93 Prohibition Against Certain Flights Within the Tripoli (HLLL) Flight Information Region (FIR) AGENCY: Federal Aviation Administration (FAA), Department of Transportation (DOT). ACTION: Final rule. SUMMARY: This action prohibits flight...

  2. 76 FR 2406 - Notice of Proposed Information Collection: Comment Request Sustainable Communities Regional Grant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection: Comment Request Sustainable Communities Regional Grant Program AGENCY: Office of Sustainable Housing and Communities, Office of the Deputy...: Reports Liaison Officer, Department of Housing and Urban Development, 451 7th Street, SW., Washington,...

  3. 78 FR 10600 - Proposed Information Collection; Comment Request; Southeast Region Logbook Family of Forms

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Southeast Region Logbook Family of Forms AGENCY: National Oceanic and Atmospheric Administration (NOAA)....

  4. 75 FR 20812 - Proposed Information Collection; Comment Request; Northwest Region Pacific Whiting Shoreside...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Northwest Region Pacific Whiting Shoreside Fishery Monitoring and Catch Accounting Program AGENCY: National...

  5. The health of healthcare, Part II: patient healthcare has cancer.

    PubMed

    Waldman, Deane

    2013-01-01

    In this article, we make the etiologic diagnosis for a sick patient named Healthcare: the cancer of greed. When we explore the two forms of this cancer--corporate and bureaucratic--we find the latter is the greater danger to We the Patients. The "treatments" applied to patient Healthcare by the Congressional "doctors" have consistently made the patient worse, not better. At the core of healthcare's woes is the government's diversion of money from healthcare services to healthcare bureaucracy. As this is the root cause, it is what we must address in order to cure, not sedate or palliate, patient Healthcare. PMID:24236323

  6. Open, networked, integrated, multimedia, client/server behavioral healthcare.

    PubMed

    Harriman, M

    1994-01-01

    Drawing upon the results of research from over 4,500 businesses that are now re-inventing themselves through the application of current information technology, the author envisions the informational characteristics of the behavioral healthcare enterprise of the future. The new technology will be open for all stakeholders in the healthcare system to interoperate, integrated between providers and facilities nationwide, decentralized, immediately accessible and continuously updating clinically useful information. Although the new information system architecture may not be fully implemented for another 10 to 15 years, the transformation is already well underway. New computer technology makes such a reinvention of the behavioral healthcare enterprise both possible and inevitable. PMID:10142492

  7. XDS in healthcare: Could it lead to a duplication problem? Field study from GVR Sweden

    NASA Astrophysics Data System (ADS)

    Wintell, M.; Lundberg, N.; Lindskld, L.

    2011-03-01

    Managing different registries and repositories within healthcare regions grows the risk of having almost the same information but with different status and with different content. This is due to the fact that when medical information is created it's done in a dynamical process that will lead to that information will change its contents during lifetime within the "active" healthcare phase. The information needs to be easy accessible, being the platform for making the medical decisions transparent. In the Region Vstra Gtaland (VGR), Sweden, data is shared from 29 X-ray departments with different Picture Archive and Communication Systems (PACS) and Radiology Information Systems (RIS) systems through the Infobroker solution, that's acts as a broker between the actors involved. Request/reports from RIS are stored as DIgital COmmunication in Medicine (DICOM)-Structured Reports (SR) objects, together with the images. Every status change within this activities are updated within the Information Infrastructure based on Integrating the Healthcare Enterprise (IHE) mission. Cross-enterprise Document Sharing for Imaging (XDS-I) were the registry and the central repository are the components used for sharing medical documentation. The VGR strategy was not to apply one regional XDS-I registry and repository, instead VGR applied an Enterprise Architecture (EA) intertwined with the Information Infrastructure for the dynamic delivery to consumers. The upcoming usage of different Regional XDS registries and repositories could lead to new ways of carrying out shared work but it can also lead into "problems". XDS and XDS-I implemented without a strategy could lead to increased numbers of status/versions but also duplication of information in the Information Infrastructure.

  8. Smoking prevention and cessation in the Africa and Middle East region: a consensus draft guideline for healthcare providers--executive summary.

    PubMed

    Ali, Ahmed Yousif M; Safwat, Tarek; Onyemelukwe, Geoffrey; Otaibi, Moh'd Amin Al; Amir, Ashraf A; Nawas, Yousef N; Aouina, Hichem; Afif, Moulay Hicham; Bolliger, Chris T

    2012-01-01

    Despite the abundance of scientific evidence confirming the health consequences of smoking and other forms of tobacco use, the tobacco epidemic remains an important public health problem and by 2030 it is predicted that more than 80% of tobacco deaths will be in developing countries. In Africa and the Middle East, many local factors contribute to the initiation and maintenance of tobacco use. Although efforts to reduce the mortality and morbidity associated with smoking and tobacco dependence are underway, there is a need for guidance on how to utilize appropriate tobacco control policies and psychology- and pharmacology-based therapies to counter tobacco dependence as recommended by the Framework Convention on Tobacco Control (FCTC). A group of tobacco cessation experts from public health services and/or academic institutions in Africa and the Middle East participated in a series of four meetings held in Cairo, Cape Town, and Dubai between May 2008 and February 2011 to develop a draft guideline tailored to their region. This article provides the background to the development of this draft smoking cessation guideline and discusses how the recommendations can be implemented and progress monitored to promote both primary prevention and cessation of tobacco use within our countries. The draft guideline for Africa and the Middle East provides an important resource in combating the devastating effects of tobacco use in these regions which can be further localized through engagement with local stakeholders in the countries of the region. PMID:22487605

  9. E-commerce in healthcare: changing the traditional landscape.

    PubMed

    Aggarwal, A K; Travers, S

    2001-01-01

    The healthcare industry, with more than one trillion dollars in revenue, accounts for about one-seventh of the U.S. economy. A significant portion of this revenue is lost to escalating healthcare system costs. This article examines the shortcomings of the traditional healthcare delivery system in terms of information flow, communication standards, case collections, and IT spending. It makes the case that e-commerce has the ability to transact some healthcare business more efficiently and cost-effectively. With the Internet as a delivery platform, several models offer improvement over the status quo. PMID:11338906

  10. Queueing for healthcare.

    PubMed

    Palvannan, R Kannapiran; Teow, Kiok Liang

    2012-04-01

    Patient queues are prevalent in healthcare and wait time is one measure of access to care. We illustrate Queueing Theory-an analytical tool that has provided many insights to service providers when designing new service systems and managing existing ones. This established theory helps us to quantify the appropriate service capacity to meet the patient demand, balancing system utilization and the patient's wait time. It considers four key factors that affect the patient's wait time: average patient demand, average service rate and the variation in both. We illustrate four basic insights that will be useful for managers and doctors who manage healthcare delivery systems, at hospital or department level. Two examples from local hospitals are shown where we have used queueing models to estimate the service capacity and analyze the impact of capacity configurations, while considering the inherent variation in healthcare. PMID:20703697

  11. RECOSCIX-WIO: Providing Scientific Information to Marine Scientists in the Western Indian Ocean Region.

    ERIC Educational Resources Information Center

    Egghe, L.; Pissierssens, P.

    1997-01-01

    Describes RECOSCIX-WIO (Regional Cooperation in Scientific Information Exchange in the Western Indian Ocean Region). Details are given on the project's history, operational structure, and communication facilities, as well as services and products including query handling and document delivery. Future plans are also discussed, including CD-ROMs and

  12. [Local and citizen participation and representation strategies in Healthcare Administration].

    PubMed

    Sancho Serena, Francesc; Grané Alsina, Montserrat; Olivet, Miquel

    2015-11-01

    The public as a whole are the rightful owners and beneficiaries of the public healthcare system in our country. As such, they collaborate in its maintenance and upkeep through payment of taxes. The government is accountable to the public as to how the ever-scarce resources are allocated. When it comes to the area of healthcare, this represents an added factor of complexity and specificity which makes the issue a particularly sensitive one. In the field of healthcare, both the General Health Law and the Law of Catalan Healthcare Code define the actors responsible for the public representation of its citizens. Nevertheless, their inclusion does not necessarily guarantee the perception of participation by its citizens or that of a greater democratic quality. The model must be understood as the intermediary link between a legally regulated framework and the actual debate, which in a globalized world with such an immense volume of information available to citizens and with the current online social networking sites, occurs at the heart of society in general, even though government has no such incorporation channel. The system will need to be developed as new technologies enable this, towards a more direct and more global models for participation. Participation is a flexible concept which, as far as possible, needs to adapt to the different problems as well as the different regions. Legislative regulation must therefore provide the mechanisms and stable frameworks for participation. In turn however, it must also establish dynamic systems capable of adapting to and incorporating the varying demands and methods of participation coming from the public in response to disparate processes. PMID:26711059

  13. Developing a Security Metrics Scorecard for Healthcare Organizations.

    PubMed

    Elrefaey, Heba; Borycki, Elizabeth; Kushniruk, Andrea

    2015-01-01

    In healthcare, information security is a key aspect of protecting a patient's privacy and ensuring systems availability to support patient care. Security managers need to measure the performance of security systems and this can be achieved by using evidence-based metrics. In this paper, we describe the development of an evidence-based security metrics scorecard specific to healthcare organizations. Study participants were asked to comment on the usability and usefulness of a prototype of a security metrics scorecard that was developed based on current research in the area of general security metrics. Study findings revealed that scorecards need to be customized for the healthcare setting in order for the security information to be useful and usable in healthcare organizations. The study findings resulted in the development of a security metrics scorecard that matches the healthcare security experts' information requirements. PMID:26718256

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

    PubMed Central

    2011-01-01

    Background This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI) and at risk for cardiovascular disease (CVD). Methods The proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30) to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention. Discussion The proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population. PMID:21791070

  15. Documentation goes wireless: a look at mobile healthcare computing devices.

    PubMed

    Waegemann, C Peter; Tessier, Claudia

    2002-09-01

    Patient care information often suffers as it travels from handwritten notes, dictation, or the memory of the clinician to the medical record. Hand-held devices equipped with mobile healthcare aplications can bring documentatin to the point of care. In this article, learn how mobile healthcare computing devices can decrease medical errors, increase efficiency, and improve the delivery of care. PMID:12233207

  16. Decision-Support Tools and Databases to Inform Regional Stormwater Utility Development in New England

    EPA Science Inventory

    Development of stormwater utilities requires information on existing stormwater infrastructure and impervious cover as well as costs and benefits of stormwater management options. US EPA has developed a suite of databases and tools that can inform decision-making by regional sto...

  17. Information Systems for Urban and Regional Planning: Asian and Pacific Perspectives.

    ERIC Educational Resources Information Center

    United Nations Centre for Regional Development, Nagoya (Japan).

    These papers produced for a research project and seminar discuss from different conceptual, methodological, and practical perspectives the use of information systems to help improve the urban and regional planning process in developing countries, particularly in Asia and the Pacific. The 15 papers are: (1) "Assessing the Context for Information

  18. Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research

    PubMed Central

    Saokaew, Surasak; Sugimoto, Takashi; Kamae, Isao; Pratoomsoot, Chayanin; Chaiyakunapruk, Nathorn

    2015-01-01

    Background Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Method Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases’ characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Results Forty databases– 20 from Thailand and 20 from Japan—were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Conclusion Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed. PMID:26560127

  19. Fast object tracking based on template matching and region information fusion extraction

    NASA Astrophysics Data System (ADS)

    Liu, Liman; Chen, Yun; Liu, Haihua

    2015-12-01

    In this paper, a fast object tracking algorithm based on template matching and region information fusion extraction is proposed. In the prediction framework, the data connection task is achieved by object template and object information extraction. And then the object is tracked accurately by using the object motion information. We handle the tracking shift by using the confidence estimation strategy. The experiments show that the proposed algorithm has robust performance.

  20. Factors influencing healthcare service quality

    PubMed Central

    Mosadeghrad, Ali Mohammad

    2014-01-01

    Background: The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context. Methods: Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations. Results: Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers. Conclusion: This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality. PMID:25114946

  1. Healthcare is primary

    PubMed Central

    Kumar, Raman

    2015-01-01

    India is undergoing a rapid transformation in terms of governance, administrative reforms, newer policy develoment, and social movements. India is also considered one of the most vibrant economies in the world. The current discourse in public space is dominated by issues such as economic development, security, corruption free governance, gender equity, and women safety. Healthcare though remains a pressing need of population; seems to have taken a backseat. In the era of decreasing subsidies and cautious investment in social sectors, the 2nd National Conference on Family Medicine and Primary Care 2015 (FMPC) brought a focus on “healthcare” in India. The theme of this conference was “Healthcare is Primary.” The conference participants discussed on the theme of why healthcare should be a national priority and why strong primary care should remain at the center of healthcare delivery system. The experts recommended that India needs to strengthen the “general health system” instead of focusing on disease based vertical programs. Public health system should have capacity and skill pool to be able to deliver person centered comprehensive health services to the community. Proactive implementation of policies towards human resource in health is the need of the hour. As the draft National Health Policy 2015 is being debated, “family medicine” (academic primary care), the unfinished agenda of National Health Policy 2002, remains a priority area of implementation. PMID:26985402

  2. Norovirus in healthcare settings

    PubMed Central

    Iturriza-Gómara, Miren; Lopman, Benjamin

    2014-01-01

    Purpose of review To provide an overview of the burden of norovirus disease in healthcare settings and the factors responsible for outbreaks in these institutions; to assess progress on interventions aimed at reducing the burden of norovirus disease. Recent findings Norovirus outbreaks in healthcare settings are driven by confluence of viral diversity, the built environment, and host factors. Some of these characteristics may be modifiable and the target of successful interventions. Summary Most norovirus outbreaks in hospital and residential care institutions are associated with a particular genotype, known as GII.4. The persistence of norovirus is associated with strain diversity, which is driven by immune evasion and viral adaptation to interaction with a variety of human histo-blood group antigens. The healthcare environment presents serious challenges for control, both because of the physical structure of the built space and the high levels of contact among patient populations who may have compromised hygiene. Increased vulnerability among the populations in healthcare institutions is likely to be multifactorial and may include the following: nutritional status, immunodeficiency or senescence, chronic inflammation, and microbiome alterations. Current control measures are based on general infection control principles, and treatment is mainly supportive and nonspecific. Vaccines and antiviral agents are being developed with promising results, but none are currently available. PMID:25101555

  3. A wireless trust model for healthcare.

    PubMed

    Wickramasinghe, Nilmini; Misra, Santosh K

    2004-01-01

    In today's context of escalating costs, managed care, regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and a technology savvy patient, the healthcare industry can no longer be complacent regarding embracing technologies to enable better, more effective and efficient practice management. In such an environment, many healthcare organisations are turning to m-commerce or wireless solutions. These solutions, in particular the mobile electronic patient record, have many advantages over their wired counterparts, including significant cost advantages, higher levels of physician acceptance, more functionalities as well as enabling easy accessibility to healthcare in remote geographic regions, however, they also bring with them challenges of their own. One such major challenge is security. To date, few models exist that help establish an appropriate framework, in the context of wireless in healthcare, in which to understand and evaluate all the security issues let alone facilitate the development of systematic and robust solutions. Our paper addresses this need by outlining an appropriate mobile trust model for such a scenario in healthcare organisations. PMID:18048204

  4. Pseudomonas aeruginosa in Healthcare Settings

    MedlinePLUS

    ... associated Infections (HAIs) Share Compartir Pseudomonas aeruginosa in Healthcare Settings On this Page What is a Pseudomonas ... Pseudomonas can be spread on the hands of healthcare workers or by equipment that gets contaminated and ...

  5. Your Heart Failure Healthcare Team

    MedlinePLUS

    ... Pressure Tools & Resources Stroke More Your Heart Failure Healthcare Team Updated:Mar 25,2016 Patients with heart failure may work with multiple healthcare professionals. It's important to develop good relationships with ...

  6. HIT plants SEEDS in healthcare education.

    PubMed

    Connors, Helen; Warren, Judith; Weaver, Charlotte

    2007-01-01

    By incorporating a clinical information system in the education curriculum as a teaching platform, the University of Kansas School of Nursing teaches nurses and other health professional students how to assess, plan, document and manage care in an electronic medium that develops healthcare informatics competencies. The outcomes of this integrated technology curriculum brings hope for transforming health professional education for 21st century practice and graduating a workforce with the leadership and competencies for improving quality and safety in patient care. It results in IT savvy healthcare providers who will cross the quality chasm. PMID:17413506

  7. Structuring a sound securitization of healthcare receivables.

    PubMed

    Spradling, Mark

    2003-02-01

    Securitization of receivables allows healthcare providers to obtain an additional funding source by selling their accounts receivables to investors. A double-lock-box structure allows providers to securitize Medicare and Medicaid receivables without violating federal laws. A 2001 revision to the Uniform Commercial Code facilitates providers' securitization of private healthcare insurance receivables by underscoring rights of a purchaser of those receivables. HIPAA privacy standards appear to permit the use and disclosure of protected health information in crafting a securitization program. The securitization should be structured to shield the value of the receivables to be transferred from the potential backruptcies of the originator and the purchaser. PMID:12602313

  8. Missed opportunities in child healthcare

    PubMed Central

    Jonker, Linda

    2014-01-01

    Background Various policies in health, such as Integrated Management of Childhood Illnesses, were introduced to enhance integrated service delivery in child healthcare. During clinical practice the researcher observed that integrated services may not be rendered. Objectives This article describes the experiences of mothers that utilised comprehensive child health services in the Cape Metropolitan area of South Africa. Services included treatment for diseases; preventative interventions such as immunisation; and promotive interventions, such as improvement in nutrition and promotion of breastfeeding. Method A qualitative, descriptive phenomenological approach was applied to explore the experiences and perceptions of mothers and/or carers utilising child healthcare services. Thirty percent of the clinics were selected purposively from the total population. A convenience purposive non-probability sampling method was applied to select 17 mothers who met the criteria and gave written consent. Interviews were conducted and recorded digitally using an interview guide. The data analysis was done using Tesch's eight step model. Results Findings of the study indicated varied experiences. Not all mothers received information about the Road to Health book or card. According to the mothers, integrated child healthcare services were not practised. The consequences were missed opportunities in immunisation, provision of vitamin A, absence of growth monitoring, feeding assessment and provision of nutritional advice. Conclusion There is a need for simple interventions such as oral rehydration, early recognition and treatment of diseases, immunisation, growth monitoring and appropriate nutrition advice. These services were not offered diligently. Such interventions could contribute to reducing the incidence of child morbidity and mortality. PMID:26245404

  9. Lean six sigma in healthcare.

    PubMed

    de Koning, Henk; Verver, John P S; van den Heuvel, Jaap; Bisgaard, Soren; Does, Ronald J M M

    2006-01-01

    Healthcare, as with any other service operation, requires systematic innovation efforts to remain competitive, cost efficient, and up-to-date. This article outlines a methodology and presents examples to illustrate how principles of Lean Thinking and Six Sigma can be combined to provide an effective framework for producing systematic innovation efforts in healthcare. Controlling healthcare cost increases, improving quality, and providing better healthcare are some of the benefits of this approach. PMID:16749293

  10. Emerging Frontiers in Healthcare Research and Delivery.

    PubMed Central

    Stevens, Alan B.; Sanghi, Sandhya

    2010-01-01

    The Health Maintenance Organization Research Network (HMORN), a consortium of 16 healthcare delivery systems with integrated research centers, held their 16th annual conference in Austin, Texas from March 2124, 2010. The conference was hosted by Scott & White Healthcare. Its theme Emerging Frontiers in Healthcare Research and Delivery reflected the objective of the conference which was to build synergy among scientists and clinicians to influence the health of the nation; to demonstrate the networks commitment to reach beyond traditional collaborators; discuss tools and technologies; and to expand opportunities for public-private partnerships in cutting-edge healthcare research and delivery. More than 320 researchers and healthcare professionals, representing each of the member HMOs, participated in this conference. Representatives from the AHRQ, CDC, NCI and NIH met with researchers to advance the quality and breadth of public domain research in HMOs. The objective of this article is to provide information about the HMORN and its 16th annual conference. PMID:21177536

  11. [Big data in medicine and healthcare].

    PubMed

    Rping, Stefan

    2015-08-01

    Healthcare is one of the business fields with the highest Big Data potential. According to the prevailing definition, Big Data refers to the fact that data today is often too large and heterogeneous and changes too quickly to be stored, processed, and transformed into value by previous technologies. The technological trends drive Big Data: business processes are more and more executed electronically, consumers produce more and more data themselves - e.g. in social networks - and finally ever increasing digitalization. Currently, several new trends towards new data sources and innovative data analysis appear in medicine and healthcare. From the research perspective, omics-research is one clear Big Data topic. In practice, the electronic health records, free open data and the "quantified self" offer new perspectives for data analytics. Regarding analytics, significant advances have been made in the information extraction from text data, which unlocks a lot of data from clinical documentation for analytics purposes. At the same time, medicine and healthcare is lagging behind in the adoption of Big Data approaches. This can be traced to particular problems regarding data complexity and organizational, legal, and ethical challenges. The growing uptake of Big Data in general and first best-practice examples in medicine and healthcare in particular, indicate that innovative solutions will be coming. This paper gives an overview of the potentials of Big Data in medicine and healthcare. PMID:26063521

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

    PubMed

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

    2010-01-01

    As the volume of data that is electronically available promliferates, the health-care industry is identifying better ways to use this data for patient care. Ideally, these data are collected in real time, can support point-of-care clinical decisions, and, by providing instantaneous quality metrics, can create the opportunities to improve clinical practice as the patient is being cared for. The business-world technology supporting these activities is referred to as business intelligence, which offers competitive advantage, increased quality, and operational efficiencies. The health-care industry is plagued by many challenges that have made it a latecomer to business intelligence and data-mining technology, including delayed adoption of electronic medical records, poor integration between information systems, a lack of uniform technical standards, poor interoperability between complex devices, and the mandate to rigorously protect patient privacy. Efforts at developing a health care equivalent of business intelligence (which we will refer to as clinical intelligence) remains in its infancy. Until basic technology infrastructure and mature clinical applications are developed and implemented throughout the health-care system, data aggregation and interpretation cannot effectively progress. The need for this approach in health care is undisputed. As regional and national health information networks emerge, we need to develop cost-effective systems that reduce time and effort spent documenting health-care data while increasing the application of knowledge derived from that data. PMID:20659837

  13. Log Pearson type 3 quantile estimators with regional skew information and low outlier adjustments

    USGS Publications Warehouse

    Griffis, V.W.; Stedinger, J.R.; Cohn, T.A.

    2004-01-01

    [1] The recently developed expected moments algorithm (EMA) [Cohn et al., 1997] does as well as maximum likelihood estimations at estimating log-Pearson type 3 (LP3) flood quantiles using systematic and historical flood information. Needed extensions include use of a regional skewness estimator and its precision to be consistent with Bulletin 17B. Another issue addressed by Bulletin 17B is the treatment of low outliers. A Monte Carlo study compares the performance of Bulletin 17B using the entire sample with and without regional skew with estimators that use regional skew and censor low outliers, including an extended EMA estimator, the conditional probability adjustment (CPA) from Bulletin 17B, and an estimator that uses probability plot regression (PPR) to compute substitute values for low outliers. Estimators that neglect regional skew information do much worse than estimators that use an informative regional skewness estimator. For LP3 data the low outlier rejection procedure generally results in no loss of overall accuracy, and the differences between the MSEs of the estimators that used an informative regional skew are generally modest in the skewness range of real interest. Samples contaminated to model actual flood data demonstrate that estimators which give special treatment to low outliers significantly outperform estimators that make no such adjustment.

  14. Healing, healthcare, missions, the church.

    PubMed

    Jarlsberg, Connie

    2014-01-01

    Churches throughout history have modeled ministry on Jesus' life of reaching out, teaching, preaching, and healing. Kampala Baptist Church (KBC) in Uganda is one such church that works to care spiritually and physically for their community. Partnering with local healthcare providers and short- and long-term healthcare missionaries, the church is transforming lives. Read about KBC and explore healthcare missions ministry. PMID:24592600

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

    PubMed

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

    2015-11-01

    We find ourselves at the end of an era of asymmetry in the domain of health information where the majority of this data is in the hands of the healthcare system. Increasingly, the public are calling for a more central role in the new paradigm that enables them to duly exercise their right of access to their health data while availing of more reliable and safer technologies which contribute to the management of their condition and promote healthy lifestyles. So far, the TIC Salud strategic plan has been developed independently from the Generalitat de Catalunya Health Department's Healthcare Plan, which sets out health policy strategy in Catalonia. However, from its initial design stage the new Healthcare Plan (2016- 2020) envisages incorporating a new strategic Information and communications technology (ICT) line called "Digital Health". Incorporating ICT into the Health Plan will allow these technologies to become integral part of all strategic healthcare processes, acting as a driving force for a shift towards a new healthcare models and an innovative relationship between the public and healthcare professionals. The Digital Health implies a disruption in itself, by way of the convergence of several technologies and their positive impact on health and healthcare procedures, by way of the public's access to information concerning their health, and by creating new opportunities for promoting health and the salutogenic paradigm which empowers people to develop their health, welfare and quality of life. PMID:26711061

  16. Off-Patent Generic Medicines vs. Off-Patent Brand Medicines for Six Reference Drugs: A Retrospective Claims Data Study from Five Local Healthcare Units in the Lombardy Region of Italy

    PubMed Central

    Colombo, Giorgio L.; Agabiti-Rosei, Enrico; Margonato, Alberto; Mencacci, Claudio; Montecucco, Carlo Maurizio; Trevisan, Roberto

    2013-01-01

    The scientific documentation supporting the potential clinical and economic benefits of a growing use of off-patent generic drugs in clinical practice seems to be limited in Italy as yet. Methods We compared differences in outcomes between off-patent generic drugs and off-patent brand drugs in real clinical practice. The outcomes were: persistence and compliance with therapy, mortality, and other health resources consumption (hospitalizations, specialist examinations, other drugs) and total costs. Retrospective analysis was carried out by using the administrative databases of five Local Healthcare Units (ASLs - Aziende Sanitarie Locali) in the Lombardy Region of Italy. Data from the five ASLs were aggregated through a meta-analysis, which produced an estimate indicator of the mean or percentage difference between the two groups (branded vs. generic) and their respective significance tests. The therapeutic areas and studied drugs were: diabetes: metformin - A10BA02; hypertension: amlodipine - C08CA01; dyslipidemia: simvastatin - C10AA01; psychiatry: sertraline - N06AB06; cardiology: propafenone - C01BC03; osteoporosis: alendronate - M05BA04. Results The 5 Local Healthcare Units (ASL) represent a population of 3,847,004 inhabitants. The selected sample included 347,073 patients, or 9.02% of the total ASL population; 67% of the patients were treated with off-patent brand drugs. The average age was 68 years, with no difference between the two groups. After 34 months of observation, compliance and persistence were in favor to generic drugs in all therapeutic areas and statistically significant in the metformin, amlodipine, simvastatin, and sertraline groups. The clinical outcomes (hospitalizations, mortality, and other health costs) show no statistically significant differences between off-patent generic vs. off-patent brand medicines. Conclusions Off-patent generic drugs appear to be a therapy option of choice in Italy as well, based on clinical outcomes and economic consequences, both for the National Health Service and patients, considering that the price difference between brand and generic drugs is completely charged on patients. PMID:24367576

  17. Factors Related to the Selection of Information Sources: A Study of Ramkhamhaeng University Regional Campuses Graduate Students

    ERIC Educational Resources Information Center

    Angchun, Peemasak

    2011-01-01

    This study assessed students' satisfaction with Ramkhamhaeng University regional library services (RURLs) and the perceived quality of information retrieved from other information sources. In particular, this study investigated factors relating to regional students' selection of information sources to meet their information needs. The

  18. Factors Related to the Selection of Information Sources: A Study of Ramkhamhaeng University Regional Campuses Graduate Students

    ERIC Educational Resources Information Center

    Angchun, Peemasak

    2011-01-01

    This study assessed students' satisfaction with Ramkhamhaeng University regional library services (RURLs) and the perceived quality of information retrieved from other information sources. In particular, this study investigated factors relating to regional students' selection of information sources to meet their information needs. The…

  19. 76 FR 73595 - Healthcare Technology, Policy & Trade Mission: Mexico City, Mexico, May 13-16, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-29

    ... International Trade Administration Healthcare Technology, Policy & Trade Mission: Mexico City, Mexico, May 13-16... Commercial Service (CS) is organizing an executive-led healthcare technology policy and trade mission to... healthcare information technologies (IT), medical devices, and other medical technology. The mission...

  20. 76 FR 9577 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... (Pub. L. 92-463) of October 6, 1972, that the Healthcare Infection Control Practices Advisory Committee... information, contact Jeffrey Hageman, M.H.S., Executive Secretary, Healthcare Infection Control...

  1. 78 FR 6328 - Healthcare Infection Control Practices Advisory Committee: Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... HUMAN SERVICES Centers for Disease Control and Prevention Healthcare Infection Control Practices... (Pub. L. 92-463) of October 6, 1972, that the Healthcare Infection Control Practices Advisory Committee... information, contact Jeffrey Hageman, M.H.S., Executive Secretary, Healthcare Infection Control...

  2. Genomics is changing personal healthcare and medicine: the dawn of iPH (individualized preventive healthcare).

    PubMed

    Mehrian-Shai, Ruty; Reichardt, Juergen K V

    2015-01-01

    This opinion piece focuses on the convergence of information technology (IT) in the form of personal monitors, especially smart phones and possibly also smart watches, individual genomic information and preventive healthcare and medicine. This may benefit each one of us not only individually but also society as a whole through iPH (individualized preventive healthcare). This shift driven by genomic and other technologies may well also change the relationship between patient and physician by empowering the former but giving him/her also much more individual responsibility. PMID:26537019

  3. New information on regional subsidence and soil fracturing in Mexico City Valley

    NASA Astrophysics Data System (ADS)

    Auvinet, G.; Mndez-Snchez, E.; Jurez-Camarena, M.

    2015-11-01

    In this paper, updated information about regional subsidence in Mexico City downtown area is presented. Data obtained by R. Gayol in 1891, are compared with information obtained recently from surveys using the reference points of Sistema de Aguas de la Ciudad de Mxico (2008) and on the elevation of a cloud of points on the ground surface determined using Light Detection and Ranging (LiDAR) technology. In addition, this paper provides an overview of recent data obtained from systematic studies focused on understanding soil fracturing associated with regional land subsidence and mapping of areas susceptible to cracking in Mexico City Valley.

  4. Healthcare avoidance: a critical review.

    PubMed

    Byrne, Sharon K

    2008-01-01

    The purpose of this study is to provide a critical review and synthesis of theoretical and research literature documenting the impact of avoidance on healthcare behaviors, identify the factors that influence healthcare avoidance and delay in the adult population, and propose a direction for future research. The Theory of Reasoned Action, Theory of Planned Behavior, Theory of Care-Seeking Behavior, the Transtheoretical Model, and the Behavioral Model of Health Services Use/Utilization are utilized to elaborate on the context within which individual intention to engage in healthcare behaviors occurs. Research literature on the concept of healthcare avoidance obtained by using computerized searches of CINAHL, MEDLINE, PSYCH INFO, and HAPI databases, from 1995 to 2007, were reviewed. Studies were organized by professional disciplines. Healthcare avoidance is a common and highly variable experience. Multiple administrative, demographic, personal, and provider factors are related to healthcare avoidance, for example, distrust of providers and/or the science community, health beliefs, insurance status, or socioeconomic/income level. Although the concept is recognized by multiple disciplines, limited research studies address its impact on healthcare decision making. More systematic research is needed to determine correlates of healthcare avoidance. Such studies will help investigators identify patients at risk for avoidant behaviors and provide the basis for health-promoting interventions. Methodological challenges include identification of characteristics of individuals and environments that hinder healthcare behaviors, as well as, the complexity of measuring healthcare avoidance. Studies need to systematically explore the influence of avoidance behaviors on specific healthcare populations at risk. PMID:18758277

  5. Sociotechnical changing in healthcare.

    PubMed

    Petrakaki, Dimitra; Cornford, Tony; Klecun, Ela

    2010-01-01

    This paper discusses a conceptual approach to the study of the implementation of ICTs in healthcare organizations. The paper uses some fundamental concepts from sociotechnical studies to address the complex process of change--the changing--that accompanies ICT innovations. The paper argues for the importance of the perspective of changing as a way to account for the dynamics as technology and people, organizations and institutions co-constitutively work-out their future together. PMID:20543363

  6. [The healthcare democracy].

    PubMed

    Saout, Christian

    2015-06-01

    Thirteen years after the law of 4th March 2002, known as the "Kouchner law", what is the situation regarding the much talked about healthcare democracy? Individual and collective rights have been granted to the users of the health care system. In addition, a series of actions have been promoted in order to exert them. Finally, a number of places and processes favouring consultation have been put in place. PMID:26146320

  7. Healthcare Systems and Motivation

    PubMed Central

    Loewy, Erich H.

    2007-01-01

    Despite the fact that most American physicians, at least until around the 1970s, stood in the way of developing a universal healthcare system, most are generally not happy with the current state of healthcare – or its lack thereof – today. The primary reasons for this general unhappiness are that insurance companies and managed care have successfully conspired to remove much of the physician's autonomy (via imposed time constraints, burdensome paperwork, the time-consuming chore of having to defend going against stringent treatment algorithms that are often inappropriate for some patients) and the satisfaction of knowing their patients. Few physicians in managed care organizations (MCOs) are able to practice without constant and blindly algorithmic interference concerning the diagnostic tests and therapeutic interventions they order. As copayments have increased, they often find that patients, even though “covered,” cannot afford the therapy they deem necessary. While physicians expect to earn sufficient to pay back their not insignificant educational debts, provide their children with help through college, and assure retirements sufficient for themselves and their spouses, these should not be considered unreasonable expectations. Most physicians today do favor universal healthcare – to the point of having included such language in their various professional codes of ethics (which, perversely enough, bioethicists as a group have failed to do). Contrary to the claims of our colleagues, Altom and Churchill, physicians seem to be genuinely frustrated as to what else they can do to change the current inequitable system. PMID:17435646

  8. Using ESB and BPEL for evolving healthcare systems towards SOA.

    PubMed

    Papakonstantinou, D; Malamateniou, F; Vassilacopoulos, G

    2008-01-01

    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. This paper takes a process perspective of healthcare delivery within and across organizational boundaries and the presents a disciplined approach for evolving healthcare systems towards a service-oriented architecture using the enterprise system bus middleware technology for resolving integration issues and the business process execution language for supporting collaboration requirements. PMID:18487821

  9. Distinct regions of prefrontal cortex are associated with the controlled retrieval and selection of social information.

    PubMed

    Satpute, Ajay B; Badre, David; Ochsner, Kevin N

    2014-05-01

    Research in social neuroscience has uncovered a social knowledge network that is particularly attuned to making social judgments. However, the processes that are being performed by both regions within this network and those outside of this network that are nevertheless engaged in the service of making a social judgment remain unclear. To help address this, we drew upon research in semantic memory, which suggests that making a semantic judgment engages 2 distinct control processes: A controlled retrieval process, which aids in bringing goal-relevant information to mind from long-term stores, and a selection process, which aids in selecting the information that is goal-relevant from the information retrieved. In a neuroimaging study, we investigated whether controlled retrieval and selection for social information engage distinct portions of both the social knowledge network and regions outside this network. Controlled retrieval for social information engaged an anterior ventrolateral portion of the prefrontal cortex, whereas selection engaged both the dorsomedial prefrontal cortex and temporoparietal junction within the social knowledge network. These results suggest that the social knowledge network may be more involved with the selection of social information than the controlled retrieval of it and incorporates lateral prefrontal regions in accessing memory for making social judgments. PMID:23300111

  10. Distinct Regions of Prefrontal Cortex Are Associated with the Controlled Retrieval and Selection of Social Information

    PubMed Central

    Satpute, Ajay B.; Badre, David; Ochsner, Kevin N.

    2014-01-01

    Research in social neuroscience has uncovered a social knowledge network that is particularly attuned to making social judgments. However, the processes that are being performed by both regions within this network and those outside of this network that are nevertheless engaged in the service of making a social judgment remain unclear. To help address this, we drew upon research in semantic memory, which suggests that making a semantic judgment engages 2 distinct control processes: A controlled retrieval process, which aids in bringing goal-relevant information to mind from long-term stores, and a selection process, which aids in selecting the information that is goal-relevant from the information retrieved. In a neuroimaging study, we investigated whether controlled retrieval and selection for social information engage distinct portions of both the social knowledge network and regions outside this network. Controlled retrieval for social information engaged an anterior ventrolateral portion of the prefrontal cortex, whereas selection engaged both the dorsomedial prefrontal cortex and temporoparietal junction within the social knowledge network. These results suggest that the social knowledge network may be more involved with the selection of social information than the controlled retrieval of it and incorporates lateral prefrontal regions in accessing memory for making social judgments. PMID:23300111

  11. Language-in-Healthcare Policy, Interaction Patterns, and Unequal Care on the U.S.-Mexico Border

    ERIC Educational Resources Information Center

    Martinez, Glenn

    2008-01-01

    This paper examines the implementation of language-in-healthcare policy in a highly bilingual, medically stressed border region of south Texas. In its current form, federal language-in-healthcare policy unevenly impacts different geographic regions. Healthcare markets along the U.S.-Mexico border are particularly taxed by the recent language

  12. CEO is a vision of the future role and position of CIO in healthcare organizations.

    PubMed

    Moghaddasi, Hamid; Sheikhtaheri, Abbas

    2010-12-01

    Literature related to chief information officer (CIO) in the developed countries during the past 20 years has been reviewed to identify the future trends of the position. The literature shows that CIO is a growing position in the healthcare industry that has achieved much popularity because today's healthcare has a great focus on information management and technology and that CIO can be future powerful strategist for healthcare organizations. Therefore, a model for an ideal healthcare CIO based on lesson learned from literature was suggested. It seems that in the developed countries, CIOs will achieve many opportunities to come in the highest executive teams of healthcare organizations and may undertake CEO roles. PMID:20703595

  13. Interoperability in healthcare: major challenges in the creation of the enterprise environment

    NASA Astrophysics Data System (ADS)

    Lindsköld, L.; Wintell, M.; Lundberg, N.

    2009-02-01

    There is today a lack of interoperability in healthcare although the need for it is obvious. A new healthcare enterprise environment has been deployed for secure healthcare interoperability in the Western Region in Sweden (WRS). This paper is an empirical overview of the new enterprise environment supporting regional shared and transparent radiology domain information in the WRS. The enterprise environment compromises 17 radiology departments, 1,5 million inhabitants, using different RIS and PACS in a joint work-oriented network and additional cardiology, dentistry and clinical physiology departments. More than 160 terabytes of information are stored in the enterprise repository. Interoperability is developed according to the IHE mission, i.e. applying standards such as Digital Imaging and Communication in Medicine (DICOM) and Health Level 7 (HL7) to address specific clinical communication needs and support optimal patient care. The entire enterprise environment is implemented and used daily in WRS. The central prerequisites in the development of the enterprise environment in western region of Sweden were: 1) information harmonization, 2) reuse of standardized messages e.g. HL7 v2.x and v3.x, 3) development of a holistic information domain including both text and images, and 4) to create a continuous and dynamic update functionality. The central challenges in this project were: 1) the many different vendors acting in the region and the negotiations with them to apply communication roles/profiles such as HL7 (CDA, CCR), DICOM, and XML, 2) the question of whom owns the data, and 3) incomplete technical standards. This study concludes that to create a workflow that runs within an enterprise environment there are a number of central prerequisites and challenges that needs to be in place. This calls for negotiations on an international, national and regional level with standardization organizations, vendors, health management and health personnel.

  14. Information and communication on risks related to medications and proper use of medications for healthcare professionals and the general public: precautionary principle, risk management, communication during and in the absence of crisis situations.

    PubMed

    Molimard, Mathieu; Bernaud, Corine; Lechat, Philippe; Bejan-Angoulvant, Theodora; Benattia, Cherif; Benkritly, Amel; Braunstein, David; Cabut, Sandrine; David, Nadine; Fourrier-Rglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Vronique; Le Jeunne, Claire; Leurs, Irina; Liard, Franois; Malbezin, Muriel; Micallef, Joelle; Nguon, Marina

    2014-01-01

    Recent drug crises have highlighted the complexity, benefits and risks of medication communication. The difficulty of this communication is due to the diversity of the sources of information and the target audience, the credibility of spokespersons, the difficulty to communicate on scientific uncertainties and the precautionary principle, which is influenced by variable perceptions and tolerances of the risk. Globally, there is a lack of training in risk management with a tendency of modern society to refuse even the slightest risk. Communication on medications is subject to regulatory or legal requirements, often uses tools and messages that are not adapted to the target audience and is often based on a poor knowledge of communication techniques. In order to improve this situation, the available information must be coordinated by reinforcing the unique medication information website and by coordinating communication between authorities by means of a single spokesperson. A particular effort must be made in the field of training in the proper use and risk of medications for both the general population and patients but also for healthcare professionals, by setting up a unified academic on-line teaching platform for continuing medical education on medications and their proper use. PMID:25099666

  15. Health-care district management information system plan: Review of operations analysis activities during calendar year 1975 and plan for continued research and analysis activities

    NASA Technical Reports Server (NTRS)

    Nielson, G. J.; Stevenson, W. G.

    1976-01-01

    Operations research activities developed to identify the information required to manage both the efficiency and effectiveness of the Veterans Administration (VA) health services as these services relate to individual patient care are reported. The clinical concerns and management functions that determine this information requirement are discussed conceptually. Investigations of existing VA data for useful management information are recorded, and a diagnostic index is provided. The age-specific characteristics of diseases and lengths of stay are explored, and recommendations for future analysis activities are articulated. The effect of the introduction of new technology to health care is also discussed.

  16. 78 FR 19648 - Proposed Information Collection; Comment Request; Northeast Region Dealer Purchase Reports

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... Region Dealer Purchase Reports AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce... official designee a detailed report of all fish purchased or received for a commercial purpose, other than... Collection Dealers submit purchase information through an electronic process by either the Web-based...

  17. 76 FR 55364 - Request for Information: Technical Inputs and Assessment Capacity Related to Regional, Sectoral...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ... Federal Register on Wednesday, July 13, 2011 (76 FR 41217). This RFI sought comments and expressions of... original Federal Register Notice of a Request for Information at 76 FR 41217 (July 13, 2011), or the United... Capacity Related to Regional, Sectoral, and Cross-Cutting Assessments for the 2013 U.S. National...

  18. 75 FR 9157 - Proposed Information Collection; Comment Request; Alaska Region Scale and Catch Weighing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... Region Scale and Catch Weighing Requirements AGENCY: National Oceanic and Atmospheric Administration... or patsy.bearden@noaa.gov . SUPPLEMENTARY INFORMATION: I. Abstract The scale and catch weighing requirements address performance standards designed to ensure that all catch delivered to the processor...

  19. Making a Traditional Study-Abroad Program Geographic: A Theoretically Informed Regional Approach

    ERIC Educational Resources Information Center

    Jokisch, Brad

    2009-01-01

    Geographers have been active in numerous focused study-abroad programs, but few have created or led language-based programs overseas. This article describes the development of a Spanish language program in Ecuador and how it was made geographic primarily through a theoretically informed regional geography course. The approach employs theoretical

  20. 75 FR 9158 - Proposed Information Collection; Comment Request; Identification of Northeast Regional Ocean...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ...; Identification of Northeast Regional Ocean Council Information Network Using Social Network Analysis AGENCY.... NROC's members come from varied expertise and work on these issues in many capacities. A social network analysis will serve to identify the network of people working on NROC's key issues, both within and...

  1. Strategies To Help Students Cope with the High Information Flow in World Regional Geography Courses.

    ERIC Educational Resources Information Center

    Heath, Douglas E.

    A traditional world regional geography course inescapably entails a flow of information that many community college students find overwhelming. This paper delineates five strategies developed over 30 years of teaching to help students cope with this fundamental problem: (1) using study guides or a manual to help students understand assigned

  2. Making a Traditional Study-Abroad Program Geographic: A Theoretically Informed Regional Approach

    ERIC Educational Resources Information Center

    Jokisch, Brad

    2009-01-01

    Geographers have been active in numerous focused study-abroad programs, but few have created or led language-based programs overseas. This article describes the development of a Spanish language program in Ecuador and how it was made geographic primarily through a theoretically informed regional geography course. The approach employs theoretical…

  3. 75 FR 31761 - Proposed Information Collection; Comment Request; Alaska Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... also specify the size and color of markings. The marking of gear aids law enforcement and enables other fishermen to report on misplaced gear. II. Method of Collection No information is submitted; this is a...

  4. 78 FR 68817 - Proposed Information Collection; Comment Request; Northeast Region Gear Identification

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... Region Gear Identification AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and.... Abstract This notice is for the extension of Paperwork Reduction Act requirements regarding fishing gear... fishing gear mark the gear with specified information. The gear marking requirements provide vessel...

  5. 78 FR 40103 - Proposed Information Collection; Comment Request; Alaska Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... markings. The marking of gear aids law enforcement and enables other fishermen to report on misplaced gear. II. Method of Collection No information is submitted; this is a gear-marking requirement. ] III....

  6. 75 FR 55301 - Proposed Information Collection; Comment Request; Northeast Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-10

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... fishing permit holders using specified fishing gear mark that gear with specified information for the... methods identified in the regulations). The regulations also specify how the gear is to be marked for...

  7. Internet and healthcare in Brazil: the role of the Working Group for Healthcare (GT Sade).

    PubMed

    Tachinardi, U

    1998-09-01

    This paper introduces the GT Sade initiative in Brazil. The group is part of the Brazilian Internet project, which goals are to depict how Internet can be useful to the society. The mission of the GT Sade group is to foster Internet applications on the healthcare area. The main projects currently under development are presented: Multicom-21, using large bandwidth connections on telemedicine; the Unified Health Record, using Internet and smart-cards for a national minimum patient data set; the Brazilian Virtual Hospital, that presents a large amount of useful information and links for healthcare professionals and people in general; the National Healthcare Information Network (RNIS), that uses Internet as a medium for data exchange among the state secretaries and publishing statistics from the national healthcare system (SUS) for general public access; and finally the virtual university proposal, which uses Internet for education and is offering its first course on nutrition. The heterogeneity of the projects is meant and is part of the group's task, which is to cover the subject as widely as possible. Through this 'demonstration' projects the group is trying to prove the usefulness and benefits of using Internet technologies, even (or mainly) on a developing country with an inadequate healthcare situation. In its short existence the GT Sade group has achieved several of its original goals. The most relevant accomplishments are: putting together different groups, eliciting synergy across the projects and encompassing a broad spectrum of applications (the 'demonstration factor'). PMID:9861509

  8. A Lexical-Ontological Resource for Consumer Healthcare

    NASA Astrophysics Data System (ADS)

    Cardillo, Elena; Serafini, Luciano; Tamilin, Andrei

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

  9. [Determination of wine original regions using information fusion of NIR and MIR spectroscopy].

    PubMed

    Xiang, Ling-Li; Li, Meng-Hua; Li, Jing-Mingz; Li, Jun-Hui; Zhang, Lu-Da; Zhao, Long-Lian

    2014-10-01

    Geographical origins of wine grapes are significant factors affecting wine quality and wine prices. Tasters' evaluation is a good method but has some limitations. It is important to discriminate different wine original regions quickly and accurately. The present paper proposed a method to determine wine original regions based on Bayesian information fusion that fused near-infrared (NIR) transmission spectra information and mid-infrared (MIR) ATR spectra information of wines. This method improved the determination results by expanding the sources of analysis information. NIR spectra and MIR spectra of 153 wine samples from four different regions of grape growing were collected by near-infrared and mid-infrared Fourier transform spe trometer separately. These four different regions are Huailai, Yantai, Gansu and Changli, which areall typical geographical originals for Chinese wines. NIR and MIR discriminant models for wine regions were established using partial least squares discriminant analysis (PLS-DA) based on NIR spectra and MIR spectra separately. In PLS-DA, the regions of wine samples are presented in group of binary code. There are four wine regions in this paper, thereby using four nodes standing for categorical variables. The output nodes values for each sample in NIR and MIR models were normalized first. These values stand for the probabilities of each sample belonging to each category. They seemed as the input to the Bayesian discriminant formula as a priori probability value. The probabilities were substituteed into the Bayesian formula to get posterior probabilities, by which we can judge the new class characteristics of these samples. Considering the stability of PLS-DA models, all the wine samples were divided into calibration sets and validation sets randomly for ten times. The results of NIR and MIR discriminant models of four wine regions were as follows: the average accuracy rates of calibration sets were 78.21% (NIR) and 82.57% (MIR), and the average accuracy rates of validation sets were 82.50% (NIR) and 81.98% (MIR). After using the method proposed in this paper, the accuracy rates of calibration and validation changed to 87.11% and 90.87% separately, which all achieved better results of determination than individual spectroscopy. These results suggest that Bayesian information fusion of NIR and MIR spectra is feasible for fast identification of wine original regions. PMID:25739204

  10. 78 FR 52925 - Agency Information Collection

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-27

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed Collection; Comment Request. AGENCY: Agency for Healthcare Research and Quality, HHS. ACTION: Notice. SUMMARY: This notice announces the intention of the Agency for Healthcare Research and...

  11. A phylogenetically informed delineation of floristic regions within a biodiversity hotspot in Yunnan, China.

    PubMed

    Li, Rong; Kraft, Nathan J B; Yang, Jie; Wang, Yuhua

    2015-01-01

    Traditional attempts to delineate floristic regions typically focus on species distributions, often ignoring the rich context that phylogenetic relationships can provide. In this study, we explore how phylogenetic relatedness, taxonomic composition, and regional phylogenetic structure change across a global biodiversity hotspot region, Yunnan, located in southwestern China. We propose a system of floristic regions within Yunnan by combining data on the distributions and phylogenetic relationships of 1,983 genera of native seed plants. We identified eight distinct floristic regions in Yunnan, which were grouped into two larger northern and southern geographical units. Phylogenetic relatedness was well correlated with taxonomic composition between floras in Yunnan. Across the Yunnan region we examined, the central Yunnan region shows the lowest level of spatial turnover in phylogenetic relationships and taxonomic composition of the floristic assemblages. Using null model analyses, we found evidence of nonrandom phylogenetic structure across the region, in which four areas show higher phylogenetic turnover than expected given the underlying taxonomic composition between sites. Our results show that the integration of phylogenetic information can provide valuable insight in floristic assessments, and help us to better understand the structure of a global biodiversity hotspot. PMID:25820037

  12. A phylogenetically informed delineation of floristic regions within a biodiversity hotspot in Yunnan, China

    PubMed Central

    Li, Rong; Kraft, Nathan J. B.; Yang, Jie; Wang, Yuhua

    2015-01-01

    Traditional attempts to delineate floristic regions typically focus on species distributions, often ignoring the rich context that phylogenetic relationships can provide. In this study, we explore how phylogenetic relatedness, taxonomic composition, and regional phylogenetic structure change across a global biodiversity hotspot region, Yunnan, located in southwestern China. We propose a system of floristic regions within Yunnan by combining data on the distributions and phylogenetic relationships of 1,983 genera of native seed plants. We identified eight distinct floristic regions in Yunnan, which were grouped into two larger northern and southern geographical units. Phylogenetic relatedness was well correlated with taxonomic composition between floras in Yunnan. Across the Yunnan region we examined, the central Yunnan region shows the lowest level of spatial turnover in phylogenetic relationships and taxonomic composition of the floristic assemblages. Using null model analyses, we found evidence of nonrandom phylogenetic structure across the region, in which four areas show higher phylogenetic turnover than expected given the underlying taxonomic composition between sites. Our results show that the integration of phylogenetic information can provide valuable insight in floristic assessments, and help us to better understand the structure of a global biodiversity hotspot. PMID:25820037

  13. A parametric Bayesian combination of local and regional information in flood frequency analysis

    NASA Astrophysics Data System (ADS)

    Seidou, O.; Ouarda, T. B. M. J.; Barbet, M.; Bruneau, P.; BobE, B.

    2006-11-01

    Because of their impact on hydraulic structure design as well as on floodplain management, flood quantiles must be estimated with the highest precision given available information. If the site of interest has been monitored for a sufficiently long period (more than 30-40 years), at-site frequency analysis can be used to estimate flood quantiles with a fair precision. Otherwise, regional estimation may be used to mitigate the lack of data, but local information is then ignored. A commonly used approach to combine at-site and regional information is the linear empirical Bayes estimation: Under the assumption that both local and regional flood quantile estimators have a normal distribution, the empirical Bayesian estimator of the true quantile is the weighted average of both estimations. The weighting factor for each estimator is conversely proportional to its variance. We propose in this paper an alternative Bayesian method for combining local and regional information which provides the full probability density of quantiles and parameters. The application of the method is made with the generalized extreme values (GEV) distribution, but it can be extended to other types of extreme value distributions. In this method the prior distributions are obtained using a regional log linear regression model, and then local observations are used within a Markov chain Monte Carlo algorithm to infer the posterior distributions of parameters and quantiles. Unlike the empirical Bayesian approach the proposed method works even with a single local observation. It also relaxes the hypothesis of normality of the local quantiles probability distribution. The performance of the proposed methodology is compared to that of local, regional, and empirical Bayes estimators on three generated regional data sets with different statistical characteristics. The results show that (1) when the regional log linear model is unbiased, the proposed method gives better estimations of the GEV quantiles and parameters than the local, regional, and empirical Bayes estimators; (2) even when the regional log linear model displays a severe relative bias when estimating the quantiles, the proposed method still gives the best estimation of the GEV shape parameter and outperforms the other approaches on higher quantiles provided the relative bias is the same for all quantiles; and (3) the gain in performance with the new approach is considerable for sites with very short records.

  14. Infrared image non-rigid registration based on regional information entropy demons algorithm

    NASA Astrophysics Data System (ADS)

    Lu, Chaoliang; Ma, Lihua; Yu, Ming; Cui, Shumin; Wu, Qingrong

    2015-02-01

    Infrared imaging fault detection which is treated as an ideal, non-contact, non-destructive testing method is applied to the circuit board fault detection. Since Infrared images obtained by handheld infrared camera with wide-angle lens have both rigid and non-rigid deformations. To solve this problem, a new demons algorithm based on regional information entropy was proposed. The new method overcame the shortcomings of traditional demons algorithm that was sensitive to the intensity. First, the information entropy image was gotten by computing regional information entropy of the image. Then, the deformation between the two images was calculated that was the same as demons algorithm. Experimental results demonstrated that the proposed algorithm has better robustness in intensity inconsistent images registration compared with the traditional demons algorithm. Achieving accurate registration between intensity inconsistent infrared images provided strong support for the temperature contrast.

  15. Healthcare knowledge management through building and operationalising healthcare enterprise memory.

    PubMed

    Cheah, Y N; Abidi, S S

    1999-01-01

    In this paper we suggest that the healthcare enterprise needs to be more conscious of its vast knowledge resources vis--vis the exploitation of knowledge management techniques to efficiently manage its knowledge. The development of healthcare enterprise memory is suggested as a solution, together with a novel approach advocating the operationalisation of healthcare enterprise memories leading to the modelling of healthcare processes for strategic planning. As an example, we present a simulation of Service Delivery Time in a hospital's OPD. PMID:10724990

  16. Developing Drought Outlook Forums in Support of a Regional Drought Early Warning Information System

    NASA Astrophysics Data System (ADS)

    Mcnutt, C. A.; Pulwarty, R. S.; Darby, L. S.; Verdin, J. P.; Webb, R. S.

    2011-12-01

    The National Integrated Drought Information System (NIDIS) Act of 2006 (P.L. 109-430) charged NIDIS with developing the leadership and partnerships necessary to implement an integrated national drought monitoring and forecasting system that creates a drought "early warning system". The drought early warning information system should be capable of providing accurate, timely and integrated information on drought conditions at the relevant spatial scale to facilitate proactive decisions aimed at minimizing the economic, social and ecosystem losses associated with drought. As part of this effort, NIDIS has held Regional Drought Outlook Forums in several regions of the U.S. The purpose of the Forums is to inform practices that reduce vulnerability to drought through an interactive and collaborative process that includes the users of the information. The Forums have focused on providing detailed assessments of present conditions and impacts, comparisons with past drought events, and seasonal predictions including discussion of the state and expected evolution of the El Nio Southern Oscillation phenomena. Regional Climate Outlook Forums (RCOFs) that include close interaction between information providers and users are not a new concept, however. RCOFs started in Africa in the 1990s in response to the 1997-98 El Nio and have since expanded to South America, Asia, the Pacific islands, and the Caribbean. As a result of feedback from the RCOFs a large body of research has gone into improving seasonal forecasts and the capacity of the users to apply the information in a way that improves their decision-making. Over time, it has become clear that more is involved than just improving the interaction between the climate forecasters and decision-makers. NIDIS is using the RCOF approach as one component in a larger effort to develop Regional Drought Early Warning Information Systems (RDEWS) around the U.S. Using what has been learned over the past decade in the RCOF process, NIDIS is working with existing regional and local networks to develop outlook forums as part of an integrated process that involves closer coordination of drought monitoring among federal, state, and local groups; a research component that can address gaps in understanding that are identified in the outlook forum process; a drought information portal (www.drought.gov) for improving communication; an education and outreach component that improves understanding to apply the information; and close coordination with the preparedness community that includes state and local planners for improved mainstreaming of the information into decisions and policies. These components allow for a mutual learning process that encourages critical assessment of the information, builds trust and identifies how information is used to reduce vulnerability and risk associated with the impacts of drought. This process also identifies the key contacts in the region that can maximize dissemination of the information including local media, and provides an ongoing dialogue that allows for feedback and improvement of the process.

  17. Review of the Mid-Atlantic Tick Summit III: A model for regional information sharing.

    PubMed

    Nadolny, Robyn M; Feldman, Katherine A; Pagac, Benedict; Stromdahl, Ellen Y; Rutz, Heather; Wee, Siok-Bi; Richards, Allen L; Smith, Joshua; Armolt, Mary; Gaff, Holly D

    2015-06-01

    Ticks are the most significant vectors of infectious diseases in the United States, inspiring many researchers to study aspects of their biology, ecology, and their effects on public health. However, regional differences in tick abundance and pathogen infection prevalence result in the inability to assume results from one area are relevant in another. Current local information on tick ranges, infection rates, and human cases is needed to assess tick-borne disease risk in any given region. The Mid-Atlantic Tick Summit III brought together over 100 area experts and researchers to share regional updates on ticks and their associated pathogens. We report some meeting highlights here. Regional meetings foster cross-disciplinary collaborations that benefit the community, and open novel lines of inquiry so that tick-bite risk can be reduced and tick-borne diseases can be treated effectively. PMID:25920376

  18. Innovation Concepts in Healthcare

    SciTech Connect

    2011-01-06

    AbstractDemographic change and advances in medical science pose increased challenges to healthcare systems globally: The economic basis is aging and thus health is becoming more and more a productivity factor. At the same time, with today’s new communication possibilities the demand and expectations of effective medical treatment have been increased. This presentation will illustrate the need for the “industrialization” of healthcare in order to achieve highest results at limited budgets. Thereby, industrialization is not meaning the medical treatment based on the assembly line approach. Rather it is to recognize the cost of medical care as an investment with respective expectations on the return of the investment. Innovations in imaging and pharmaceutical products as well as in processes - that lead to similar medical results, but with lower efforts - are keys in such scenarios.BiographyProf. Dr. Hermann Requardt, 54, is a member of the Managing Board of Siemens AG and Chief Executive Officer of the Healthcare Sector. In addition he is the CTO of Siemens AG and Head of Corporate Technology, the central research department at Siemens.After completing his studies in physics and philosophy at the Darmstadt University of Technology and Johann Wolfgang Goethe University in Frankfurt and receiving a doctorate in biophysics, he worked at the Institute of Aerospace Medicine at the German Aerospace Center.In 1984 he joined the Medical Technology Group of Siemens AG, where he was responsible for projects in the Magnetic Resonance (MR) division. He was appointed head of the division in 1995. From 2001 to 2006, as a member of the Executive Management of the Medical Solutions Group, he was responsible for several areas, including technological development.In 2006 he became a Member of the Siemens’ Managing Board and head of Corporate Technology. He was additionally appointed as the Sector Healthcare CEO in 2008.Since 2006 he is an honorary professor in physics of the Johann Wolfgang Goethe University in Frankfurt.                                                                                

  19. [Economic evaluation in healthcare].

    PubMed

    Detournay, Bruno

    2014-05-01

    Economics was only recently considered as a dimension of health technology assessment in France. Yet there are always limits in resources that we collectively agree to devote to health. A comparative "economic" appraisal is therefore needed to guide health choices and contribute to price regulation. Methodologies are based on the determination of incremental cost-effectiveness ratios compared with a reference. The interpretation of these ratios is never isolated from the context of the decision. Health economic evaluation is not involved in healthcare rationing, but it contributes to the rationality of decisions in the interest of the overall population. PMID:24939547

  20. Innovation Concepts in Healthcare

    ScienceCinema

    None

    2011-04-25

    AbstractDemographic change and advances in medical science pose increased challenges to healthcare systems globally: The economic basis is aging and thus health is becoming more and more a productivity factor. At the same time, with today?s new communication possibilities the demand and expectations of effective medical treatment have been increased. This presentation will illustrate the need for the ?industrialization? of healthcare in order to achieve highest results at limited budgets. Thereby, industrialization is not meaning the medical treatment based on the assembly line approach. Rather it is to recognize the cost of medical care as an investment with respective expectations on the return of the investment. Innovations in imaging and pharmaceutical products as well as in processes - that lead to similar medical results, but with lower efforts - are keys in such scenarios.BiographyProf. Dr. Hermann Requardt, 54, is a member of the Managing Board of Siemens AG and Chief Executive Officer of the Healthcare Sector. In addition he is the CTO of Siemens AG and Head of Corporate Technology, the central research department at Siemens.After completing his studies in physics and philosophy at the Darmstadt University of Technology and Johann Wolfgang Goethe University in Frankfurt and receiving a doctorate in biophysics, he worked at the Institute of Aerospace Medicine at the German Aerospace Center.In 1984 he joined the Medical Technology Group of Siemens AG, where he was responsible for projects in the Magnetic Resonance (MR) division. He was appointed head of the division in 1995. From 2001 to 2006, as a member of the Executive Management of the Medical Solutions Group, he was responsible for several areas, including technological development.In 2006 he became a Member of the Siemens? Managing Board and head of Corporate Technology. He was additionally appointed as the Sector Healthcare CEO in 2008.Since 2006 he is an honorary professor in physics of the Johann Wolfgang Goethe University in Frankfurt.                                                                                

  1. SOA governance in healthcare organisations.

    PubMed

    Koumaditis, Konstantinos; Themistocleous, Marinos; Vassilakopoulos, Georgios

    2013-01-01

    Service Oriented Architecture (SOA) is increasingly adopted by many sectors, including healthcare. Due to the nature of healthcare systems there is a need to increase SOA adoption success rates as the non integrated nature of healthcare systems is responsible for medical errors that cause the loss of tens of thousands patients per year. Following our previous research [1] we propose that SOA governance is a critical success factor for SOA success in healthcare. Literature reports multiple SOA governance models that have limitations and they are confusing. In addition to this, there is a lack of healthcare specific SOA governance models. This highlights a literature void and thus the purpose of this paper is to proposed a healthcare specific SOA governance framework. PMID:23823423

  2. Volume and Value of Big Healthcare Data

    PubMed Central

    Dinov, Ivo D.

    2016-01-01

    Modern scientific inquiries require significant data-driven evidence and trans-disciplinary expertise to extract valuable information and gain actionable knowledge about natural processes. Effective evidence-based decisions require collection, processing and interpretation of vast amounts of complex data. The Moore's and Kryder's laws of exponential increase of computational power and information storage, respectively, dictate the need rapid trans-disciplinary advances, technological innovation and effective mechanisms for managing and interrogating Big Healthcare Data. In this article, we review important aspects of Big Data analytics and discuss important questions like: What are the challenges and opportunities associated with this biomedical, social, and healthcare data avalanche? Are there innovative statistical computing strategies to represent, model, analyze and interpret Big heterogeneous data? We present the foundation of a new compressive big data analytics (CBDA) framework for representation, modeling and inference of large, complex and heterogeneous datasets. Finally, we consider specific directions likely to impact the process of extracting information from Big healthcare data, translating that information to knowledge, and deriving appropriate actions. PMID:26998309

  3. [Patients requiring high healthcare spending].

    PubMed

    Niehaus, F

    2008-03-01

    Data from private insurance companies make it possible to analyse how healthcare spending is distributed across individuals, how it depends on the age of the people and how it changes over time. Within age groups, healthcare spending is less concentrated if recipients are older. Over the analysed period of time, a considerable levelling of expenses takes place. These findings lead to the conclusion that the ageing population will result in a greater and more evenly spread utilisation of healthcare facilities. PMID:18405231

  4. Determining a healthcare organization's value.

    PubMed

    Hahn, W

    1994-08-01

    As the consolidation activity among healthcare providers increases, it becomes more important than ever for healthcare financial managers to understand how to determine a healthcare organization's fair market value. There are many methods of determining an organization's value, but three general methods are the foundation of all others: the market comparable method, the underlying assets method, and the income, or cash flow, method. PMID:10146044

  5. Assessment of Web-Based Authentication Methods in the U.S.: Comparing E-Learning Systems to Internet Healthcare Information Systems

    ERIC Educational Resources Information Center

    Mattord, Herbert J.

    2012-01-01

    Organizations continue to rely on password-based authentication methods to control access to many Web-based systems. This research study developed a benchmarking instrument intended to assess authentication methods used in Web-based information systems (IS). It developed an Authentication Method System Index (AMSI) to analyze collected data from

  6. Assessment of Web-Based Authentication Methods in the U.S.: Comparing E-Learning Systems to Internet Healthcare Information Systems

    ERIC Educational Resources Information Center

    Mattord, Herbert J.

    2012-01-01

    Organizations continue to rely on password-based authentication methods to control access to many Web-based systems. This research study developed a benchmarking instrument intended to assess authentication methods used in Web-based information systems (IS). It developed an Authentication Method System Index (AMSI) to analyze collected data from…

  7. The importance of measuring unmet healthcare needs.

    PubMed

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

    2014-01-01

    Major restructuring of the health sector has been undertaken in many countries, including New Zealand and England, yet objective assessment of the outcomes has rarely been recorded. In the absence of comprehensive objective data, the success or otherwise of health reforms has been inferred from narrowly-focussed data or anecdotal accounts. A recent example relates to a buoyant King's Fund report on the quest for integrated health and social care in Canterbury, New Zealand which prompted an equally supportive editorial article in the British Medical Journal (BMJ) suggesting it may contain lessons for England's National Health Service. At the same time, a report published in the New Zealand Medical Journal expressed concerns at the level of unmet healthcare needs in Canterbury. Neither report provided objective information about changes over time in the level of unmet healthcare needs in Canterbury. We propose that the performance of healthcare systems should be measured regularly, objectively and comprehensively through documentation of unmet healthcare needs as perceived by representative segments of the population at formal interview. Thereby the success or otherwise of organisational changes to a health system and its adequacy as demographics of the population evolve, even in the absence of major restructuring of the health sector, can be better documented. PMID:25331313

  8. Delineating sea surface water quality regions from remotely sensed data using textural information

    NASA Astrophysics Data System (ADS)

    Kyriakidis, Phaedon C.; Vasios, George K.; Kitsiou, Dimitra

    2015-06-01

    The delineation of ocean regions with similar water quality characteristics is an all important component of the study of marine environment with direct implications for management actions. Marine eutrophication constitutes an important facet of ocean water quality, and pertains to the natural process representing excessive algal growth due to nutrient supply of marine systems. Remote sensing technology provides the de-facto means for marine eutrophication assessment over large regions of the ocean, with increasingly high spatial and temporal resolutions. In this work, monthly measurements of sea water quality variables - chlorophyll, nitrates, phosphates, dissolved oxygen - obtained from the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) with spatial resolution 0.125 degrees for the East Mediterranean region over the period January 1999 to December 2010, are used to define regions or zones of similar eutrophication levels. A novel variant of the K-medoids clustering algorithm is proposed, whereby the spatial association of the different variables (multivariate textural information) is explicitly accounted for in terms of the multivariate variogram; i.e., a measure of joint dissimilarity between different variables as a function of geographical distance. Similar water quality regions are obtained for various months and years, focusing on the spring season and on the qualitative comparison of the traditional and proposed classification methods. The results indicate that the proposed clustering method yields more physically meaningful clusters due to the incorporation of the multivariate textural information.

  9. Contrasting Evolutionary Dynamics and Information Content of the Avian Mitochondrial Control Region and ND2 Gene

    PubMed Central

    Barker, F. Keith; Benesh, Mariah K.; Vandergon, Arion J.; Lanyon, Scott M.

    2012-01-01

    Mitochondrial DNA is an important tool for inference of population history in animals. A variety of mitochondrial loci have been sampled for this purpose, but many studies focus on the non-coding D-loop or control region (CR), which in at least some species appears hypermutable. Unfortunately, analyses of this region are sometimes complicated by segmental duplications, as well as by difficulties in sequencing through repeat expansions, driving many researchers to favor single-copy protein-coding or ribosomal RNA genes. Without systematic comparison, it is unclear if, how much, and what sort of information might be lost by focusing on coding regions, or conversely whether such regions might offer significant advantages over the CR. In this study, we compare the information content, both in terms of genealogy and tests of neutral equilibrium, of the mitochondrial CR and protein-coding ND2 gene of the red-winged blackbird (Agelaius phoeniceus) and its close relative the tricolored blackbird (A. tricolor). Both gene regions violate the standard infinite sites assumption central to moment-based population genetic inference, as well as exhibiting considerable among-site rate heterogeneity, obscuring significant departures from neutral equilibrium. Given the ubiquity of rate heterogeneity in mtDNA, use of more sophisticated tests that account for this should be obligatory. The two regions yield quite similar genealogical reconstructions, as well as indicating similar departures from neutral equilibrium assumptions for A. phoeniceus. However, individual Sanger-read-length fragments (?600 bases) of the CR have significantly higher information content than comparable fragments of ND2, suggesting that limited sampling of the mitochondrial genome should focus on the CR. PMID:23071562

  10. Ethical issues in healthcare financing.

    PubMed

    Maharaj, S R; Paul, T J

    2011-07-01

    The four goals of good healthcare are to relieve symptoms, cure disease, prolong life and improve quality of life. Access to healthcare has been a perpetual challenge to healthcare providers who must take into account important factors such as equity, efficiency and effectiveness in designing healthcare systems to meet the four goals of good healthcare. The underlying philosophy may designate health as being a basic human right, an investment, a commodity to be bought and sold, a political demand or an expenditure. The design, policies and operational arrangements will usually reflect which of the above philosophies underpin the healthcare system, and consequently, access. Mechanisms for funding include fee-for-service, cost sharing (insurance, either private or government sponsored) free-of-fee at point of delivery (payments being made through general taxes, health levies, etc) or cost-recovery. For each of these methods of financial access to healthcare services, there are ethical issues which can compromise the four principles of ethical practices in healthcare, viz beneficence, non-maleficence, autonomy and justice. In times of economic recession, providing adequate healthcare will require governments, with support from external agencies, to focus on poverty reduction strategies through provision of preventive services such as immunization and nutrition, delivered at primary care facilities. To maximize the effect of such policies, it will be necessary to integrate policies to fashion an intersectoral approach. PMID:22097685

  11. Producing information for Vulnerability, Impacts and Adaptation work: The COordinated Regional Downscaling EXperiment (CORDEX) (Invited)

    NASA Astrophysics Data System (ADS)

    Giorgi, F.

    2013-12-01

    Regional climate information is needed for use in Vulnerability, Impacts and Adaptation (VIA) studies. This information can be obtained either from Global Climate Model (GCM) simulations or from different downscaling techniques that regionally enhance the GCM fields to produce fine scale climate information. Downscaling techniques include both dynamical (i.e. Regional Climate Models, or RCMs) and statistical methods, and can be applied in a variety of contexts, such as process studies and regional to local climate change projections. One of the key issues in producing climate information for VIA application is that of suitably characterizing underlying uncertainties. In fact, there are several sources of uncertainty in climate projections: limitations and systematic errors in GCMs and downscaling tools, greenhouse gas (GHG) emission and concentration scenarios, response of different models (physics and configurations) to GHG forcing, internal decadal to multidecadal variability of the climate system. In order to characterize these uncertainties, large ensembles of model projections are needed, a task that is best approached in a mullti-model, multi-laboratory international context. These premises have lead to the inception of the COordinated Regional Downscaling EXperiment (CORDEX), under the auspices of the World Climate Research program (WGRP). The purpose of CORDEX is threefold: 1) to evaluate and possibly improve regional downscaling techniques (both dynamical and statistical); 2) to produce a new generation of regional climate change projections for regions worldwide based on a multi-model approach; 3) to foster the interactions across the climate and VIA research communites. The CORDEX Phase I framework has been designed and implemented, and related activities have been strongly growing in the last 1-2 years with a wide international participation. This paper will review the status of CORDEX, especially drawing from the results of a major pan-CORDEX conference taking place on 4-7 November 2013 in Brussels. In particular, the paper will summarize lessons learned from the CORDEX Phase I activities and discuss future directions and areas in need of strengthening in view of the development of the CORDEX Phase II framework.

  12. Nordic privatization and private healthcare.

    PubMed

    Ovretveit, John

    2003-01-01

    The role of the private sector in public healthcare systems is much debated, but there is little research to inform the debate. In the Nordic countries the extent and type of private sector involvement is largely unknown and the changes and the consequences have not been studied. This paper presents a conceptual framework and some limited data about the changing private-public mix and privatization in the Nordic countries between 1985 and 2000. The data suggest a small increase in both private financing and provision which has accelerated in recent years, especially in specific healthcare fields such as diagnostic centres, dentistry, primary medical care and care for older people. The overall increase is small, but large in certain sectors. Differences between the countries can only be understood in relation to their historical, financial, economic and political context, even though there are many commonalities. Impact also is context dependent, but the findings do show a cross-country pattern of a willingness to experiment and a change in underlying assumptions. The findings show a more extensive interpenetration of private and public than previously recognized but more research is required, especially about changes in recent years about which data are scarce. The paper considers the factors driving these trends, the likely larger changes in the next 10 years and the possible consequences for patients, professionals, managers and governments. It notes the different ways governments can control or influence finance and provision. It proposes that the Nordic and other governments improve regulation and data collection about the private sector and consider influencing private providers through partnership arrangements, rather than leaving the developments to be shaped by growing consumer demands or market logic alone. PMID:12968800

  13. Suicide Information Database-Cymru: a protocol for a population-based, routinely collected data linkage study to explore risks and patterns of healthcare contact prior to suicide to identify opportunities for intervention

    PubMed Central

    John, Ann; Dennis, M; Kosnes, L; Gunnell, D; Scourfield, J; Ford, D V; Lloyd, K

    2014-01-01

    Introduction Prevention of suicide is a global public health challenge extending beyond mental health services. Linking routinely collected health and social care system data records for the same individual across different services and over time has enormous potential in suicide research. Most previous research linking suicide mortality data with routinely collected electronic health records involves only one or two domains of healthcare provision such as psychiatric inpatient care. This protocol paper describes the development of a population-based, routinely collected data linkage study: the Suicide Information Database Cymru (SID-Cymru). SID-Cymru aims to contribute to the information available on people who complete suicide. Methods and analysis SID-Cymru will facilitate a series of electronic case–control studies based in the Secure Anonymised Information Linkage (SAIL) Databank. We have identified 2664 cases of suicide in Wales between 2003 and 2011 from routinely collected mortality data using International Classification of Diseases, Tenth Revision, codes X60–X84 (intentional self-harm) and Y10–Y34 (undetermined intent). Each case will be matched by age and sex to at least five controls. Records will be collated and linked from routinely collected health and social data in Wales for each individual. Conditional logistic regression will be applied to produce crude and confounder (including general practice, socioeconomic status) adjusted ORs. Ethics and dissemination The SAIL Databank has the required ethical permissions in place to analyse anonymised data. Ethical approval has been granted by the Information Governance Review Panel (IGRP). Findings will be disseminated through peer-reviewed publications, consultations with stakeholders and national/international conference presentations. The improved understanding of the prior health, nature of previous contacts with services and wider social circumstances of those who complete suicide will assist in prevention policy, service organisation and delivery. SID-Cymru is funded through the National Institute for Social Care and Health Research, Welsh Government (RFS-12-25). PMID:25424996

  14. Early-season warning of soybean rust regional epidemics using El Nio Southern/Oscillation information

    NASA Astrophysics Data System (ADS)

    Del Ponte, Emerson M.; Maia, Aline De H. N.; Dos Santos, Thiago V.; Martins, Eduardo J.; Baethgen, Walter E.

    2011-07-01

    Soybean rust (SBR) is a disease of significant impact to Brazilian soybean production. Twenty-four locations in a major growing region in southern Brazil, where long-term (30 years) weather information was available, were selected to estimate the risk of SBR epidemics and identify potential predictors derived from El Nio 3.4 region. A rainfall-based model was used to predict SBR severity in an "epidemic development window" (the months of February and March for the studied region) in the time series. Twenty-eight daily simulations for each year-location ( n = 720) were performed considering each day after 31 January as a hypothetical detection date (HDD) to estimate a severity index (SBRindex). The mean SBRindex in a single year was defined as the `growing season severity index' (GSSI) for that year. A probabilistic risk assessment related GSSI and sea surface temperatures (SST) at the El Nio 3.4. region (here categorized as warm, cold or neutral phase) in October-November-December (OND) of the same growing season. Overall, the median GSSI across location-years was 34.5%. The risk of GSSI exceeding 60% was generally low and ranged from 0 to 20 percentage points, with the higher values found in the northern regions of the state when compared to the central-western. During a warm OND-SST phase, the probability of GSSI exceeding its overall mean (locations pooled) increased significantly by around 25 percentage points compared to neutral and cold SST phases, especially over the central western region. This study demonstrates the potential to use El Nio/Southern Oscillation information to anticipate the risk of SBR epidemics up to 1 month in advance at a regional scale.

  15. Sharing self-related information is associated with intrinsic functional connectivity of cortical midline brain regions.

    PubMed

    Meshi, Dar; Mamerow, Loreen; Kirilina, Evgeniya; Morawetz, Carmen; Margulies, Daniel S; Heekeren, Hauke R

    2016-01-01

    Human beings are social animals and they vary in the degree to which they share information about themselves with others. Although brain networks involved in self-related cognition have been identified, especially via the use of resting-state experiments, the neural circuitry underlying individual differences in the sharing of self-related information is currently unknown. Therefore, we investigated the intrinsic functional organization of the brain with respect to participants' degree of self-related information sharing using resting state functional magnetic resonance imaging and self-reported social media use. We conducted seed-based correlation analyses in cortical midline regions previously shown in meta-analyses to be involved in self-referential cognition: the medial prefrontal cortex (MPFC), central precuneus (CP), and caudal anterior cingulate cortex (CACC). We examined whether and how functional connectivity between these regions and the rest of the brain was associated with participants' degree of self-related information sharing. Analyses revealed associations between the MPFC and right dorsolateral prefrontal cortex (DLPFC), as well as the CP with the right DLPFC, the left lateral orbitofrontal cortex and left anterior temporal pole. These findings extend our present knowledge of functional brain connectivity, specifically demonstrating how the brain's intrinsic functional organization relates to individual differences in the sharing of self-related information. PMID:26948055

  16. Sharing self-related information is associated with intrinsic functional connectivity of cortical midline brain regions

    PubMed Central

    Meshi, Dar; Mamerow, Loreen; Kirilina, Evgeniya; Morawetz, Carmen; Margulies, Daniel S.; Heekeren, Hauke R.

    2016-01-01

    Human beings are social animals and they vary in the degree to which they share information about themselves with others. Although brain networks involved in self-related cognition have been identified, especially via the use of resting-state experiments, the neural circuitry underlying individual differences in the sharing of self-related information is currently unknown. Therefore, we investigated the intrinsic functional organization of the brain with respect to participants’ degree of self-related information sharing using resting state functional magnetic resonance imaging and self-reported social media use. We conducted seed-based correlation analyses in cortical midline regions previously shown in meta-analyses to be involved in self-referential cognition: the medial prefrontal cortex (MPFC), central precuneus (CP), and caudal anterior cingulate cortex (CACC). We examined whether and how functional connectivity between these regions and the rest of the brain was associated with participants’ degree of self-related information sharing. Analyses revealed associations between the MPFC and right dorsolateral prefrontal cortex (DLPFC), as well as the CP with the right DLPFC, the left lateral orbitofrontal cortex and left anterior temporal pole. These findings extend our present knowledge of functional brain connectivity, specifically demonstrating how the brain’s intrinsic functional organization relates to individual differences in the sharing of self-related information. PMID:26948055

  17. [The organization of system of information support of regional health care].

    PubMed

    Konovalov, A A

    2014-01-01

    The comparative analysis was implemented concerning versions of architecture of segment of unified public information system of health care within the framework of the regional program of modernization of Nizhniy Novgorod health care system. The author proposed means of increasing effectiveness of public investments on the basis of analysis of aggregate value of ownership of information system. The evaluation is given concerning running up to target program indicators and dynamics of basic indicators of informatization of institutions of oblast health care system. PMID:25373297

  18. How useful is landslide hazard information? Lessons learned in the San Francisco Bay region

    USGS Publications Warehouse

    Howell, David G.; Brabb, Earl E.; Ramsey, David W.

    2000-01-01

    Landslides, worldwide and in the United States, are arguably the most costly natural hazard. Substantial landslide information is available, but much of it remains underutilized, as a disconnect exists among geologists, decision makers, and the public. The lack of a national landslide insurance policy exacerbates this situation and promotes litigation as the principal recourse for recouping landslide-damage losses. The U.S. Geological Survey's landslide investigation in the San Francisco Bay region of California provides a context for making suggestions on how Earth science information could be used more effectively.

  19. How useful is landslide hazard information? Lessons learned in the San Francisco Bay region

    USGS Publications Warehouse

    Howell, D.G.; Brabb, E.E.; Ramsey, D.W.

    1999-01-01

    Landslides, worldwide and in the United States, are arguably the most costly natural hazard. Substantial landslide information is available, but much of it remains underutilized, as a disconnect exists among geologists, decision makers, and the public. The lack of a national landslide insurance policy exacerbates this situation and promotes litigation as the principal recourse for recouping landslide-damage losses. The U.S. Geological Survey's landslide investigation in the San Francisco Bay region of California provides a context for making suggestions on how Earth science information could be used more effectively.

  20. Personal healthcare system using cloud computing.

    PubMed

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

    2013-01-01

    A personal healthcare system used with cloud computing has been developed. It enables a daily time-series of personal health and lifestyle data to be stored in the cloud through mobile devices. The cloud automatically extracts personally useful information, such as rules and patterns concerning lifestyle and health conditions embedded in the personal big data, by using a data mining technology. The system provides three editions (Diet, Lite, and Pro) corresponding to users' needs. PMID:23920710

  1. Quality of Big Data in Healthcare

    SciTech Connect

    Sukumar, Sreenivas R.; Ramachandran, Natarajan; Ferrell, Regina Kay

    2015-01-01

    The current trend in Big Data Analytics and in particular Health information technology is towards building sophisticated models, methods and tools for business, operational and clinical intelligence, but the critical issue of data quality required for these models is not getting the attention it deserves. The objective of the paper is to highlight the issues of data quality in the context of Big Data Healthcare Analytics.

  2. E-health leads Nova Scotia's healthcare transformation.

    PubMed

    Powers, Patrick

    2009-01-01

    Nova Scotia's healthcare policy direction seems well-defined and well-established for the foreseeable future. This is the case, despite the recent electoral transition from a Progressive Conservative to a New Democratic Party government for the first time in the province's history; and despite the threat of the province's net direct debt increasing through 2012, after eight years of declining net direct debt as a percentage of the province's gross domestic product. As well, little public consideration is being given to disrupting the current regional healthcare organizational structure by further consolidating the province's nine district health authorities (DHA), as occurred last year in Alberta and New Brunswick. Moreover, the Health Information Technology Services Program of Nova Scotia (HITS-NS), the province's shared IT services or provincial service delivery organization, is steadily expanding the inventory of clinical, financial, and administrative software applications hosted for eight DHAs on a common Meditech Client-Server platform, as well as some applications for Capital Health DHA 9 (CDHA) and IWK Health Centre (IWK), the province's consolidated women's and children's hospital located in Halifax. PMID:20057240

  3. Globalization of healthcare: a U.K. perspective.

    PubMed

    Ellis, Peter

    2003-01-01

    This commentary identifies the ability of the globalization of healthcare information and knowledge to empower populations and individuals. This, in turn, allows people to better hold to account the vested political and professional interests in order to provide or enable improvements to access and delivery of modern and effective health services. The author argues the importance of the wealth of the population to the availability of good healthcare and the contribution that healthcare industries and services could make to the economy of a particular country, notwithstanding its status as a developed, a developing or an underdeveloped nation. PMID:14660884

  4. Health is wealth: considerations to european healthcare.

    PubMed

    Unger, F

    2012-07-01

    (Full text is available at http://www.manu.edu.mk/prilozi). European Healthcare is a duty, imbedded in our European culture, to help people in sickness, to promote a healthy society through education and the prevention of diseases. Human Life is our highest value; the concept of Health is fundamental to Life and leads to the creation of Wealth. Health is the result of a common European cultural endeavour. The provision of Healthcare in Europe is highly diverse and must be understood in the light of different geographical and cultural development perspectives. In the 21st century Health is becoming a matter of general European interest and will be an increasingly important priority within the enlarged European Union. Healthcare Systems must enshrine the principal of Health for All as their ultimate goal. Healthcare, essential to life, is enormously complex and dependent on: -the needs of the population and its demographic structures; -progress in all aspects of medical practice; -financing models. Healthcare provision is developing from a National to a European endeavour as a European Healthcare Market (EHCM) serving its people, legitimised by the European Convention, which sets out the principals of a socio-market economy, competition and self-responsibility (Fig. 1). The component parts of the EHCM are the Patient, Medical Arts and Sciences, Medical Providers, Medical Organisation and all stakeholders. The Medical Arts and Sciences together with the Medical Organization are to be entirely reshaped as strategic European tasks, while the stakeholder, financing, monitoring and controlling are subsidiary tasks for the national authorities. The Convention provides a unique opportunity to create a European Market for Health. Greater European cooperation enables effective use of resources, access and quality of care (2512th Council meeting, EU, June 2003). The EHCM serves the patients and creates the conditions for continuing wealth creation. To achieve sustainable effects, the main component in structuring medicine is the clinical leadership. Demographics and Healthcare financing issues are the most sensible areas to tackle as a priority. This requires reconciling national health policies with European obligations. In the spirit of the Lisbon Council conclusions and the European Convention the EHCM provides: -Health for all; -Provision based on evidence and effectiveness; -Control of costs. The European Institute of Medicine sees this as a great opportunity to consolidate the different National models and inherited systems in an EHCM and consequently to stimulate clinical leadership to achieve sustainable reforms. The common concern is the increasing cost of provision. Stabilizing costs in an environment of a decreasing working population is very challenging. By modernizing systems there is potential for controlling costs, the processes for which have to be identified. Most national reforms have failed due to massive political influence especially where Healthcare together with Welfare is operated as a state-monopoly. This Strategic Vision has four mutually dependent parts: the patient is in the centre, and surrounded by clusters representing the Medical Arts, the Medical Organization and Financing. This Strategic Vision is structured in 4 segments, which are the cornerstones for establishing systems for the EHCM: A. The Patient There is a change in today's paradigm: The patient becomes the focal point. The patient of today is increasingly well informed and motivated. The patient is at the centre of all efforts, and all healthcare provisions are constructed around the patient. The patient is both a consumer and a contributor to the EHCM. B. Cluster I: Medical Arts The optimisation of Medical Arts and Sciences is an essential prere-quisite of the Strategic Visions. This cluster focuses on the basics of diagnosis, therapy and prevention. Conservative, invasive and prophylactic principles cover the whole range of possibilities including the prediction and prevention of diseases. To use Outcome Related Medicine (ORM) as a measure of effectiveness, medical conditions have to be classified. The capacity for purchasing has a direct effect on the access of patients and clinicians to all therapies and diagnostics. It is necessary to monitor the effectiveness of healthcare provisions, to perform quality-control checks and to measure that of therapy by means of health technology assessment and outcome indicators. Assessment can be done by patients, clinicians, Healthcare organisations and providers of finance. Research, development and industry play indispensable parts in developing the medical arts. Europe has to encourage and promote innovation in new therapies and diagnostics. C. Cluster II: Organization in Medicine Greater effectiveness in the organisation of healthcare can be achieved by the alignment of best practices and in boosting synergies in access and quality. The main nucleus of the EHCM is that Healthcare is delivered by doctors for in and out-patients in acute, chronic and long-term conditions. New educational concepts on healthcare provision will have to be introduced at universities and schools for nurses and paramedics. It will be essential in the future to create and to foster sustainable clinical leadership. There will be no sustainable reform in the future without a solid core of medical professionals. E-Health will play a major role in medicine for information, transfer of findings and avoiding duplication of effort. A patient's "Health literacy" will gain in importance. It is foreseen that 80% of patients will perform "self-care" actions without the involvement of Healthcare professionals. D: Cluster III: Financing of Healthcare Healthcare financing must be patient oriented and make use of several instruments: insurance premiums, co-payment systems, capitation, taxes, voluntary payments, out-of-pocket expenses etc. Covering Healthcare costs will need a combination of national Healthcare allocations and individual contributions to provide all citizens with equal access, responsiveness and to demonstrate fairness in financing. Surveying Europe, a variety of systems are in operation; including the Anglo-Saxon (Beveridge) universal state centred tax-based social security system, and the continental "Bismarck" model financed by social insurance and corporate elements. (Chassard and Quintin 1992). The private sector will gain increasingly in importance. In the future co-payment systems will be unavoidable, and the methods of financing by solidarity contributions will need to be redefined. The Three Clusters are the sides of a triangle (Fig. 2) consisting of medical arts - organization - financing, with the patient at the centre, creating a special market with special rules guided by human considerations. After each section this mutual relationship is discussed demonstrating how interrelated are the components, the whole Healthcare system. Reforms of the present system can be tackled only by a comprehensive approach, gradually adapting all the clusters to the new Strategic Vision and transferred to the European Healthcare market (EHCM). The Goals of this Strategic Vision are: -To provide Healthcare for all European citizens; -To transform Healthcare from national state-monopolies to an open European market allowing mobility and better use of resources; -To identify potential for cost control. Conclusion The practice of the Medical Arts is a perpetual endeavour of man. Its mission and purpose is to cure, and prevent diseases and heal trauma, to control pain and to prolong human life as long as possible in an optimal healthy condition. Medicine has been in the past based on charity. Its delivery was provided locally via private initiatives. In modern times the provision of medical care has extended to cover whole populations; its delivery organised nationally by public Healthcare systems to provide Health for All. At the beginning of the 21st century the patient has become more independent and self-motivated. The trend is towards the provision of Medical Services based on the patients' own responsibility in a free market. Medicine, as a European endeavour, develops into an open market known as the European Healthcare Market. (Fig. 3) The delivery of Healthcare in Europe is now a matter for serious public discussion. The old national structures are seen to have failed. This has resulted in growing public frustration while the costs are exploding. People react angrily if they are denied access to care or services. In many countries Healthcare is considered as a part of social welfare and has a very high political priority, which creates a national state-monopoly with a few private exceptions. This is a source of mismanagement and discomfort to patients. Europe is now ready to form a European market for Healthcare with the essential prerequisite "Health for All" as a part of our culture. This market depends on clinical leadership. Key challenges are progress in therapy and diagnostics, which make Healthcare more and more specialized and expensive in an environment of an ageing population compounded by declining birth rates. (Cluster III). In Europe, Medicine represents up to 14% of GNP (D: Cluster III). When all other health markets such as wellness, para-medicine and all related structures in health and care are included, this is estimated to increase to 20-25% of GNP. Public contributions to the costs via insurance premiums and taxes cannot grow unlimitedly while the working population is shrinking. The potentials for costs reduction have to be quickly realised by redefining the Healthcare packages that can be provided from public funds as the level of commitment and solidarity to be given by our society. Patients will be informed of these levels. The private sector will cover any additional costs not covered by public funds and therefore will gain more importance. (ABSTRACT TRUNCATED) PMID:22952091

  5. Designing role of online health educators in healthcare services.

    PubMed

    Anshari, Muhammad; Almunawar, Mohammad Nabil

    2015-01-01

    Web technology provides healthcare organizations the ability to broaden services beyond usual practices, and thus provides a particularly advantageous environment to achieve complex e-health goals. Furthermore, introducing web technology in healthcare services may add value to the overall healthcare process. Web technology helps healthcare organizations to extend the online health services (e-health) beyond their traditional mechanism. The changes enable customers (patients) to participate more in the process of healthcare, such as through their ability to generate personal health data to their personalized web-based interface. It allows patients to have greater control of information flow between healthcare organizations and customers, and among customers themselves. In this study the authors investigate the extended role of healthcare staff that provide e-health services. The authors have developed e-health models that accommodate customers' participation to engage more actively in the healthcare system. Through the model the authors developed a prototype--namely Clinic 2.0. Clinic 2.0 is set up to facilitate interactions between healthcare providers and customers. In the proposed systems, the authors introduced Online Health Educator (OHE)--a healthcare staff that is specifically responsible for administering Clinic 2.0. The authors have conducted a survey in Indonesia to draw the expectation of participants regarding the important role of OHE in Clinic 2.0 through a semi-structured interview conducted with participants to further investigate the pivotal roles of OHE. The authors found that e-health services need OHE to achieve customers' satisfaction. PMID:25665076

  6. Health, healthcare access, and use of traditional versus modern medicine in remote Peruvian Amazon communities: a descriptive study of knowledge, attitudes, and practices.

    PubMed

    Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom

    2015-04-01

    There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manat and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making. PMID:25688165

  7. Health, Healthcare Access, and Use of Traditional Versus Modern Medicine in Remote Peruvian Amazon Communities: A Descriptive Study of Knowledge, Attitudes, and Practices

    PubMed Central

    Williamson, Jonathan; Ramirez, Ronald; Wingfield, Tom

    2015-01-01

    There is an urgent need for healthcare research, funding, and infrastructure in the Peruvian Amazon. We performed a descriptive study of health, health knowledge and practice, and healthcare access of 13 remote communities of the Manat and Amazon Rivers in northeastern Peru. Eighty-five adults attending a medical boat service were interviewed to collect data on socioeconomic position, health, diagnosed illnesses, pain, healthcare access, and traditional versus modern medicine use. In this setting, poverty and gender inequality were prevalent, and healthcare access was limited by long distances to the health post and long waiting times. There was a high burden of reported pain (mainly head and musculoskeletal) and chronic non-communicable diseases, such as hypertension (19%). Nearly all participants felt that they did not completely understand their diagnosed illnesses and wanted to know more. Participants preferred modern over traditional medicine, predominantly because of mistrust or lack of belief in traditional medicine. Our findings provide novel evidence concerning transitional health beliefs, hidden pain, and chronic non-communicable disease prevalence in marginalized communities of the Peruvian Amazon. Healthcare provision was limited by a breach between health education, knowledge, and access. Additional participatory research with similar rural populations is required to inform regional healthcare policy and decision-making. PMID:25688165

  8. Meeting the Regional Climate Information Needs of Decision Makers: The CORDEX Framework

    NASA Astrophysics Data System (ADS)

    Asrar, G. R.; Jones, C.; Giorgi, F.

    2011-12-01

    Regional Climate Downscaling (RCD), both dynamical (e.g. regional climate modeling) and statistical, is an important approach to produce fine scale climate information for use in impact assessment and adaptation/mitigation studies and practices. RCD techniques have evolved significantly over the last decade, however a coherent and wide picture of regional climate change based on RCD products is still not available and the potentials, limitations and uncertainties of RCD methods need to be better understood by the user community. In order to address these issues a new initiative has been launched under the WCRP auspices, referred to as Coordinated Regional climate Downscaling EXperiment, or CORDEX. The aim of CORDEX is to bring together the international RCD community to assess different RCD techniques, recommend best practices and produce a next generation set of RCD-based projections of climate change for regions world-wide. This will involve close interactions between the RCD, global climate modeling, and end users communities. This paper will describe the motivations and design of the first phase of the CORDEX framework, which has a priority focus on Africa, along with the steps that are envisioned to achieve the CORDEX goals within the time framework of the Fifth IPCC assessment report. Some early results for Africa will be presented, together with a short summary of the CORDEX activities in Asia, Americas and other regions of the world.

  9. Informing Decisions with a Climate Synthesis Product: Implications for Regional Climate Services

    NASA Astrophysics Data System (ADS)

    Guido, Z.; Hill, D.; Crimmins, M.; Ferguson, D. B.

    2012-12-01

    The demand for regional climate information is increasing and spurring efforts to provide a broad slate of climate services that inform policy and resource management and elevate general knowledge. Routine syntheses of existing climate-related information may be an effective strategy for connecting climate information to decision making, but few studies have formally assessed their contribution to informing decisions. During the 2010-2011 winter, drought conditions expanded and intensified in Arizona and New Mexico, creating an opportunity to develop and evaluate a pithy, monthly regional climate communication productLa Nia Drought Trackerthat synthesized and interpreted drought and climate information. Six issues were published and subsequently evaluated through an online survey. On average, 417 people consulted the publication each month. Many of the survey respondents indicated that they made at least one drought-related decision, and the product at least moderately influenced the majority of those decisions, some of which helped mitigate economic losses and reduce climate vulnerability. The product also improved understanding of climate and drought for more than 90 percent of the respondents and helped the majority of them better prepare for drought. These, and other results demonstrate that routine interpretation and synthesis of existing climate information can help enhance access to and understanding and use of climate information in decision-making. Moreover, developing regional, contextual knowledge within climate service programs can facilitate the implementation of activities like the Tracker that enhance the use of climate information without engaging in time-consuming collaborative processes that can prevent the timely production of the services. We present results from the case study of the Tracker and place it within the context of the challenges and opportunities associated with providing climate services, particularly those services that require several-to-many months of work but often do not generate substantial financial sponsorship. These medium-term climate services, like the Tracker, present formidable challenges. However, we argue, they are vital to satisfying stakeholder demand, creating new and strengthening existing partnerships, aiding decisions, advancing climate literacy, and fostering future projectsmain goals of climate services.

  10. 78 FR 49520 - Scientific Information Request on Imaging Techniques for the Surveillance, Diagnosis, and Staging...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-14

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Imaging... Healthcare Research and Quality (AHRQ), HHS. ACTION: Request for scientific information submissions. SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information...

  11. Integrating emergy evaluation and geographic information systems for monitoring resource use in the Abruzzo region (Italy).

    PubMed

    Pulselli, Riccardo Maria

    2010-11-01

    This paper presents an application of an environmental accounting method, namely emergy evaluation, developed for the monitoring and assessment of environmental resource use by local communities in the Abruzzo Region (Italy). Once quantified and classified according to their origin (renewable or non-renewable, local or external), emergy flows were elaborated through a geographic information system (GIS) that allowed us to represent their spatial distribution throughout the region. Outcomes took the form of patterns in which different emergy intensities, namely empower (unit: seJ yr(-1)), were represented through a graduated grey-scale and visualized on a cartographic basis. The concentration of emergy flows, depending on the activity of local communities, showed variable levels of environmental load in different areas. In particular, spatial zones with homogeneous values of empower density (unit: seJ yr(-1) km(-2))--high, medium and low--were detected in order to identify areas with a similar "thermodynamic" nature, emergy being a thermodynamics based function. This allowed for the representation, at a glance, of a kind of geography that mirrors the behavior of a population settled in an area as additional information for investigating the effects of the use of urban structures and functions and improving our understanding of regional systems. A combined use of emergy evaluation and GIS could thus provide a complementary view of a territorial system and inform policy makers for planning specific strategies of future development. PMID:20663603

  12. Land-use planning of Volyn region (Ukraine) using Geographic Information Systems (GIS) technologies

    NASA Astrophysics Data System (ADS)

    Strielko, Irina; Pereira, Paulo

    2014-05-01

    Land-use development planning is carried out in order to create a favourable environment for human life, sustainable socioeconomic and spatial development. Landscape planning is an important part of land-use development that aims to meet the fundamental principles of sustainable development. Geographic Information Systems (GIS) is a fundamental tool to make a better landscape planning at different territorial levels, providing data and maps to support decision making. The objective of this work is to create spatio-temporal, territorial and ecological model of development of Volyn region (Ukraine). It is based on existing spatial raster and vector data and includes the analysis of territory dynamics as the aspects responsible for it. A spatial analyst tool was used to zone the areas according to their environmental components and economic activity. This analysis is fundamental to define the basic parameters of sustainability of Volyn region. To carry out this analysis, we determined the demographic capacity of districts and the analysis of spatial parameters of land use. On the basis of the existing natural resources, we observed that there is a need of landscape protection and integration of more are natural areas in the Pan-European Ecological Network. Using GIS technologies to landscape planning in Volyn region, allowed us to identify, natural areas of interest, contribute to a better resource management and conflict resolution. Geographic Information Systems will help to formulate and implement landscape policies, reform the existing administrative system of Volyn region and contribute to a better sustainable development.

  13. Healthcare Wide Hazards: Bloodborne Pathogens

    MedlinePLUS

    ... Updates US Public Health Service recommendations for the management of the health-care personnel (HCP) who have occupational exposure to blood ... Updates US Public Health Service recommendations for the management of the health-care personnel (HCP) who have occupational exposure to blood ...

  14. A cross-sectional pilot study assessing needs and attitudes to implementation of Information and Communication Technology for rational use of medicines among healthcare staff in rural Tanzania

    PubMed Central

    2014-01-01

    Background In resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. Health workers lack updated medical information and treatment support. Information and Communication Technology (ICT) could help tackle this. The impact of ICT on health systems in resource-poor countries is likely to be significant and transform the practice of medicine just as in high-income countries. However, research for finding the best way of doing this is needed. We aimed to assess current approaches to and use of ICT among health workers in two rural districts of Tanzania in relation to the current drug distribution practices, drug stock and continuing medical information (CME), as well as assessing the feasibility of using ICT to improve ordering and use of medicines. Methods This pilot study was conducted in 2010–2011, mapping the drug distribution chain in Tanzania, including problems and barriers. The study was conducted in Bunda and Serengeti districts, both part of the ICT4RD (ICT for rural development) project. Health workers involved in drug procurement and use at 13 health facilities were interviewed on use and knowledge of ICT, and their attitudes to its use in their daily work. They were also shown and interviewed about their thoughts on an android tablet application prototype for drug stock inventory and drug ordering, based on the Tanzanian Medical Stores Department (MSD) current paper forms. Results The main challenge was a stable supply of essential medicines. Drug supplies were often delayed and incomplete, resulting in stock-outs. All 20 interviewed health workers used mobile phones, 8 of them Smartphones with Internet connection. The Health workers were very positive to the tablet application and saw its potential in reducing drug stock-outs. They also expressed a great need and wish for CME by distance. Conclusion The tablet application was easily used and appreciated by health workers, and thus has the potential to save time and effort, reduce transportation costs and minimise drug stock-outs. Furthermore, the android tablet could be used to reach out with CME programs to health care workers at remote health facilities, as well as those in towns. PMID:25158806

  15. The A to Z of healthcare data breaches.

    PubMed

    Kobus, Theodore J

    2012-01-01

    There currently exists a myriad of privacy laws that impact a healthcare entity, including more than 47 notification laws that require notification when a data breach occurs, as well as the breach notification requirements of the Health Information Technology for Economic and Clinical Health Act. Given the plethora of issues a healthcare entity faces, there are certain principles that can be built into an organization's philosophy that will comply with the law and help protect it from reputational harm. PMID:22833327

  16. Healthcare system evolution towards SOA: a security perspective.

    PubMed

    Koufi, Vassiliki; Malamateniou, Flora; Vassilacopoulos, George; Papakonstantinou, Despina

    2010-01-01

    Healthcare providers often face the challenge of integrating diverse and geographically disparate IT systems to respond to changing requirements and to exploit the capabilities of modern technologies. Hence, systems evolution, through modification and extension of the existing IT infrastructure, becomes a necessity. This paper assumes a healthcare systems evolution towards a service-oriented architecture (SOA) and places emphasis on the development of an appropriate authorization model and mechanism that ensures authorized access to integrated patient information through web service invocations. PMID:20841810

  17. Accountability and Primary Healthcare

    PubMed Central

    Mukhi, Shaheena; Barnsley, Jan; Deber, Raisa B.

    2014-01-01

    This paper examines the accountability structures within primary healthcare (PHC) in Ontario; in particular, who is accountable for what and to whom, and the policy tools being used. Ontario has implemented a series of incremental reforms, using expenditure policy instruments, enforced through contractual agreements to provide a defined set of publicly financed services that are privately delivered, most often by family physicians. The findings indicate that reporting, funding, evaluation and governance accountability requirements vary across service provider models. Accountability to the funder and patients is most common. Agreements, incentives and compensation tools have been used but may be insufficient to ensure parties are being held responsible for their activities related to stated goals. Clear definitions of various governance structures, a cohesive approach to monitoring critical performance indicators and associated improvement strategies are important elements in operationalizing accountability and determining whether goals are being met. PMID:25305392

  18. Accountability and primary healthcare.

    PubMed

    Mukhi, Shaheena; Barnsley, Jan; Deber, Raisa B

    2014-09-01

    This paper examines the accountability structures within primary healthcare (PHC) in Ontario; in particular, who is accountable for what and to whom, and the policy tools being used. Ontario has implemented a series of incremental reforms, using expenditure policy instruments, enforced through contractual agreements to provide a defined set of publicly financed services that are privately delivered, most often by family physicians. The findings indicate that reporting, funding, evaluation and governance accountability requirements vary across service provider models. Accountability to the funder and patients is most common. Agreements, incentives and compensation tools have been used but may be insufficient to ensure parties are being held responsible for their activities related to stated goals. Clear definitions of various governance structures, a cohesive approach to monitoring critical performance indicators and associated improvement strategies are important elements in operationalizing accountability and determining whether goals are being met. PMID:25305392

  19. A Framework for the Development of Multi-scale Regional Climate Information

    NASA Astrophysics Data System (ADS)

    Gonzalez, P. L.; Goddard, L.; Greene, A. M.

    2010-12-01

    Climate information for the next few decades is required for both risk management and planning purposes. On this time horizon natural and anthropogenic factors can be equally important. We introduce here a strategy for the layering of information on different timescales - anthropogenically-forced climate change, natural low-frequency fluctuations and year-to-year variability - each with its associated uncertainty range. The approach involves the combination of dynamical and statistical projections, with specific methodologies being regionally tailored. The example of South Eastern South America will be presented. Here, such tools can play a crucial role in the development of land-use and water management policies. Approaches of varying complexity are considered in order to take advantage of observations, IPCC climate change projections and initialized decadal predictions, and to assess the uncertainties in these sources of information.

  20. Analysis of surface-water data network in Kansas for effectiveness in providing regional streamflow information

    USGS Publications Warehouse

    Medina, K.D.; Tasker, Gary D.

    1985-01-01

    The surface water data network in Kansas was analyzed using generalized least squares regression for its effectiveness in providing regional streamflow information. The correlation and time-sampling error of the streamflow characteristic are considered in the generalized least squares method. Unregulated medium-flow, low-flow and high-flow characteristics were selected to be representative of the regional information that can be obtained from streamflow gaging station records for use in evaluating the effectiveness of continuing the present network stations, discontinuing some stations; and/or adding new stations. The analysis used streamflow records for all currently operated stations that were not affected by regulation and discontinued stations for which unregulated flow characteristics , as well as physical and climatic characteristics, were available. The state was divided into three network areas, western, northeastern, and southeastern Kansas, and analysis was made for three streamflow characteristics in each area, using three planning horizons. The analysis showed that the maximum reduction of sampling mean square error for each cost level could be obtained by adding new stations and discontinuing some of the present network stations. Large reductions in sampling mean square error for low-flow information could be accomplished in all three network areas, with western Kansas having the most dramatic reduction. The addition of new stations would be most beneficial for man- flow information in western Kansas, and to lesser degrees in the other two areas. The reduction of sampling mean square error for high-flow information would benefit most from the addition of new stations in western Kansas, and the effect diminishes to lesser degrees in the other two areas. Southeastern Kansas showed the smallest error reduction in high-flow information. A comparison among all three network areas indicated that funding resources could be most effectively used by discontinuing more stations in northeastern and southeastern Kansas and establishing more new stations in western Kansas. (Author 's abstract)

  1. AnnotQTL: a new tool to gather functional and comparative information on a genomic region

    PubMed Central

    Lecerf, F.; Bretaudeau, A.; Sallou, O.; Desert, C.; Blum, Y.; Lagarrigue, S.; Demeure, O.

    2011-01-01

    AnnotQTL is a web tool designed to aggregate functional annotations from different prominent web sites by minimizing the redundancy of information. Although thousands of QTL regions have been identified in livestock species, most of them are large and contain many genes. This tool was therefore designed to assist the characterization of genes in a QTL interval region as a step towards selecting the best candidate genes. It localizes the gene to a specific region (using NCBI and Ensembl data) and adds the functional annotations available from other databases (Gene Ontology, Mammalian Phenotype, HGNC and Pubmed). Both human genome and mouse genome can be aligned with the studied region to detect synteny and segment conservation, which is useful for running inter-species comparisons of QTL locations. Finally, custom marker lists can be included in the results display to select the genes that are closest to your most significant markers. We use examples to demonstrate that in just a couple of hours, AnnotQTL is able to identify all the genes located in regions identified by a full genome scan, with some highlighted based on both location and function, thus considerably increasing the chances of finding good candidate genes. AnnotQTL is available at http://annotqtl.genouest.org. PMID:21596783

  2. Development, Validation and Deployment of a Real Time 30 Day Hospital Readmission Risk Assessment Tool in the Maine Healthcare Information Exchange

    PubMed Central

    Hao, Shiying; Wang, Yue; Jin, Bo; Shin, Andrew Young; Zhu, Chunqing; Huang, Min; Zheng, Le; Luo, Jin; Hu, Zhongkai; Fu, Changlin; Dai, Dorothy; Wang, Yicheng; Culver, Devore S.; Alfreds, Shaun T.; Rogow, Todd; Stearns, Frank; Sylvester, Karl G.; Widen, Eric; Ling, Xuefeng B.

    2015-01-01

    Objectives Identifying patients at risk of a 30-day readmission can help providers design interventions, and provide targeted care to improve clinical effectiveness. This study developed a risk model to predict a 30-day inpatient hospital readmission for patients in Maine, across all payers, all diseases and all demographic groups. Methods Our objective was to develop a model to determine the risk for inpatient hospital readmission within 30 days post discharge. All patients within the Maine Health Information Exchange (HIE) system were included. The model was retrospectively developed on inpatient encounters between January 1, 2012 to December 31, 2012 from 24 randomly chosen hospitals, and then prospectively validated on inpatient encounters from January 1, 2013 to December 31, 2013 using all HIE patients. Results A risk assessment tool partitioned the entire HIE population into subgroups that corresponded to probability of hospital readmission as determined by a corresponding positive predictive value (PPV). An overall model c-statistic of 0.72 was achieved. The total 30-day readmission rates in low (score of 030), intermediate (score of 3070) and high (score of 70100) risk groupings were 8.67%, 24.10% and 74.10%, respectively. A time to event analysis revealed the higher risk groups readmitted to a hospital earlier than the lower risk groups. Six high-risk patient subgroup patterns were revealed through unsupervised clustering. Our model was successfully integrated into the statewide HIE to identify patient readmission risk upon admission and daily during hospitalization or for 30 days subsequently, providing daily risk score updates. Conclusions The risk model was validated as an effective tool for predicting 30-day readmissions for patients across all payer, disease and demographic groups within the Maine HIE. Exposing the key clinical, demographic and utilization profiles driving each patients risk of readmission score may be useful to providers in developing individualized post discharge care plans. PMID:26448562

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

    PubMed Central

    Juhnke, Christin; Mhlbacher, Axel C.

    2013-01-01

    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 SPSS18. The number of factors retained was controlled by Kaiser's criterion, validation of screeplots and interpretability of the items. Cronbach's ? 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 KaiserMeyerOlkin of 0.914 for the patients (experts: 38.427%, KaiserMeyerOlkin = 0.797). Cronbach's ? 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. PMID:24363639

  4. A perspective of adaptation in healthcare.

    PubMed

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

    2014-01-01

    Emerging new technologies in healthcare has proven great promises for managing patient care. In recent years, the evolution of Information and Communication Technologies pushes many research studies to think about treatment plan adaptation in this area. The main goal is to accelerate the decision making by dynamically generating new treatment due to unexpected situations. This paper portrays the treatment adaptation from a new perspective inspired from the human nervous system named autonomic computing. Thus, the selected potential studies are classified according to the maturity levels of this paradigm. To guarantee optimal and accurate treatment adaptation, challenges related to medical knowledge and data are identified and future directions to be explored in healthcare systems are discussed. PMID:25160175

  5. Effectiveness of the New Hampshire stream-gaging network in providing regional streamflow information

    USGS Publications Warehouse

    Olson, Scott A.

    2003-01-01

    The stream-gaging network in New Hampshire was analyzed for its effectiveness in providing regional information on peak-flood flow, mean-flow, and low-flow frequency. The data available for analysis were from stream-gaging stations in New Hampshire and selected stations in adjacent States. The principles of generalized-least-squares regression analysis were applied to develop regional regression equations that relate streamflow-frequency characteristics to watershed characteristics. Regression equations were developed for (1) the instantaneous peak flow with a 100-year recurrence interval, (2) the mean-annual flow, and (3) the 7-day, 10-year low flow. Active and discontinued stream-gaging stations with 10 or more years of flow data were used to develop the regression equations. Each stream-gaging station in the network was evaluated and ranked on the basis of how much the data from that station contributed to the cost-weighted sampling-error component of the regression equation. The potential effect of data from proposed and new stream-gaging stations on the sampling error also was evaluated. The stream-gaging network was evaluated for conditions in water year 2000 and for estimated conditions under various network strategies if an additional 5 years and 20 years of streamflow data were collected. The effectiveness of the stream-gaging network in providing regional streamflow information could be improved for all three flow characteristics with the collection of additional flow data, both temporally and spatially. With additional years of data collection, the greatest reduction in the average sampling error of the regional regression equations was found for the peak- and low-flow characteristics. In general, additional data collection at stream-gaging stations with unregulated flow, relatively short-term record (less than 20 years), and drainage areas smaller than 45 square miles contributed the largest cost-weighted reduction to the average sampling error of the regional estimating equations. The results of the network analyses can be used to prioritize the continued operation of active stations, the reactivation of discontinued stations, or the activation of new stations to maximize the regional information content provided by the stream-gaging network. Final decisions regarding altering the New Hampshire stream-gaging network would require the consideration of the many uses of the streamflow data serving local, State, and Federal interests.

  6. Co-speech gestures influence neural activity in brain regions associated with processing semantic information

    PubMed Central

    Dick, Anthony Steven; Goldin-Meadow, Susan; Hasson, Uri; Skipper, Jeremy I.; Small, Steven L.

    2009-01-01

    Everyday communication is accompanied by visual information from several sources, including co-speech gestures, which provide semantic information listeners use to help disambiguate the speakers message. Using fMRI, we examined how gestures influence neural activity in brain regions associated with processing semantic information. The BOLD response was recorded while participants listened to stories under three audiovisual conditions and one auditory-only (speech alone) condition. In the first audiovisual condition, the storyteller produced gestures that naturally accompany speech. In the second, she made semantically unrelated hand movements. In the third, she kept her hands still. In addition to inferior parietal and posterior superior and middle temporal regions, bilateral posterior superior temporal sulcus and left anterior inferior frontal gyrus responded more strongly to speech when it was further accompanied by gesture, regardless of the semantic relation to speech. However, the right inferior frontal gyrus was sensitive to the semantic import of the hand movements, demonstrating more activity when hand movements were semantically unrelated to the accompanying speech. These findings show that perceiving hand movements during speech modulates the distributed pattern of neural activation involved in both biological motion perception and discourse comprehension, suggesting listeners attempt to find meaning, not only in the words speakers produce, but also in the hand movements that accompany speech. PMID:19384890

  7. Implementation and Evaluation of the WADGPS System in the Taipei Flight Information Region

    PubMed Central

    Jan, Shau-Shiun; Lu, Shih-Chieh

    2010-01-01

    This paper describes the implementation of the Wide Area Differential Global Positioning System (WADGPS) system in order to evaluate the operational performance of a satellite based aviation navigation system within Taipei Flight Information Region (FIR). The main objective of the WADGPS is to provide real time integrity information regarding the use of GPS for civil aviation applications. This paper uses the e-GPS observation stations operated by the Taiwan Ministry of Interior (MOI) as the WADGPS reference stations to collect the L1-L2 dual-frequency GPS measurements. A WADGPS master station is also implemented to process all GPS measurements sent from each reference station, and then generate the vector corrections. These vector corrections consist of the satellite ephemeris and clock errors, and a grid of ionospheric delays. The data stream also includes confidence bounds for the corrections and “Use/Do Not Use” messages to provide integrity. These messages are then passed to the WADGPS user through the Internet. This paper discusses the WADGPS system architecture and the system performance analysis. A five-day operation performance in Taipei Flight Information Region (FIR) is presented in this paper. The results show that the WADGPS can improve the accuracy performance of GPS positioning and fulfill the integrity performance required by Non-Precision Approach (NPA) defined by the International Civil Aviation Organization (ICAO). PMID:22319284

  8. Implementation and evaluation of the WADGPS system in the Taipei Flight Information Region.

    PubMed

    Jan, Shau-Shiun; Lu, Shih-Chieh

    2010-01-01

    This paper describes the implementation of the Wide Area Differential Global Positioning System (WADGPS) system in order to evaluate the operational performance of a satellite based aviation navigation system within Taipei Flight Information Region (FIR). The main objective of the WADGPS is to provide real time integrity information regarding the use of GPS for civil aviation applications. This paper uses the e-GPS observation stations operated by the Taiwan Ministry of Interior (MOI) as the WADGPS reference stations to collect the L1-L2 dual-frequency GPS measurements. A WADGPS master station is also implemented to process all GPS measurements sent from each reference station, and then generate the vector corrections. These vector corrections consist of the satellite ephemeris and clock errors, and a grid of ionospheric delays. The data stream also includes confidence bounds for the corrections and "Use/Do Not Use" messages to provide integrity. These messages are then passed to the WADGPS user through the Internet. This paper discusses the WADGPS system architecture and the system performance analysis. A five-day operation performance in Taipei Flight Information Region (FIR) is presented in this paper. The results show that the WADGPS can improve the accuracy performance of GPS positioning and fulfill the integrity performance required by Non-Precision Approach (NPA) defined by the International Civil Aviation Organization (ICAO). PMID:22319284

  9. Evidence-based healthcare in developing countries.

    PubMed

    Pearson, Alan; Jordan, Zoe

    2010-06-01

    Developing countries have limited resources, so it is particularly important to invest in healthcare that works. The case for evidence-based practice has long been made in the West. However, poor access to information makes this endeavour near impossible for health professionals working with vulnerable communities in low-income economies. This paper provides a call to action to create an evidence base for health professionals in developing countries and identify appropriate strategies for the dissemination of this information in realistic and meaningful ways. PMID:21077397

  10. A new method to obtain uniform distribution of ground control points based on regional statistical information

    NASA Astrophysics Data System (ADS)

    Ma, Chao; An, Wei; Deng, Xinpu

    2015-10-01

    The Ground Control Points (GCPs) is an important source of fundamental data in geometric correction for remote sensing imagery. The quantity, accuracy and distribution of GCPs are three factors which may affect the accuracy of geometric correction. It is generally required that the distribution of GCP should be uniform, so they can fully control the accuracy of mapping regions. In this paper, we establish an objective standard of evaluating the uniformity of the GCPs' distribution based on regional statistical information (RSI), and get an optimal distribution of GCPs. This sampling method is called RSIS for short in this work. The Amounts of GCPs in different regions by equally partitioning the image in regions in different manners are counted which forms a vector called RSI vector in this work. The uniformity of GCPs' distribution can be evaluated by a mathematical quantity of the RSI vector. An optimal distribution of GCPs is obtained by searching the RSI vector with the minimum mathematical quantity. In this paper, the simulation annealing is employed to search the optimal distribution of GCPs that have the minimum mathematical quantity of the RSI vector. Experiments are carried out to test the method proposed in this paper, and sampling designs compared are simple random sampling and universal kriging model-based sampling. The experiments indicate that this method is highly recommended as new GCPs sampling design method for geometric correction of remotely sensed imagery.

  11. Death Valley regional groundwater flow model calibration using optimal parameter estimation methods and geoscientific information systems

    USGS Publications Warehouse

    D'Agnese, F. A.; Faunt, C.C.; Hill, M.C.; Turner, A.K.

    1996-01-01

    A three-layer Death Valley regional groundwater flow model was constructed to evaluate potential regional groundwater flow paths in the vicinity of Yucca Mountain, Nevada. Geoscientific information systems were used to characterize the complex surface and subsurface hydrogeological conditions of the area, and this characterization was used to construct likely conceptual models of the flow system. The high contrasts and abrupt contacts of the different hydrogeological units in the subsurface make zonation the logical choice for representing the hydraulic conductivity distribution. Hydraulic head and spring flow data were used to test different conceptual models by using nonlinear regression to determine parameter values that currently provide the best match between the measured and simulated heads and flows.

  12. Introducing the Healthcare Delivery Research Program | Healthcare Delivery Research Blog

    Cancer.gov

    Understanding the many challenges of cancer care is the focus of the new Healthcare Delivery Research Program in the Division of Cancer Control and Population Sciences at the National Cancer Institute (NCI).

  13. Improving healthcare using Lean processes.

    PubMed

    Baker, G Ross

    2014-01-01

    For more than a decade, healthcare organizations across Canada have been using Lean management tools to improve care processes, reduce preventable adverse events, increase patient satisfaction and create better work environments. The largest system-wide effort in Canada, and perhaps anywhere, is currently under way in Saskatchewan. The jury is still out on whether Lean efforts in that province, or elsewhere in Canada, are robust enough to transform current delivery systems and sustain new levels of performance. This issue of Healthcare Quarterly features several articles that provide a perspective on Lean methods in healthcare. PMID:25191802

  14. 78 FR 68030 - U.S. Healthcare Education Mission to New Delhi, Hyderabad, and Ahmedabad, India, January 27...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ... is amending the Notice published at 78 FR 42505, July 16, 2013, regarding the U.S. Healthcare... International Trade Administration U.S. Healthcare Education Mission to New Delhi, Hyderabad, and Ahmedabad... Information section of the Notice of the U.S. Healthcare Education Mission to New Delhi, Hyderabad,...

  15. Neural regions discriminating contextual information as conveyed through the learned preferences of others

    PubMed Central

    Lee, Su Mei; McCarthy, Gregory

    2015-01-01

    The human brain consists of a network of regions that are engaged when one observes the movements of others. Observing unexpected movements, as defined by the context, often elicits greater activity, particularly in the right posterior superior temporal sulcus (pSTS). This implies that observers use contextual information to form expectations about an agent’s goal and subsequent movements. The current study sought to identify regions that support the formation of these context-dependent expectations, with the pSTS being one candidate, given the consistent contextual modulation of its activity. We presented participants with fictitious individuals who had emotion-dependent food preferences, and instructed participants to indicate which food they expected each individual to choose based on the individual’s current emotional state. Each individual’s preference and emotional state therefore created a context that informed the observer’s expectation of the individual’s choice. Multi-voxel pattern analysis (MVPA) was used to assess if these different contexts could be discriminated in the pSTS and elsewhere in the brain. No evidence for context discrimination was found in the pSTS. Context discrimination was found instead a network of other brain regions including the anterior medial prefrontal cortex (amPFC), bilateral parietal cortex, left middle temporal gyrus (L MTG) and left anterior temporal lobe (L ATL), which have been previously associated with context processing, and semantic and memory retrieval. All together, these regions possibly support the formation of context-dependent expectations of an agent’s goal. PMID:26441592

  16. Data Hemorrhages in the Health-Care Sector

    NASA Astrophysics Data System (ADS)

    Johnson, M. Eric

    Confidential data hemorrhaging from health-care providers pose financial risks to firms and medical risks to patients. We examine the consequences of data hemorrhages including privacy violations, medical fraud, financial identity theft, and medical identity theft. We also examine the types and sources of data hemorrhages, focusing on inadvertent disclosures. Through an analysis of leaked files, we examine data hemorrhages stemming from inadvertent disclosures on internet-based file sharing networks. We characterize the security risk for a group of health-care organizations using a direct analysis of leaked files. These files contained highly sensitive medical and personal information that could be maliciously exploited by criminals seeking to commit medical and financial identity theft. We also present evidence of the threat by examining user-issued searches. Our analysis demonstrates both the substantial threat and vulnerability for the health-care sector and the unique complexity exhibited by the US health-care system.

  17. Healthcare in Disasters and the Role of RFID.

    PubMed

    Madanian, Samaneh; Parry, David; Norris, Tony

    2015-01-01

    Disasters either natural or man-made are inevitable, and therefore disaster management has always been an important function of government. Since during a disaster healthcare is often adversely affected, a lot of effort has been made in terms of researching effective responses and ways of improving the quality of delivered care to direct casualties and the rest of the community. In this regard, information technology plays an important role to help healthcare systems achieve this goal. One of these technologies that has become popular recently is Radio-Frequency Identification (RFID). This paper explores the relationship between emergency management and disaster healthcare and examines the role of RFID. It is suggested that RFID will become an integral part of disaster healthcare and a means of improving response performance. PMID:26262309

  18. Improve processes on healthcare: current issues and future trends.

    PubMed

    Chen, Jason C H; Dolan, Matt; Lin, Binshan

    2004-01-01

    Information Technology (IT) is a critical resource for improving today's business competitiveness. However, many healthcare providers do not proactively manage or improve the efficiency and effectiveness of their services with IT. Survival in a competitive business environment demands continuous improvements in quality and service, while rigorously maintaining core values. Electronic commerce continues its development, gaining ground as the preferred means of business transactions. Embracing e-healthcare and treating IT as a strategic tool to improve patient safety and the quality of care enables healthcare professionals to benefit from technology formerly used only for management purposes. Numerous improvement initiatives, introduced by both the federal government and the private sector, seek to better the status quo in IT. This paper examines the current IT climate using an enhanced "Built to Last" model, and comments on future IT strategies within the healthcare industry. PMID:18048217

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

    PubMed

    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. PMID:23113795

  20. Effectiveness of the streamflow-gaging network in Kentucky in providing regional streamflow information

    USGS Publications Warehouse

    Ruhl, K.J.

    1993-01-01

    This report describes the results of an analysis of the effectiveness of the strearnflow-gaging network in Kentucky in providing regional streamflow information. The data available for analysis included streamflow-gaging stations in Kentucky and selected stations in adjoining States. One phase of the analysis determined the increased effectiveness of the network if hypothetical new stations were added to it. The analysis was based on the principles of generalized least squares regression. The results indicated that new stations having small drainage areas (less than 100 square miles) produced the greatest reduction in average sampling-error variance from current conditions in the mean-flow analysis. Only stations with drainage areas ranging from 200 to 450 square miles produced a significant effect on the low-flow analysis. Data from new stations having small drainage areas (less than 100 square miles) and fairly steep slopes (25 feet per mile) would make the greatest improvement in peak-flow information.