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Sample records for regional healthcare information

  1. 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

  2. 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

  3. 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

  4. Development of a Regional Laboratory Healthcare Network

    PubMed Central

    Huff, Stanley M.; Evans, R. Scott; Gandhi, Santosh; Jensen, Blake

    1988-01-01

    In order to provide cost effective patient care and to provide better information access and exchange capabilities for healthcare providers, a regional healthcare network has been created. The goals of the network are to provide laboratory computer services to 8 hospitals, to provide the decision support capabilities of the HELP system to a group of affiliated hospitals in the intermountain region, and to allow access and exchange of clinical patient data among the various institutions. The network has nodes separated by over 30 miles and includes Tandem, Prime, Data General, and IBM hardware. Problems encountered in creating the network include the lack of appropriate standards, development of strategies for error handling and system isolation, complexities in data translation, and functional overlap between the systems.

  5. 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

  6. An overview in healthcare information systems security.

    PubMed

    Bourka, A; Polemi, N; Koutsouris, D

    2001-01-01

    The scope of this paper is to present the current needs and trends in the field of healthcare systems security. The approach applied within the described review was based on three major steps. The first step was to define the point and ways of penetration and integration of security services in current healthcare related applications addressing technical, organisational and legal/regulatory issues. The second step was to specify and evaluate common security technologies applied in healthcare information systems pointing out gaps and efficient solutions, whereas the third was to draw conclusions for the present conditions and identify the future trends of healthcare information security. A number of EU RTD Projects were selected, categorised, analysed and comparatively evaluated in terms of security. The technical focus was on key security technologies, like Public Key Infrastructures (PKIs) based on Trusted Third Parties (TTPs) in conjunction with other state-of-the-art security components (programming tools, data representation formats, security standards and protocols, security policies and risk assessment techniques). The experience gained within this review will provide valuable input for future security applications in the healthcare sector, solving existing problems and addressing real user needs. PMID:11604927

  7. 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

  8. 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

  9. 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

  10. Information superhighway or information traffic jam for healthcare consumers?

    PubMed

    McGrath, I

    1997-01-01

    The phenomenal development and growth of the information superhighway over the past few years has brought with an ever-increasing number of sites associated with health care. At the same time, community access to the Internet and multimedia technology has allowed greater access to healthcare sites by consumers wishing to find healthcare information relevant to their needs. The Internet has greater potential for improving the healthcare knowledge of the community, especially in remote areas or in parts of the community that have limited access to community health infrastructure. However, most of the current development of healthcare sites has focused on the needs of healthcare professionals rather than consumers. Indeed, with the volume of information available over the Internet, it is easy to spend hours browsing through a maze of sites with information that often is fragmented, incomplete, or only accessible with a password. Once a relevant site is located, the information often is presented as vast amounts of text with possibly some graphics. It appears little consideration is given during the development of web sites to the actual presentation of the information. For the full potential of the information superhighway to be realized in relation to health care, more consideration should be given during the development stages of web sites to how the information is presented and how to make access more streamlined. PMID:10167219

  11. 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

  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, 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

  13. Adaptive information networks in healthcare: spontaneous interoperability.

    PubMed

    DelloStritto, James J

    2009-01-01

    In this paper we consider self organizing frameworks for healthcare in a model mimicking biologic frameworks. We support self organization via attribute based memory mapped information in original random form. 'Spontaneous interoperability' and subsequent adaptability is facilitated by the memory map which describes the serialized electronic ordering of transferred information, its evolutionary history, and meta-data associated with the information. Memory maps are transferred in a discovery process facilitating interoperability by means of application adaptation. We demonstrate the potential for network entities utilizing the framework to work together even though they were initially unaware of the potential. We recognize the challenges faced, define initial targeted infrastructure to aid in the advancement of adaptive networks, and suggest future work. The goals of adaptability in healthcare require timely access to information relevant to the decision process and the elimination of slow and costly integrations. It will allow for accurate representation, diversity, longevity/viability, and increased depth/ range of computable information for computational intelligence enhancement. Increased availability of information provided by an adaptive network may help to improved patient outcomes and provide earlier detection, prevention of disease, and a reduction in medical errors. PMID:19745478

  14. [Financing of regional healthcare in Kazakhstan].

    PubMed

    Kim, S V

    2005-01-01

    It is suggested in the paper how to finance stages of healthcare in Kazakhstan. The introduction of the Budget Code is expected to change the functioning of the financial department for the better. PMID:15828399

  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. 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

  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. 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

  20. 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

  1. 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...

  2. 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…

  3. 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

  4. 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

  5. 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…

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

    PubMed

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

    2006-01-01

    The paper presents an integrated, distributed Healthcare Enterprise Information Portal (HEIP) and Hospital Information Systems (HIS) framework over wireless/wired infrastructure at National Taiwan University Hospital (NTUH). A single sign-on solution for the hospital customer relationship management (CRM) in HEIP has been established. The outcomes of the newly developed Outpatient Information Systems (OIS) in HIS are discussed. The future HEIP blueprints with CRM oriented features: e-Learning, Remote Consultation and Diagnosis (RCD), as well as on-Line Vaccination Services are addressed. Finally, the integrated HEIP and HIS architectures based on the middleware technologies are proposed along with the feasible approaches. The preliminary performance of multi-media, time-based data exchanges over the wireless HEIP side is collected to evaluate the efficiency of the architecture. PMID:17946647

  7. 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

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

    PubMed

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

    2012-10-01

    Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent. PMID:22086739

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

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

    PubMed

    Masaud-Wahaishi, Abdulmutalib; Ghenniwa, Hamada

    2009-01-01

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

  11. 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

  12. An agenda for healthcare and information simulation.

    PubMed

    Young, Terry

    2005-08-01

    With healthcare systems around the world undergoing redesign and refocusing on patients, there is a strategic role that simulation modellers could play. The creation of strategic scenarios that work according to process philosophies--as used, for instance, in manufacturing--could help to deliver high quality care to millions of people. There may, in addition, be serendipitous synergies between some of these industrial process philosophies and known simulation techniques. This paper addresses some strategic issues around the processes of care delivery, and considers the resultant research agenda. Not only is this strategic agenda one that would help care providers, but it is possible to derive some concepts that enable technology to be valued as part of care provision. The paper explores how, in general terms, value propositions may be derived that are acceptable to commissioning agencies and accessible to technology vendors. Were it possible to formalise these, they would be of significant benefit both to healthcare service providers and to their suppliers. PMID:16134431

  13. 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...

  14. 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…

  15. 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

  16. 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

  17. 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.

  18. 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

  19. An Informatics Blueprint for Healthcare Quality Information Systems

    PubMed Central

    Niland, Joyce C.; Rouse, Layla; Stahl, Douglas C.

    2006-01-01

    There is a critical gap in our nation's ability to accurately measure and manage the quality of medical care. A robust healthcare quality information system (HQIS) has the potential to address this deficiency through the capture, codification, and analysis of information about patient treatments and related outcomes. Because non-technical issues often present the greatest challenges, this paper provides an overview of these socio-technical issues in building a successful HQIS, including the human, organizational, and knowledge management (KM) perspectives. Through an extensive literature review and direct experience in building a practical HQIS (the National Comprehensive Cancer Network Outcomes Research Database system), we have formulated an “informatics blueprint” to guide the development of such systems. While the blueprint was developed to facilitate healthcare quality information collection, management, analysis, and reporting, the concepts and advice provided may be extensible to the development of other types of clinical research information systems. PMID:16622161

  20. 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.

  1. 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

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

    PubMed

    Román, I; Roa, L M; Madinabeitia, G; Millán, 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

  3. Healthcare Information Systems to Assess Influenza Outbreaks

    PubMed Central

    Figar, S.; Aliperti, V.; Salazar, E.; Otero, C.; Schpilberg, M.; Taliercio, V.; Otero, P.; de Quirós, F. González 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

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. The holistic architectural approach to integrating the healthcare record in the overall information system.

    PubMed

    Ferrara, F M; Sottile, P A; Grimson, W

    1999-01-01

    The integration and evolution of existing systems represents one of the most urgent problems facing those responsible for healthcare information systems so that the needs of the whole organisation are addressed. The management of the healthcare record represents one of the major requirements in the overall process, however it is also necessary to ensure that the healthcare record and other healthcare information is integrated within the context of an overall healthcare information system. The CEN ENV 12967-1 'Healthcare Information Systems Architecture' standard defines a holistic architectural approach where the various, organisational, clinical, administrative and managerial requirements co-exist and cooperate, relying on a common heritage of information and services. This paper reviews the middleware-based approach adopted by CEN ENV 12967-1 and the specialisation necessary for the healthcare record based on CEN ENV 12265 'Electronic Healthcare Record Architecture'. PMID:10725017

  12. Using key performance indicators as knowledge-management tools at a regional health-care authority level.

    PubMed

    Berler, Alexander; Pavlopoulos, Sotiris; Koutsouris, Dimitris

    2005-06-01

    The advantages of the introduction of information and communication technologies in the complex health-care sector are already well-known and well-stated in the past. It is, nevertheless, paradoxical that although the medical community has embraced with satisfaction most of the technological discoveries allowing the improvement in patient care, this has not happened when talking about health-care informatics. Taking the above issue of concern, our work proposes an information model for knowledge management (KM) based upon the use of key performance indicators (KPIs) in health-care systems. Based upon the use of the balanced scorecard (BSC) framework (Kaplan/Norton) and quality assurance techniques in health care (Donabedian), this paper is proposing a patient journey centered approach that drives information flow at all levels of the day-to-day process of delivering effective and managed care, toward information assessment and knowledge discovery. In order to persuade health-care decision-makers to assess the added value of KM tools, those should be used to propose new performance measurement and performance management techniques at all levels of a health-care system. The proposed KPIs are forming a complete set of metrics that enable the performance management of a regional health-care system. In addition, the performance framework established is technically applied by the use of state-of-the-art KM tools such as data warehouses and business intelligence information systems. In that sense, the proposed infrastructure is, technologically speaking, an important KM tool that enables knowledge sharing amongst various health-care stakeholders and between different health-care groups. The use of BSC is an enabling framework toward a KM strategy in health care. PMID:16138535

  13. 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...

  14. 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...

  15. 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...

  16. 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

  17. 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

  18. Asan Medical Information System for Healthcare Quality Improvement

    PubMed Central

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

    2010-01-01

    Objectives This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Methods Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. Results AMIS consisted of several distinctive systems: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. Conclusions AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed. PMID:21818439

  19. Security of healthcare information systems based on the CORBA middleware.

    PubMed

    Blobel, B; Holena, M

    1997-01-01

    The development of healthcare systems in accordance to the "Shared Care" paradigm results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems demand a high level of data protection and data security, both with respect to patient information and with respect to users. The security concepts and measures available and additionally needed in health information systems based on CORBA architecture are described in this paper. The proposed security solution is also open to other middleware approaches, such as DHE or HL7. PMID:10179515

  20. 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

  1. Healthcare information system approaches based on middleware concepts.

    PubMed

    Holena, M; Blobel, B

    1997-01-01

    To meet the challenges for efficient and high-level quality, health care systems must implement the "Shared Care" paradigm of distributed co-operating systems. To this end, both the newly developed and legacy applications must be fully integrated into the care process. These requirements can be fulfilled by information systems based on middleware concepts. In the paper, the middleware approaches HL7, DHE, and CORBA are described. The relevance of those approaches to the healthcare domain is documented. The description presented here is complemented through two other papers in this volume, concentrating on the evaluation of the approaches, and on their security threats and solutions. PMID:10175361

  2. 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

  3. 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

  4. Designing healthcare information technology to catalyse change in clinical care.

    PubMed

    Lester, William T; Zai, Adrian H; Grant, Richard W; Chueh, Henry C

    2008-01-01

    The gap between best practice and actual patient care continues to be a pervasive problem in our healthcare system. Efforts to improve on this knowledge-performance gap have included computerised disease management programs designed to improve guideline adherence. However, current computerised reminder and decision support interventions directed at changing physician behaviour have had only a limited and variable effect on clinical outcomes. Further, immediate pay-for-performance financial pressures on institutions have created an environment where disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their real-world effectiveness. The authors present a review of disease management as well as a conceptual framework to guide the development of more effective health information technology (HIT) tools for translating clinical information into clinical action. PMID:18534073

  5. 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…

  6. 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

  7. 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

  8. Public/private information sharing in healthcare fraud investigations.

    PubMed

    Sheehan, J G

    1999-01-01

    Private insurers have good reason, both in their private interest and in the public interest, for pursuing and rooting out fraud in the healthcare system; moreover, they often have sophisticated data systems, substantial investigative information, and management expertise that can be useful to prosecutors. It makes sense, as a public policy matter, to undertake steps to encourage insurers to be aggressive in pursuing legitimate fraud cases, and to provide a framework for effective cooperation and information sharing with law enforcement. At the same time, prosecutors are responsible for enforcing equal justice under the law; thus, any such relationship must be handled in an appropriate manner, with safeguards to protect privacy and the reputation of investigative subjects. While the courts have not yet explored many of the relevant legal and factual issues in this area, the author surveys existing guidance under governing laws and policies applicable to state and federal prosecutors, and suggests techniques to prevent inappropriate communication or use of such information. PMID:10662440

  9. Redesign of healthcare processes classification to improve the processes of gathering information and data processing on professional and organisational quality in healthcare.

    PubMed

    Ritonja, S A; Hocevar, Z

    2001-01-01

    One of the most important instruments for gathering information and processing data relating to professional and organisational quality in health systems is "healthcare processes classification". The authors found that a typical problem of many European countries is a lack of reliable information in the field of healthcare, mainly because the development of quality instruments, including healthcare processes classification, is not a priority for medical and other health professions. Additionally, it is difficult to update this instrument coherently with organisational changes and developmental achievements. This article describes the approach used by the University Medical Centre in Ljubjana, Slovenia, to redesign its healthcare processes classification in order to improve the quality of healthcare. PMID:11729622

  10. 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

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

    PubMed

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

    2010-02-01

    This article analyzes the role of ICT within the complicated gear between information, knowledge and healthcare practices, which particular focus on two specific cases: the digitalization process of the healthcare system and the application of knowledge into the healthcare practices. In both cases, international and local experiences suggest, and sometimes demonstrate the importance of the participation, capacity-building and empowerment of healthcare practitioners for the generation, transfer and use of information and knowledge empowered by the digital tools which should bring into the system better performance, more efficacy, efficiency, equity, equality, security, quality. PMID:20211347

  12. Healthcare coverage for undocumented migrants in Spain: Regional differences after Royal Decree Law 16/2012.

    PubMed

    Cimas, Marta; Gullon, Pedro; Aguilera, Eva; Meyer, Stefan; Freire, José Manuel; Perez-Gomez, Beatriz

    2016-04-01

    The economic crisis has prompted the debate on how to regulate health coverage of undocumented migrants in publicly funded healthcare systems. Spain, as one of the most heavily affected countries in Europe, can be considered a case of particular interest. In 2012 the Spanish Government issued a Royal Decree Law (RDL 16/2012) which revoked their previous full right to public healthcare coverage, now limited for some exceptions. However, the Spanish National Health System is highly decentralized, and this Central Government decree had to be implemented by the Regional Health Authorities. Our aim is to compare regional policies regarding entitlement to healthcare for undocumented migrants after RDL 16/2012 in the 17 Autonomous Regions by performing an exhaustive review of the regional health policy regulations published after the enactment of RDL 16/2012. Our analysis shows that many Regions adopted legal, legislative and administrative actions to void or limit its effects, while others applied it as intended, resulting in huge differences in healthcare coverage for irregular migrants among Spanish Regions. The unequal implementation of this Law constitutes a paradigmatic example of the complexity of nation-wide regulation of controversial key issues in decentralized health systems. In addition, our results highlight that within-country differences in access and/or entitlement can be as relevant as those reported among-country when there is healthcare decentralization. PMID:26948703

  13. How to co-develop services, work, and information systems in healthcare: the daisy approach.

    PubMed

    Korpela, Mikko; Ikävalko, Pauliina; Luukkonen, Irmeli; Martikainen, Susanna; Palmén, Marilla; Tiihonen, Tuija; Toivanen, Marika; Vainikainen, Vilma

    2013-01-01

    Information systems in healthcare need to be designed and developed in a collaborative way. However, existing collaborative methodologies for the parallel development of healthcare work and information systems are vague and fragmented. Furthermore, they neither address people-centred healthcare nor limited-resource contexts. In this paper we introduce an emerging holistic approach, based on a unifying theoretical basis, for co-developing the services, work and information systems in healthcare. The approach intends to (a) be collaborative in nature; (b) address the domains of both healthcare professionals and ordinary people / communities; (c) span the main analysis and design tasks of socio-technical information systems development from needs assessment through requirements setting to functional-architectural solutions; (d) be contextually sensitive; and (e) be practicable in "real life" beyond research settings. PMID:23941943

  14. Healthcare chains - enabling application and data privacy controls for healthcare information systems.

    PubMed

    Omran, Esraa; Grandison, Tyrone; Abu Almaati, Shereef

    2010-01-01

    Healthcare applications that have access control, disclosure management and or privacy enforcement requirements may implement the respective solutions to these issues at the application level or at the database level or in both. Unfortunately, there are technical and non-technical factors that influence what can be done. In this paper we present a flexible, simple and novel approach to seamlessly imbuing current healthcare applications and their supporting infrastructure with security and privacy functionality, while being cognizant of these factors. This approach is called the Chain method. This paper will highlight the smaller design footprint, the increased ease of implementation and use of the Chain method, while demonstrating that it is as powerful and effective as traditional methods. PMID:20841811

  15. 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

  16. 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

  17. 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…

  18. 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...

  19. 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...

  20. 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...

  1. A qualitative analysis of immigrant population health practices in the Girona Healthcare Region

    PubMed Central

    2010-01-01

    Background The research we present here forms part of a two-phase project - one quantitative and the other qualitative - assessing the use of primary health care services. This paper presents the qualitative phase of said research, which is aimed at ascertaining the needs, beliefs, barriers to access and health practices of the immigrant population in comparison with the native population, as well as the perceptions of healthcare professionals. Moroccan and sub-Saharan were the immigrants to who the qualitative phase was specifically addressed. The aims of this paper are as follows: to analyse any possible implications of family organisation in the health practices of the immigrant population; to ascertain social practices relating to illness; to understand the significances of sexual and reproductive health practices; and to ascertain the ideas and perceptions of immigrants, local people and professionals regarding health and the health system. Methods Qualitative research based on discursive analysis. Data gathering techniques consisted of discussion groups with health system users and semi-structured individual interviews with healthcare professionals. The sample was taken from the Basic Healthcare Areas of Salt and Banyoles (belonging to the Girona Healthcare Region), the discussion groups being comprised of (a) 6 immigrant Moroccan women, (b) 7 immigrant sub-Saharan African women and (c) 6 immigrant and native population men (2 native men, 2 Moroccan men and 2 sub-Saharan men); and the semi-structured interviews being conducted with the following healthcare professionals: (a) 3 gynaecologists, (b) 3 nurses and 1 administrative staff. Results Use of the healthcare system is linked to the perception of not being well, knowledge of the healthcare system, length of time resident in Spain and interiorization of traditional Western medicine as a cure mechanism. The divergences found among the groups of immigrants, local people and healthcare professionals with regard to healthcare education, use of the healthcare service, sexual and reproductive healthcare and reticence with regard to being attended by healthcare personnel of the opposite sex demonstrate a need to work with the immigrant population as a heterogeneous group. Conclusions The results we have obtained support the idea that feeling unwell is a psycho-social process, as it takes place within a specific socio-cultural situation and spans a range of beliefs, perceptions and ideas regarding symptomology and how to treat it. PMID:20587020

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

    PubMed

    Nardon, Fabiane Bizinella; de A Moura, Lincoln

    2007-01-01

    São Paulo is the largest city in Brazil and one of the largest cities in the world. In 2004, São Paulo City Department of Health decided to implement a Healthcare Information System to support managing healthcare services and provide an ambulatory health record. The resulting information system is one of the largest public healthcare information systems ever built, with more than 2 million lines of code. Although statistics shows that most software projects fail, and the risks for the São Paulo initiative were enormous, the information system was completed on-time and on-budget. In this paper, we discuss the software engineering principles adopted that allowed to accomplish that project's goals, hoping that sharing the experience of this project will help other healthcare information systems initiatives to succeed. PMID:17911673

  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. 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

  6. Medicine and spiritual healing within a region of Canada: preliminary findings concerning Christian Scientists' healthcare practices.

    PubMed

    Manca, Terra

    2013-09-01

    Christian Science is the largest and most recognized of various spiritual healing groups that encourage members to forgo or overcome the need for medicine. Even so, it appears that some Scientists occasionally use medicine. In this study, I argue that Scientists in one region of Canada respond to influences on their healthcare practices differently and follow a variety of healthcare practices. These practices range from refusing medically necessary treatment (which could potentially harm individuals' health) to making full use of the medical system. I base my findings primarily on interviews with eleven current members and one former Christian Scientist. PMID:21681598

  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. [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

  9. 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.

  10. Is variation management included in regional healthcare governance systems? Some proposals from Italy.

    PubMed

    Nuti, Sabina; Seghieri, Chiara

    2014-01-01

    The Italian National Health System, which follows a Beveridge model, provides universal healthcare coverage through general taxation. Universal coverage provides uniform healthcare access to citizens and is the characteristic usually considered the added value of a welfare system financed by tax revenues. Nonetheless, wide differences in practice patterns, health outcomes and regional usages of resources that cannot be justified by differences in patient needs have been demonstrated to exist. Beginning with the experience of the health care system of the Tuscany region (Italy), this study describes the first steps of a long-term approach to proactively address the issue of geographic variation in healthcare. In particular, the study highlights how the unwarranted variation management has been addressed in a region with a high degree of managerial control over the delivery of health care and a consolidated performance evaluation system, by first, considering it a high priority objective and then by actively integrating it into the regional planning and control mechanism. The implications of this study can be useful to policy makers, professionals and managers, and will contribute to the understanding of how the management of variation can be implemented with performance measurements and financial incentives. PMID:24050981

  11. Regional Disparities in the Distribution of Healthcare Workers: Evidence From Iran, Chaharmahal and Bakhtiari Province

    PubMed Central

    Asar, Mohamad Ezati; Varehzardi, Ramin; Vasokolaei, Ghasem Rajabi; Haghi, Mehdi; Fazelipor, Morteza

    2015-01-01

    A health care service is a prerequisite for sustainable development. This requires access to balanced health workers in different geographic areas. The first step is to identify inequality in access to health workers in different areas. This study is a descriptive study was carried out on the cities in Chaharmahal and Bakhtiari province. TOPSIS technique was used to rank the cities in terms of regional disparities in the distribution of health workers. The findings revealed that distinct disparities in the distribution of healthcare workers across Chaharmahal and Bakhtiari province. Shahrekord and Ardal cities were classified as 1st and 7th respectively. Policy makers should consider priority (regional planning, budget and resources allocation) according to the distribution of healthcare workers. PMID:25716410

  12. 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…

  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. 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

  15. 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

  16. 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.

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

    PubMed

    de Lima, Luciana Dias; Viana, Ana Luiza d'Ávila; Machado, Cristiani Vieira; de Albuquerque, Mariana Vercesi; de Oliveira, Roberta Gondim; Iozzi, Fabíola Lana; Scatena, João 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

  18. Accessibility and use of primary healthcare for immigrants living in the Niagara Region.

    PubMed

    Lum, Irene D; Swartz, Rebecca H; Kwan, Matthew Y W

    2016-05-01

    Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers. PMID:27017093

  19. 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

  20. Knowledge management prerequisites for building an information society in healthcare.

    PubMed

    Kisilowska, Malgorzata

    2006-01-01

    The European Research Area requires either technological development or information literacy of health professionals. This information literacy shall be understood much deeper and broader than a basic preparation to use ICT tools in everyday life only. The author's first aim is to present the literature review and analysis of different definition of the "information" concept in Polish and foreign sources for health sciences, to emphasize a problem fundamental for an information society development, i.e. lack of adequate "information" understanding. Health professionals' information literacy shall also build an awareness of conceptual differences among numerous classifications, thesauruses, and information-retrieval languages, which result in different information received in a retrieval process. This problem can be of crucial effect for either health research or practice. Understanding the problem shall mobilize the researchers, classifiers, and indexers to co-ordinate efforts aimed in organizing "a translator" covering the most popular classifications' and thesauruses' concepts, to make an international research co-operation easier, relevant, and safe for the patients. PMID:16188493

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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…

  8. 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...

  9. 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...

  10. 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...

  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. Good Medicine and Good Healthcare Demand Good Information (Systems).

    PubMed

    Winter, A; Hilgers, R-D; Hofestädt, R; Hübner, U; Knaup-Gregori, P; Ose, C; Schmoor, C; Timmer, A; Wege, D

    2015-01-01

    The demand for evidence-based health informatics and benchmarking of 'good' information systems in health care gives an opportunity to continue reporting on recent papers in the German journal GMS Medical Informatics, Biometry and Epidemiology (MIBE) here. The publications in focus deal with a comparison of benchmarking initiatives in German-speaking countries, use of communication standards in telemonitoring scenarios, the estimation of national cancer incidence rates and modifications of parametric tests. Furthermore papers in this issue of MIM are introduced which originally have been presented at the Annual Conference of the German Society of Medical Informatics, Biometry and Epidemiology. They deal as well with evidence and evaluation of 'good' information systems but also with data harmonization, surveillance in obstetrics, adaptive designs and parametrical testing in statistical analysis, patient registries and signal processing. PMID:26395286

  13. 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

  14. 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

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

    PubMed Central

    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

  16. 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

  17. 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

  18. Surveillance of healthcare-associated infections in Piemonte, Italy: results from a second regional prevalence study

    PubMed Central

    2014-01-01

    Background A prevalence survey of healthcare-associated infections (HAIs) was previously performed in the Piemonte region in 2000. In the decade following the survey, many studies were performed at both the regional and hospital levels, and training courses were developed to address issues highlighted by the survey. In 2010, a second regional prevalence study was performed. The aim of this paper is to present the results of the second prevalence study and discuss them within the context of the HAI prevention and control programmes that have been implemented in the decade since the original survey was conducted. Methods The study involved all public hospitals in the Piemonte region. Uni- and multivariate analyses were performed to assess the main risk factors associated with HAIs, including both overall and site-specific infections. Results A total of 7841 patients were enrolled: 6.8% were affected by at least one HAI. The highest prevalence of HAIs was found in intensive care units (18.0%, 95% CI 14.0-22.6), while UTIs presented the highest relative frequency (26.7%), followed by respiratory tract infections (21.9%). The age of the patient, hospital size and urinary and central venous catheter status were significantly associated with HAIs. Conclusions The study results showed an increase in HAI prevalence, despite prevention and control efforts, as well as training implemented after the first regional survey. Nevertheless, these data are consistent with the current literature. Furthermore, despite its limits, the prevalence approach remains an important means for involving healthcare workers, emphasising HAIs and revealing critical problems that need be addressed. PMID:24899239

  19. Healthcare-use for Major Infectious Disease Syndromes in an Informal Settlement in Nairobi, Kenya

    PubMed Central

    Olack, Beatrice; Shultz, Alvin; Roder, Sanam; Kimani, Kabuiya; Feikin, Daniel R.; Burke, Heather

    2011-01-01

    A healthcare-use survey was conducted in the Kibera informal settlement in Nairobi, Kenya, in July 2005 to inform subsequent surveillance in the site for infectious diseases. Sets of standardized questionnaires were administered to 1,542 caretakers and heads of households with one or more child(ren) aged less than five years. The average household-size was 5.1 (range 1-15) persons. Most (90%) resided in a single room with monthly rents of US$ 4.50-7.00. Within the previous two weeks, 49% of children (n=1,378) aged less than five years (under-five children) and 18% of persons (n=1,139) aged ≥5 years experienced febrile, diarrhoeal or respiratory illnesses. The large majority (>75%) of illnesses were associated with healthcare-seeking. While licensed clinics were the most-frequently visited settings, kiosks, unlicensed care providers, and traditional healers were also frequently visited. Expense was cited most often (50%) as the reason for not seeking healthcare. Of those who sought healthcare, 34-44% of the first and/or the only visits were made with non-licensed care providers, potentially delaying opportunities for early optimal intervention. The proportions of patients accessing healthcare facilities were higher with diarrhoeal disease and fever (but not for respiratory diseases in under-five children) than those reported from a contemporaneous study conducted in a rural area in Kenya. The findings support community-based rather than facility-based surveillance in this setting to achieve objectives for comprehensive assessment of the burden of disease. PMID:21608421

  20. 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; Macías, 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

  1. 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.

  2. 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

  3. 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

  4. The UK Freedom of Information Act (2000) in healthcare research: a systematic review

    PubMed Central

    Fowler, Alexander J; Agha, Riaz A; Camm, Christian F; Littlejohns, Peter

    2013-01-01

    Objectives To assess the use and utility of the Freedom of Information Act (2000) in healthcare research since 2005 and to determine if any particular feature of studies found led to greater data acquisition. Design PRISMA compliant systematic review. Participants An extensive literature search was performed of EMBASE, MEDLINE, CINAHL, psychINFO, BNI, AMED, HMIC and Health business elite databases from January 2005 to January 2013 using terms ‘Freedom of information’, ‘Freedom of information act’ and ‘Freedom of information act 2000’. Papers were considered for publication if they described utilising the UK Freedom of information act to gather data for healthcare research. 16 articles met these criteria. Primary and Secondary outcome measures Primary outcome was the number and characteristics of studies utilising the Freedom of Information Act to collect the data for healthcare research. Secondary outcome measures were any features that improved data acquisition rates (including to whom the request was made, the number of questions asked per request, etc.) Results 16 articles described utilising the Freedom of Information Act for healthcare research, and these investigated a broad range of topics. The median number of requests made was 86 (range 1–172), the total number of requests was 1732. A total of 15 817 pieces of data were retrieved by all studies. The amount of data collected was defined as the number of questions asked multiplied by the number of full responses. A median of five questions were asked per study (range 5–6.5) and the overall response rate was 86%. The National Health Service litigation authority responded to 100% of requests, while Primary Care Trusts had the lowest response rate of 81% for healthcare bodies. A positive correlation between number of requests made and data obtained (0.508, p<0.05) and number of requests made and increased response rate (0.737, p<0.01), both reached the statistical significance. Conclusions Researchers should make greater use of the Act to access the information they need that is not otherwise disclosed. We discuss the issues with the research utilising the Act and how future research of this type could be optimised. PMID:24285626

  5. 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

  6. The distribution of online healthcare information: a case study on melanoma.

    PubMed

    Bhavnani, Suresh K

    2003-01-01

    To understand the difficulties users face when retrieving comprehensive healthcare information, this paper analyzes how facts related to a widely available healthcare topic are distributed across high-quality webpages. An inter-rater experiment with two skin-cancer physicians helped identify 14 facts necessary for a comprehensive understanding of melanoma risk and prevention. A second inter-rater experiment analyzed how those facts were distributed across 189 relevant webpages from high-quality sites. The analysis revealed that the distribution of facts is highly skewed, where few pages have many facts, many pages have a few facts, and no single page or site provides all the facts. A more detailed analysis suggests that the distribution is being caused by a trade-off between depth and breadth, leading to the existence of general, specialized, and sparse pages. Furthermore, the analyses reveal patterns and complexities in the relationships between facts, pages, and websites. These distribution results pinpoint the difficulties faced by searchers, and provide insights for the design of future systems that guide users in retrieving comprehensive healthcare information. PMID:14728138

  7. Shopping in the healthcare information systems market--a search for well-camouflaged land mines.

    PubMed

    Grams, R R

    1998-10-01

    The selection of a healthcare information system is analogous to a big game hunt. The buyers perceive themselves as the hunters while the truth is just the opposite. To strip away the carefully crafted facade of corporate marketing is an art form and requires due diligence on the part of the shopper. Suggestions are offered to the consumer on how to pierce the shell of corporate silence and find the facts that will make a significant difference in product selection. The objectives on the seller's side are to make as much profit as possible and give as little as required to make the sale. The buyer is looking for the best product, the best company, and the most painless installation. The ground between these two vastly different goals is the battlefield of healthcare computer procurement. May the best shopper win! Caveat emptor. PMID:9809272

  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; Frémont, Pierre; Gagnon, Johanne; Tremblay, Nadine; Légaré, 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. Maturity Models of Healthcare Information Systems and Technologies: a Literature Review.

    PubMed

    Carvalho, João Vidal; Rocha, Álvaro; Abreu, António

    2016-06-01

    The maturity models are instruments to facilitate organizational management, including the management of its information systems function. These instruments are used also in hospitals. The objective of this article is to identify and compare the maturity models for management of information systems and technologies (IST) in healthcare. For each maturity model, it is identified the methodology of development and validation, as well as the scope, stages and their characteristics by dimensions or influence factors. This study resulted in the need to develop a maturity model based on a holistic approach. It will include a comprehensive set of influencing factors to reach all areas and subsystems of health care organizations. PMID:27083575

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

    PubMed

    Rosenälv, Jessica; Lundell, Karl-Henrik

    2012-01-01

    "We need a precise framework of regulations in order to maintain appropriate and structured health care documentation that ensures that the information maintains a sufficient level of quality to be used in treatment, in research and by the actual patient. The users shall be aided by clearly and uniformly defined terms and concepts, and there should be an information structure that clarifies what to document and how to make the information more useful. Most of all, we need to standardize the information, not just the technical systems." (eHälsa - nytta och näring, Riksdag report 2011/12:RFR5, p. 37). In 2010, the Swedish Government adopted the National e-Health - the national strategy for accessible and secure information in healthcare. The strategy is a revision and extension of the previous strategy from 2006, which was used as input for the most recent efforts to develop a national information structure utilizing business-oriented generic models. A national decision on healthcare informatics standards was made by the Swedish County Councils, which decided to follow and use EN/ISO 13606 as a standard for the development of a universally applicable information structure, including archetypes and templates. The overall aim of the Swedish strategy for development of National Healthcare Information Architecture is to achieve high level semantic interoperability for clinical content and clinical contexts. High level semantic interoperability requires consistently structured clinical data and other types of data with coherent traceability to be mapped to reference clinical models. Archetypes that are formal definitions of the clinical and demographic concepts and some administrative data were developed. Each archetype describes the information structure and content of overarching core clinical concepts. Information that is defined in archetypes should be used for different purposes. Generic clinical process model was made concrete and analyzed. For each decision-making step in the process where information is processed, the amount and type of information and its structure were defined in terms of reference templates. Reference templates manage clinical, administrative and demographic types of information in a specific clinical context. Based on a survey of clinical processes at the reference level, the identification of specific clinical processes such as diabetes and congestive heart failure in adults were made. Process-specific templates were defined by using reference templates and populated with information that was relevant to each health problem in a specific clinical context. Throughout this process, medical data for knowledge management were collected for each health problem. Parallel with the efforts to define archetypes and templates, terminology binding work is on-going. Different strategies are used depending on the terminology binding level. PMID:22491102

  12. 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…

  13. 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

  14. 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

  15. [Primary healthcare: a multidimensional study on challenges and potential in the São Paulo Metropolitan Region (SP, Brazil)].

    PubMed

    Heimann, Luiza Sterman; Ibanhes, Lauro Cesar; Boaretto, Roberta Cristina; Castro, Iracema Ester do Nascimento; Telesi Júnior, Emilio; Cortizo, Carlos Tato; Fausto, Márcia Cristina Rodrigues; do Nascimento, Vânia Barbosa; Kayano, Jorge

    2011-06-01

    This paper presents some results of a case study in the Metropolitan Region of São Paulo (SP, Brazil) as part of a multicentric study conducted in Argentina, Brazil, Paraguay and Uruguay. The aim is to evaluate Primary Health Care (PHC) as a strategy to achieve integrated and universal healthcare systems. The methodological approach was based on five analytical dimensions: stewardship capability; financing; provision; comprehensiveness and intersectoral approach. The techniques included literature review, document analysis and interviews with key informants: policy makers; managers, experts, users and professionals. The results were organized in response to the challenges and possibilities of PHC as a structural system according to the five dimensions. The following emerged from the interviews: different interpretations on the concept and role of PHC and a consensus as the gateway to the system; weaknesses in funding; challenges in health workforce administration and the need for new legal-institutional design for regional management. The potential aspects were: broader coverage/universality, PHC as the basis for the organization of the system; connection with the territory and understanding specific population needs. PMID:21709984

  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. An Evaluation of Healthcare Information on the Internet: The Case of Colorectal Cancer Prevention

    PubMed Central

    Chen, Chia-Ching; Yamada, Tetsuji; Smith, John

    2014-01-01

    Health information, provided through the Internet, has recently received attention from consumers and healthcare providers as an efficient method of motivating people to get screened for colorectal cancer (CRC). In this study, the primary purpose was to investigate the extent to which consumers were better educated about CRC screening information because of the information available on the Internet. Another purpose was to identify how better-informed consumers, with reliable and trustworthy health information, were enabled to make sound decisions regarding CRC screening. The data used in this study was taken from the 2003 Health Information National Trends Survey. People aged 55 and older were classified based on their compliance with recommended CRC screening. The study applied the PRECEDE-PROCEED model to evaluate the effects of health information taken from the Internet regarding CRC screening. The credibility and reliance of cancer related information on the Internet was significantly associated with patient compliance to be screened for CRC. Experience and knowledge of Internet use had a significant impact on the utilization of CRC screening. This analysis suggests that the design and publishing websites concerning CRC should emphasize credibility and reliance. Websites providing information about CRC must also contain the most current information so that people are able to make educated decisions about CRC screening. PMID:24424284

  20. 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

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

    PubMed

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

    1999-01-01

    The integration and evolution of existing systems represents one of the most urgent priorities of health care information systems in order to allow the whole organisation to meet the increasing clinical organisational and managerial needs. The CEN ENV 12967-1 'Healthcare Information Systems Architecture'(HISA) standard defines an architectural approach based on a middleware of business-specific common services, enabling all parts of the local and geographical system to operate on the common information heritage of the organisation and on exploiting a set of common business-oriented functionality. After an overview on the key aspects of HISA, this paper discusses the positioning of the authorization and security aspects in the overall architecture. A global security framework is finally proposed. PMID:10724897

  2. The G8-global healthcare applications project (GHAP) - recommendations for the way into the information society

    PubMed

    Dietzel

    1999-12-16

    The Global Healthcare Applications Project has sought to demonstrate the potential of telematics in the field of medicine and healthcare and to promote joint approaches to issues such as the setting of standards. This has been done through 10 sub-projects covering a range of applications and issues: 1. Towards a global public health information network - Coordinator: Germany (Ulrich Laaser, ulaaser@mail.uni-bielefeld.de; URL: http://health.ibs.uni-bielefeld. de/i-jphe/database/documents/abstract/laaser-g7.htm(C45-60_laaser-g7. pdf) 2. Improving prevention, early detection, diagnosis and treatment of cancer. - Coordinator: France (Gerard Brugal, gerard. brugal@imag.fr; URL: http://pathconsult.imag.fr/G7/G7_index.html) 3. Improving prevention, diagnosis and treatment of major cardiovascular diseases. - Coordinator: Italy (Attilio Maseri, amaseri@rm.unicatt.it; URL: http://www.g7cardio.org) 4. International concerted action for collaboration in telemedicine. - Coordinator: Canada (Andre Lacroix, lacroixa@ere.umontreal.ca; URL: http:// www.g7sp4.org) 5. Enabling mechanisms for a global healthcare network, including Internet connectivity. - Coordinator: UK (Ray Rogers, r.rogers@mcmail.com; URL: http://www.ehto.be/sp5) 6. International harmonisation of the use of data cards in healthcare: Internet Connectivity Coordinator: USA (Elliot R. Siegel, siegel@nlm.nih.gov; URL: http://www.nlm.nih.gov/) - Smart Cards and information exchange security in health care Joint Coordinators: France, European Commission, Italy and Germany (Jacques Sauret, jacques.sauret@sante.gouv.fr and G8-HC@sesam-vitale.fr; URL: http:/www.sesam-vitale.fr/Projects/Netlink-G7-En/) 7. Evidence and effectiveness. - Coordinator: Canada (Andrew Penn, andrew. penn@ualberta.ca; URL: http://www.medlib.com/spi/web.htm) 8. Multilingual anatomical digital database. - Coordinator: USA (Michael J. Ackermann; URL: http://www.nlm.nih.gov) 9. Medical image reference centre. - Coordinator: Japan (Eturo Kashiwagi,EK-WEY@mhw. go.jp; URL: http://www.medirec.ncc.go.jp) 10. Special Interactive TV and Multimedia Programmes for Professionals and Public in Dentistry and International Online Academy for Dentistry and Oral Medicine. - Coordinator: Germany (Alexander Ammann, ammann@quinline.com; URL: http://quinline.globaldent.com) - Further information: http://www. bmgesundheit.de PMID:10611059

  3. 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

  4. 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

  5. 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

  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. 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

  8. 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

  9. 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

  10. Knowledge sharing and information integration in healthcare using ontologies and deductive databases.

    PubMed

    Nardon, Fabiane Bizinella; Moura, Lincoln A

    2004-01-01

    This paper describes a method for using Semantic Web technologies for sharing knowledge in healthcare. It combines deductive databases and ontologies, so that it is possible to extract knowledge that has not been explicitly declared within the database. A representation of the UMLS (Unified Medical Language System) Semantic Network and Metathesaurus was created using the RDF standard, in order to represent the basic medical ontology. The inference over the knowledge base is done by the TRI-DEDALO System, a deductive data-base created to query and update RDF based knowledge sources as well as conventional relational databases. Finally, an ontology was created for the Brazilian National Health Card data interchange format, a standard to capture and transmit health encounter information throughout the country. This paper demonstrates how this approach can be used to integrate heterogeneous information and to answer complex queries in a real world environment. PMID:15360775

  11. 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

  12. Measuring disparities in information capture timeliness across healthcare settings: effects on data quality.

    PubMed

    Lorence, Daniel

    2003-10-01

    The emergence of evidence-based medicine in the United States has created an industry-wide environment where the quality of data maintained by healthcare organizations is becoming a critical factor in the delivery of medical care. Such a transition necessitates a corresponding need for consistent data collection and maintenance methods. In this study results of a national survey of health information managers were used to assess prevalence of a standard data quality practice, the adoption of policies related to timeliness of data capture. Findings from this survey show that, on a national level, only a slight majority of respondents indicated adoption of timeliness policies. About 61% of respondents indicate they have policies and procedures addressing data timeliness, although persistent patterns of nonadoption were found. We examine how the timeliness of data collection might serve as part of an overall data collection strategy that managers can employ to improve the quality of their information. PMID:14584619

  13. 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

  14. 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

  15. 75 FR 1120 - Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-08

    ... AFFAIRS Agency Information Collection (Health-Care Use Survey for Enduring Freedom and Operation Iraqi... of Veterans Affairs. ACTION: Notice. SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of... of Veterans Affairs, will submit the collection of information abstracted below to the Office...

  16. The role of organizational factors in the adoption of healthcare information technology in Florida hospitals.

    PubMed

    Hikmet, Neset; Bhattacherjee, Anol; Menachemi, Nir; Kayhan, Varol O; Brooks, Robert G

    2008-03-01

    This study examines whether specific organizational characteristics, such as hospital size, geographic location (urban versus rural), system membership (stand-alone versus system-affiliated), and tax status (for-profit versus non-profit), influence adoption of healthcare information technologies (HIT) in hospitals. We hypothesize the above organizational characteristics to be related to hospitals' adoption of clinical, administrative, and strategic HIT, as well as all HIT in general. Using survey data collected from 98 Florida hospitals, we demonstrate that hospital size, system membership, and tax status, but not geographic location, are systematically related to HIT adoption, and that such factors explain about 28-41% of the adoption variance. A mixed pattern of effects emerge for clinical, administrative, and strategic HIT. For instance, hospital size appears to be less relevant for administrative HIT, where its effect is compensated by those of system membership and tax status. Implications for future HIT research and practice are discussed. PMID:18390163

  17. 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

  18. 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

  19. [Healthcare expenditure].

    PubMed

    Huguier, Michel

    2012-10-01

    Healthcare expenditure is divided between medical infrastructure and individual patient management. Total healthcare costs in France amount to roughly 175 billion euros, financed through public health insurance (77%), private insurance (14%), and individual expenditure (9%). The principal expenditures are for hospitalization (44%), community medical, dental and paramedical care (28%), drugs (20%) and miscellaneous resources (8%). The main factors of rising costs are medical progress and aging. More controllable costs include healthcare provision, the level of reimbursement, public education and information, and physician training. France devotes 9.2% of its gross national product to healthcare, compared to 7-8% in Sweden, Germany and the United Kingdom, representing a diference of about 18 billion euros. In France there is a chronic imbalance between resources and expenditure, creating a cumulative budget deficit of about 100 billlion euros. Major efforts must be made to improve efficiency, and it will be necessary to choose between preserving our healthcare system or our financial system. If the latter is prioritized, healthcare will inevitably deteriorate. PMID:23815025

  20. Feasibility and Acceptability of the Informant AD8 for Cognitive Screening in Primary Healthcare: A Pilot Study

    PubMed Central

    Dong, YanHong; Tsou, Keith Yu Kei; Chen, Christopher Li-Hsian

    2014-01-01

    Objectives. The utility of informant AD8 for case finding of cognitive impairment at primary healthcare settings is unknown and therefore its feasibility and acceptability for targeted screening at a primary healthcare clinic should be investigated. Methods. The informants of older adult patients attending a primary healthcare clinic in Singapore were administered the AD8. Positive screening findings were provided to patients' primary care physicians for referrals to specialist memory clinics. The acceptability of AD8 was evaluated by collecting feedbacks from the informants and primary care physicians. Results. 205 patients and their informants were recruited. However, 6 (2.9%) informants were uncontactable, while the majority of the remaining 199 patients with completed AD8 (96.5%, n = 192) found it acceptable where 59 (29.6%) patients were deemed cognitively impaired (AD8 ≥ 2). Clinicians (100%, n = 5) found the AD8 helpful in facilitating referrals to memory clinics. However, most referral recommendations (81.4%, n = 48) were declined by patients and/or informant due to limited insight of implications of cognitive impairment. Conclusions. The AD8 can be easily administered and is well tolerated. It detected cognitive impairment in one-third of older adult patients and therefore may be useful for case finding of cognitive impairment in the primary healthcare. PMID:25548780

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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…

  7. 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,…

  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. 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

  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. 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

  12. Patient information leaflets for prostate cancer: which leaflets should healthcare professionals recommend?

    PubMed

    Rees, C E; Ford, J E; Sheard, C E

    2003-03-01

    This study evaluated 31 patient information leaflets (PILs) discussing treatment options for prostate cancer. In stage one, the authors evaluated the leaflets' quality, readability and suitability using objective measures: the DISCERN instrument; Flesch formula; and the Suitability Assessment of Materials (SAM) instrument, respectively. Although the leaflets varied in terms of their scores on each measure, it was possible to identify the best five leaflets across the three conditions. In stage two, eight men with prostate cancer took part in a focus group discussion or individual interview to outline their views regarding a number of leaflets, including the best five booklets or leaflets identified in stage one of the study. The interviews were audiotaped and analysed using a template analysis. Patients were able to discriminate between the best five leaflets or booklets and identify their preferred booklets. These were the booklets: "Understanding cancer of the prostate" by CancerBACUP, "Prostate cancer: everything you need to know" by the Prostate Cancer Charity and "The treatment of prostate cancer. Questions and answers" by the Covent Garden Cancer Research Trust. On the basis of their high ratings for the objective measures and patients' views, healthcare professionals are advised to recommend these three booklets to men with prostate cancer who want written information about the disease. However, randomised controlled trials are needed to examine the impact of these booklets on the psychosocial outcomes of men with prostate cancer. PMID:12642198

  13. 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

  14. Improving the network management of integrated primary mental healthcare for older people in a rural Australian region: protocol for a mixed methods case study

    PubMed Central

    Fuller, Jeffrey; Oster, Candice; Dawson, Suzanne; O'Kane, Deb; Lawn, Sharon; Henderson, Julie; Gerace, Adam; Reed, Richard; Nosworthy, Ann; Galley, Philip; McPhail, Ruth; Cochrane, Eimear Muir

    2014-01-01

    Introduction An integrated approach to the mental healthcare of older people is advocated across health, aged care and social care sectors. It is not clear, however, how the management of integrated servicing should occur, although interorganisational relations theory suggests a reflective network approach using evaluation feedback. This research will test a network management approach to help regional primary healthcare organisations improve mental health service integration. Methods and analysis This mixed methods case study in rural South Australia will test facilitated reflection within a network of health and social care services to determine if this leads to improved integration. Engagement of services will occur through a governance group and a series of three 1-day service stakeholder workshops. Facilitated reflection and evaluation feedback will use information from a review of health sector and local operational policies, a network survey about current service links, gaps and enablers and interviews with older people and their carers about their help seeking journeys. Quantitative and qualitative analysis will describe the policy enablers and explore the current and ideal links between services. The facilitated reflection will be developed to maximise engagement of senior management in the governance group and the service staff at the operational level in the workshops. Benefit will be assessed through indicators of improved service coordination, collective ownership of service problems, strengthened partnerships, agreed local protocols and the use of feedback for accountability. Ethics, benefits and dissemination Ethics approval will deal with the sensitivities of organisational network research where data anonymity is not preserved. The benefit will be the tested utility of a facilitated reflective process for a network of health and social care services to manage linked primary mental healthcare for older people in a rural region. Dissemination will make use of the sectoral networks of the governance group. PMID:25227632

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

    PubMed

    Namoğlu, Nihan; Ulgen, Yekta

    2013-01-01

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

  16. 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

  17. [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

  18. 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

  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. 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

  1. Embracing 21st Century Information Sharing: Defining a New Paradigm for the Food and Drug Administration's Regulation of Biopharmaceutical Company Communications with Healthcare Professionals.

    PubMed

    Spears, James M; Francer, Jeffrey K; Turner, Natale A

    2015-01-01

    The Food and Drug Administration (FDA) plays a unique role in protecting the public health and minimizing the risk of the distribution of unsafe or ineffective medicines in the United States. Perhaps equally as important for public health, however, is the need for healthcare professionals to be well informed about the benefits and risks of the medicines they prescribe. In this way, information sharing is critical to healthcare delivery. FDA's current interpretation of laws and regulations governing healthcare communications prohibits biopharmaceutical companies from sharing certain accurate, data-driven information about FDA-approved uses and medically accepted alternative uses of FDA-approved drugs with healthcare professionals. Often, these uses are the standard of care for good medical practice and are, accordingly, reimbursed under the federal healthcare programs. FDA has failed to describe adequately how manufacturers can share truthful and non-misleading information about such uses with healthcare professionals and formulary decision makers. This failure could impede medical innovation, negatively impact patient care, and increase healthcare costs. To improve public health, FDA should reform its current approach and provide manufacturers with a clear safe harbor on how to share data and information on both approved uses and medically accepted alternative uses of FDA-approved drugs with healthcare professionals. This Article describes key principles for a new regulatory paradigm. PMID:26292475

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

    PubMed

    Zvárová, Jana; Pribík, Vladimír

    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

  3. A results-based logic model for primary healthcare: a conceptual foundation for population-based information systems.

    PubMed

    Watson, Diane E; Broemeling, Anne-Marie; Wong, Sabrina T

    2009-11-01

    A conceptual framework for population-based information systems is needed if these data are to be created and used to generate information to support healthcare policy, management and practice communities that seek to improve quality and account for progress in primary healthcare (PHC) renewal. This paper describes work conducted in British Columbia since 2003 to (1) create a Results-Based Logic Model for PHC using the approach of the Treasury Board of Canada in designing management and accountability frameworks, together with a literature review, policy analysis and broad consultation with approximately 650 people, (2) identify priorities for information within that logic model, (3) use the logic model and priorities within it to implement performance measurement and research and (4) identify how information systems need to be structured to assess the impact of variation or change in PHC inputs, activities and outputs on patient, population and healthcare system outcomes. The resulting logic model distinguishes among outcomes for which the PHC sector should be held more or less accountable. PMID:21037902

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

    PubMed

    Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José

    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

  5. 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 System–2 (DHIMS–2) 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 DHIMS–2 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 = 0.61–0.75) and the percentage of missing data was 3.1% (95% C I = 2.96–3.24). 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

  6. 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

  7. '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

  8. 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

  9. 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

  10. Simvastatin is associated with reduced risk of acute pancreatitis: findings from a regional integrated healthcare system

    PubMed Central

    Wu, Bechien U; Pandol, Stephen J; Liu, In-Lu Amy

    2016-01-01

    Objective To characterise the relationship between simvastatin and risk of acute pancreatitis (AP). Design We conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to simvastatin was calculated from time of initial dispensation until 60 days following prescription termination. AP cases were defined by ICD-9 CM 577.0 and serum lipase≥3 times normal. Patients were censored at death, last follow-up, and onset of AP or end-of-study. Incidence rate of pancreatitis among simvastatin users was compared with the adult reference population. Robust Poisson regression was used to generate risk ratio (RR) estimates for simvastatin use adjusted for age, gender, race/ethnicity, gallstone-related disorders, hypertriglyceridaemia, smoking and alcohol dependence. Analysis was repeated for atorvastatin. Results Among 3 967 859 adult patients (median duration of follow-up of 3.4 years), 6399 developed an initial episode of AP. A total of 707 236 patients received simvastatin during the study period. Patients that received simvastatin were more likely to have gallstone-related disorders, alcohol dependence or hypertriglyceridaemia compared with the reference population. Nevertheless, risk of AP was significantly reduced with simvastatin use, crude incidence rate ratio 0.626 (95% CL 0.588, 0.668), p<0.0001. In multivariate analysis, simvastatin was independently associated with reduced risk of pancreatitis, adjusted RR 0.29 (95% CL 0.27, 0.31) after adjusting for age, gender, race/ethnicity, gallstone disorders, alcohol dependence, smoking and hypertriglyceridaemia. Similar results were noted with atorvastatin, adjusted RR 0.33 (0.29, 0.38). Conclusions Use of simvastatin was independently associated with reduced risk of AP in this integrated healthcare setting. Similar findings for atorvastatin suggest a possible class effect. PMID:24742713

  11. 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

  12. 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

    2016-01-01

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

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

    PubMed

    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

  14. 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

  15. 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. PMID:27034543

  16. 78 FR 55282 - Federal Housing Administration (FHA) Healthcare Facility Documents: Notice of Information...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-10

    ... Management Division, Office of Residential Care Facilities, Office of Healthcare Programs, Office of Housing... Facility Documents On May 3, 2012, at 77 FR 26304, and consistent with the Paperwork Reduction Act of 1995... Register on May 3, 2012, at 77 FR 26218, a proposed rule that proposed to strengthen regulations for...

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

    PubMed Central

    Doyle, J D

    1999-01-01

    The roles of hospital librarians have evolved from keeping print materials to serving as a focal point for information services and structures within the hospital. Concepts that emerged from the Integrated Academic Information Management Systems (IAIMS) as described in the Matheson Report and the 1994 Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards have combined to propel hospital libraries into many new roles and functions. This paper will review the relationship of the two frameworks, provide a view of their commonalities, and establish the advantages of both for hospital librarianship as a profession. PMID:10550022

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

    PubMed Central

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

    2014-01-01

    Introduction This study assessed the perceptions and behaviors of US adults about the security of their protected health information (PHI). Methods The first cycle of the fourth wave of the Health Information National Trends Survey was analyzed to assess respondents’ concerns about PHI breaches. Multivariate logistic regression was used to assess the effect of such concerns on disclosure of sensitive medical information to a healthcare professional (p<0.05). Results Most respondents expressed concerns about data breach when their PHI was being transferred between healthcare professionals by fax (67.0%; 95% CI 64.2% to 69.8%) or electronically (64.5%; 95% CI 61.7% to 67.3%). About 12.3% (95% CI 10.8% to 13.8%) of respondents had ever withheld information from a healthcare provider because of security concerns. The likelihood of information withholding was higher among respondents who perceived they had very little say about how their medical records were used (adjusted OR=1.42; 95% CI 1.03 to 1.96). Conclusions This study underscores the need for enhanced measures to secure patients’ PHI to avoid undermining their trust. PMID:23975624

  19. Using Information and Communication Technology in Home Care for Communication between Patients, Family Members, and Healthcare Professionals: A Systematic Review

    PubMed Central

    Lindberg, Birgitta; Nilsson, Carina; Zotterman, Daniel; Söderberg, Siv; Skär, Lisa

    2013-01-01

    Introduction. Information and communication technology (ICT) are becoming a natural part in healthcare both for delivering and giving accessibility to healthcare for people with chronic illness living at home. Aim. The aim was to review existing studies describing the use of ICT in home care for communication between patients, family members, and healthcare professionals. Methods. A review of studies was conducted that identified 1,276 studies. A selection process and quality appraisal were conducted, which finally resulted in 107 studies. Results. The general results offer an overview of characteristics of studies describing the use of ICT applications in home care and are summarized in areas including study approach, quality appraisal, publications data, terminology used for defining the technology, and disease diagnosis. The specific results describe how communication with ICT was performed in home care and the benefits and drawbacks with the use of ICT. Results were predominated by positive responses in the use of ICT. Conclusion. The use of ICT applications in home care is an expanding research area, with a variety of ICT tools used that could increase accessibility to home care. Using ICT can lead to people living with chronic illnesses gaining control of their illness that promotes self-care. PMID:23690763

  20. A review of accessibility of administrative healthcare databases in the Asia-Pacific region

    PubMed Central

    Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

    2015-01-01

    Objective We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. Methods The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Results Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3–6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but accessibility was restricted based on requirements by data custodians. Conclusions Compared with previous research, this study describes the landscape of databases in the selected countries with more granularity using an assessment tool developed for this purpose. A high number of databases were identified but most had restricted access, preventing their potential use to support research. We hope that this study helps to improve the understanding of the AHDB landscape, increase data sharing and database research in Asia-Pacific countries. PMID:27123180

  1. An empirical study of opinion leader effects on mobile information technology adoption in healthcare.

    PubMed

    Hao, Haijing; Padman, Rema; Telang, Rahul

    2011-01-01

    Given the increasing number of applications but slow adoption of IT, including mobile IT, in healthcare, it is important to develop a better understanding of the contextual factors that motivate IT adoption by physicians. Although studies have shown that age or gender may affect physicians' IT adoption, those factors cannot be controlled when deploying a new IT. Therefore, the current research examines empirical evidence of a contextual factor, opinion leader effects, on IT adoption in healthcare that can be influenced by organizational policies. Using a unique panel dataset of physicians' usage of a mobile clinical IT from a community hospital, we observe a significant result that physicians under the influence of opinion leaders are three times more likely to adopt the IT than otherwise. This finding suggests that incentivizing a small proportion of opinion leaders to adopt a new IT has the potential to motivate wider adoption across the organization. PMID:22195108

  2. 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

  3. 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

  4. Rural veteran access to healthcare services: investigating the role of information and communication technologies in overcoming spatial barriers.

    PubMed

    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

  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. In science communication, why does the idea of a public deficit always return? How do the shifting information flows in healthcare affect the deficit model of science communication?

    PubMed

    Ko, Henry

    2016-05-01

    The healthcare field contains a multitude of opportunities for science communication. Given the many stakeholders dancing together in a multidirectional tango of communication, we need to ask how much does the deficit model apply to the health field? History dictates that healthcare professionals are the holders of all knowledge, and the patients and other stakeholders are the ones that need the scientific information communicated to them. This essay argues otherwise, in part due to the rise of shared decision-making and patients and other stakeholders acting as partners in healthcare. The traditional deficit model in health held that: (1) doctors were experts and patients were consumers, (2) it is impossible for the public to grasp the many disciplines of knowledge in medicine, (3) if experts have trouble keeping up with medical research then the public surely can't keep up, and (4) it is safer for healthcare professionals to communicate to the public using a deficit model. However, with the rise of partnerships with patients in healthcare decision-making, the deficit model might be weakening. Examples of public participation in healthcare decision-making include: (1) crowd-sourcing public participation in systematic reviews, (2) public participation in health policy, (3) public collaboration in health research, and (4) health consumer groups acting as producers of health information. With the challenges to the deficit model in science communication in health, caution is needed with the increasing role of technology and social media, and how these may affect the legitimacy of healthcare information flows away from the healthcare professional. PMID:27117770

  8. Actor-Network Theory and its role in understanding the implementation of information technology developments in healthcare

    PubMed Central

    2010-01-01

    Background Actor-Network Theory (ANT) is an increasingly influential, but still deeply contested, approach to understand humans and their interactions with inanimate objects. We argue that health services research, and in particular evaluations of complex IT systems in health service organisations, may benefit from being informed by Actor-Network Theory perspectives. Discussion Despite some limitations, an Actor-Network Theory-based approach is conceptually useful in helping to appreciate the complexity of reality (including the complexity of organisations) and the active role of technology in this context. This can prove helpful in understanding how social effects are generated as a result of associations between different actors in a network. Of central importance in this respect is that Actor-Network Theory provides a lens through which to view the role of technology in shaping social processes. Attention to this shaping role can contribute to a more holistic appreciation of the complexity of technology introduction in healthcare settings. It can also prove practically useful in providing a theoretically informed approach to sampling (by drawing on informants that are related to the technology in question) and analysis (by providing a conceptual tool and vocabulary that can form the basis for interpretations). We draw on existing empirical work in this area and our ongoing work investigating the integration of electronic health record systems introduced as part of England's National Programme for Information Technology to illustrate salient points. Summary Actor-Network Theory needs to be used pragmatically with an appreciation of its shortcomings. Our experiences suggest it can be helpful in investigating technology implementations in healthcare settings. PMID:21040575

  9. Drug information service for drug product procurement in the Veterans Affairs health-care system: preliminary experience.

    PubMed

    Haynes, L M; Patterson, A A; Wade, S U

    1992-03-01

    The preliminary experience of the drug information service of the Department of Veterans Affairs (VA) central office is described. The drug information service assists the drug and pharmaceutical product management section of the pharmacy service for the VA central office. The purpose of the drug information service is to promote efficacious drug therapy while meeting cost containment goals for pharmaceutical products. The pharmacist coordinator of this service has experience in both patient care and drug information service. The drug information service is involved in the following activities: (1) making recommendations for contract bidding on therapeutically equivalent products, (2) identifying prescription duplication within the system, (3) reporting product defects, (4) planning drug procurement in unique situations, such as during war, (5) developing gender-specific therapy, (6) evaluating the appropriateness of brand-name-only purchasing of certain products, (7) evaluating new drug products, (8) compiling national drug-use data, and (9) projecting drug price increases. The VA drug information service has diverse responsibilities meant to optimize drug therapy and reduce pharmacy costs in the VA health-care system. PMID:1598933

  10. 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

  11. 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…

  12. 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

  13. 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

  14. 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.

  15. Barriers to physicians' adoption of healthcare information technology: an empirical study on multiple hospitals.

    PubMed

    Lin, Chihung; Lin, I-Chun; Roan, Jinsheng

    2012-06-01

    Prior research on technology usage had largely overlooked the issue of user resistance or barriers to technology acceptance. Prior research on the Electronic Medical Records had largely focused on technical issues but rarely on managerial issues. Such oversight prevented a better understanding of users' resistance to new technologies and the antecedents of technology rejection. Incorporating the enablers and the inhibitors of technology usage intention, this study explores physicians' reactions towards the electronic medical record. The main focus is on the barriers, perceived threat and perceived inequity. 115 physicians from 6 hospitals participated in the questionnaire survey. Structural Equation Modeling was employed to verify the measurement scale and research hypotheses. According to the results, perceived threat shows a direct and negative effect on perceived usefulness and behavioral intentions, as well as an indirect effect on behavioral intentions via perceived usefulness. Perceived inequity reveals a direct and positive effect on perceived threat, and it also shows a direct and negative effect on perceived usefulness. Besides, perceived inequity reveals an indirect effect on behavioral intentions via perceived usefulness with perceived threat as the inhibitor. The research finding presents a better insight into physicians' rejection and the antecedents of such outcome. For the healthcare industry understanding the factors contributing to physicians' technology acceptance is important as to ensure a smooth implementation of any new technology. The results of this study can also provide change managers reference to a smooth IT introduction into an organization. In addition, our proposed measurement scale can be applied as a diagnostic tool for them to better understand the status quo within their organizations and users' reactions to technology acceptance. By doing so, barriers to physicians' acceptance can be identified earlier and more effectively before leading to technology rejection. PMID:21336605

  16. An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

    PubMed

    Takeda, Hiroshi; Matsumura, Yasushi; Kuwata, Shigeki; Nakano, Hirohiko; Shanmai, Ji; Qiyan, Zhang; Yufen, Chen; Kusuoka, Hideo; Matsuoka, Masaki

    2004-03-31

    To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security. PMID:15066564

  17. Mobile healthcare.

    PubMed

    Morgan, Stephen A; Agee, Nancy Howell

    2012-01-01

    Mobile technology's presence in healthcare has exploded over the past five years. The increased use of mobile devices by all segments of the US population has driven healthcare systems, providers, and payers to accept this new form of communication and to develop strategies to implement and leverage the use of mobile healthcare (mHealth) within their organizations and practices. As healthcare systems move toward a more value-driven model of care, patient centeredness and engagement are the keys to success. Mobile healthcare will provide the medium to allow patients to participate more in their care. Financially, mHealth brings to providers the ability to improve efficiency and deliver savings to both them and the healthcare consumer. However, mHealth is not without challenges. Healthcare IT departments have been reluctant to embrace this shift in technology without fully addressing security and privacy concerns. Providers have been hesitant to adopt mHealth as a form of communication with patients because it breaks with traditional models. Our healthcare system has just started the journey toward the development of mHealth. We offer an overview of the mobile healthcare environment and our approach to solving the challenges it brings to healthcare organizations. PMID:23330297

  18. 78 FR 4983 - Proposed Information Collection; Women Veterans Healthcare Barriers Survey Activity: Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-23

    ...The Veterans Health Administration (VHA) is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed new collection, and allow 60 days for public......

  19. 77 FR 60997 - Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-05

    ... collection project: ``Development of a Health Information Rating System (HIRS).'' In accordance with the... Information Rating System (HIRS) Over the past several years, low health literacy has been identified as an... estimated excess cost for the US health care system of $50 billion to $73 billion per year. Health...

  20. Building a generic architecture for medical information exchange among healthcare providers.

    PubMed

    Li, Y C; Kuo, H S; Jian, W S; Tang, D D; Liu, C T; Liu, L L; Hsu, C Y; Tan, Y K; Hu, C H

    2001-05-01

    Due to the inability to exchange clinical information among hospitals, continuity of care cannot be maintained and a tremendous amount of medical resource has been wasted. This paper describes an architecture that would facilitate exchange of clinical information among heterogeneous hospital information systems. It is dubbed 'Medical Information Exchange Center' or MIEC as part of a six-year Health Information Network Project hosted by the Department of Health. MIEC was designed so that it is innovative yet technically feasible today. It is convenient for authorized users yet secure enough so people can trust and has minimal impact to participated hospitals. Authorized users will be able to access information through two web-based interfaces directed to physician and non-physician users respectively. Hospitals are connected through a virtual private network to exchange patient information and users need to obtain a private key from the certificate authority in order to securely connect to MIEC. A pilot project was conducted to demonstrate the feasibility of this architecture and the problems encountered were discussed. PMID:11311678

  1. 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.

  2. A quality of life survey of individuals with urinary incontinence who visit a self-help website: implications for those seeking healthcare information.

    PubMed

    Rozensky, Ronald H; Tovian, Steven M; Gartley, Cheryle B; Nichols, Thom R; Layton, Matthew

    2013-09-01

    Urinary Incontinence (UI) affects 200 million people worldwide with annual direct costs in the US alone estimated at $16.3 billion. Those with UI have reported a decrease in general quality of life with symptoms of depression, anxiety, low self-esteem, poor body image, and social stigmatization. The purpose of this study was to examine the feasibility of collecting self-reported quality of life data in a self-selected sample of individuals who visited a website providing information, education, and management suggestions regarding UI. Participants included 374 individuals with UI who responded to a solicitation for enrollment in a "Continence Comprehensive Health and Life Assessment" survey posted on The Simon Foundation for Continence website (www.simonfoundation.org). Types of problems and events associated with UI, including social connectivity and quality of life, are discussed along with limitations of the study and implications for future research. Given that 13.01% of respondents had not spoken to a healthcare provider about their UI symptoms, 24.73% had never seen a healthcare professional who "specializes in bladder problems," and 75% said they were not currently using any active approach to managing symptoms, use of such information is discussed in terms of how to construct internet healthcare information to maximize seeking appropriate healthcare services and preparing internet-based information regarding incontinence diagnosis and treatment. PMID:23615860

  3. 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

  4. 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.

  5. The Greek healthcare system.

    PubMed

    Siantou, Vassiliki; Athanasakis, Kostas; Kyriopoulos, John

    2009-01-01

    Greece is among the OECD countries with the highest healthcare spending as a percentage of Gross Domestic Product (9.1% of GDP in 2006). Despite this, several issues such as high private health expenditure, informal payments, implementation of Electronic Patient Records and an integrated primary healthcare system have not been solved since the establishment of the national healthcare system in 1983. The aim of this paper is to provide a comprehensive picture of the healthcare system in Greece. Thus, general information regarding health status of the population is given, along with a description of the organizational structure of the National Health System as well as the social insurance system. Furthermore, main themes such as health financing and reimbursement, resource allocation and expenditure, pharmaceutical policy and future challenges are presented. PMID:19670523

  6. PERSIVAL, a System for Personalized Search and Summarization over Multimedia Healthcare Information.

    ERIC Educational Resources Information Center

    McKeown, Kathleen R.; Chang, Shih-Fu; Cimino, James; Feiner, Steven K.; Friedman, Carol; Gravano, Luis; Hatzivassiloglou, Vasileios; Johnson, Steven; Jordan, Desmond A.; Klavans, Judith L.; Kushniruk, Andre; Patel, Vimla; Teufel, Simone

    This paper reports on the ongoing development of PERSIVAL (Personalized Retrieval and Summarization of Image, Video, and Language), a system designed to provide personalized access to a distributed digital library of medical literature and consumer health information. The goal for PERSIVAL is to tailor search, presentation, and summarization of…

  7. 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

  8. 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

  9. 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

  10. 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

  11. Foundations need to be set to promote connectivity among healthcare organizations, providers.

    PubMed

    2004-12-01

    Promoting good regional and national electronic data sharing in healthcare will not be possible unless two goals are accomplished: An electronic health record is widely adopted by healthcare providers and an infrastructure for information sharing is developed, according to a new report from a public/private collaborative called Connecting for Health. PMID:15682567

  12. [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

  13. 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

  14. Travelling abroad for aesthetic surgery: Informing healthcare practitioners and providers while improving patient safety.

    PubMed

    Jeevan, R; Birch, J; Armstrong, A P

    2011-02-01

    Travelling abroad for surgery is a phenomenon reported internationally. It is particularly likely for aesthetic procedures not undertaken routinely by national health services. We assessed the impact of these patients presenting to the UK National Health Service (NHS) with concerns or complications on their return. All 326 UK consultant members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) were asked to complete a short questionnaire about patients that had presented to the NHS with complications or concerns following surgery abroad. The results were subsequently presented to the Department of Health (DH). 203 (62%) UK consultant plastic surgeons responded. 76 (37%) of the 203 respondents had seen such patients in their NHS practice, most commonly following breast or abdominal procedures. A quarter underwent emergency surgery, a third out-patient treatment and a third elective surgical revision. In response to these findings, the DH clarified that NHS teams should provide emergency care to such patients but should not undertake any elective revision procedures. Travelling abroad for aesthetic surgery may reduce its cost. However, aesthetic procedures have high minor complication rates, and peri-operative travel is associated with increased risks. Fully informed consent is unlikely when patients do not meet their surgeon prior to paying and travelling for surgery, and national health services are used to provide a free safety net on their return. To help minimise the potential risks, BAPRAS has clarified the responsibilities of the NHS and is acting to better inform UK patients considering travelling abroad. PMID:20462822

  15. 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.

  16. 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

  17. 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

  18. Measuring the performance of primary healthcare: existing capacity and potential information to support population-based analyses.

    PubMed

    Broemeling, Anne-Marie; Watson, Diane E; Black, Charlyn; Sabrina, T Wong

    2009-11-01

    WHAT DID WE DO?: We reviewed the degree to which existing population-based data in Canada can be used to describe and report on primary healthcare (PHC) performance. We identified gaps in current data sources and made recommendations on how these gaps might be addressed to support quality improvement and public reporting for PHC. WHAT DID WE LEARN?: Population-based survey and administrative data are available to describe population characteristics and other contextual factors for PHC, as well as some aspects of the material, financial and human resources inputs, and selected activities and decisions at the policy, management and clinical levels. Existing data can also be used to describe some volumes and types of PHC outputs. However, we currently have limited population-based data to assess selected qualities of PHC services (e.g., coordination and interpersonal effectiveness) and most immediate outcomes of PHC. The ability to link data to assess outcomes and attribute changes in outcomes to PHC is limited. A full report describing more than 130 indicators from existing data sources and gaps in current data is available at www.chspr.ubc.ca. WHAT ARE THE IMPLICATIONS?: As we look to the future, there is a clear need to build on existing data sources to expand PHC data capacity in Canada. Data are needed to inform an understanding of PHC outputs, outcomes and the linkages among PHC dimensions. Commitment to a comprehensive PHC data collection strategy and information system is needed across Canadian provinces and territories to inform policy development and planning, to evaluate PHC redesign initiatives and to meet the accountability expectations of Canadians. PMID:21037903

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. Data mining applications in healthcare.

    PubMed

    Koh, Hian Chye; Tan, Gerald

    2005-01-01

    Data mining has been used intensively and extensively by many organizations. In healthcare, data mining is becoming increasingly popular, if not increasingly essential. Data mining applications can greatly benefit all parties involved in the healthcare industry. For example, data mining can help healthcare insurers detect fraud and abuse, healthcare organizations make customer relationship management decisions, physicians identify effective treatments and best practices, and patients receive better and more affordable healthcare services. The huge amounts of data generated by healthcare transactions are too complex and voluminous to be processed and analyzed by traditional methods. Data mining provides the methodology and technology to transform these mounds of data into useful information for decision making. This article explores data mining applications in healthcare. In particular, it discusses data mining and its applications within healthcare in major areas such as the evaluation of treatment effectiveness, management of healthcare, customer relationship management, and the detection of fraud and abuse. It also gives an illustrative example of a healthcare data mining application involving the identification of risk factors associated with the onset of diabetes. Finally, the article highlights the limitations of data mining and discusses some future directions. PMID:15869215

  9. Determinants of adherence to seasonal influenza vaccination among healthcare workers from an Italian region: results from a cross-sectional study

    PubMed Central

    Durando, P; Dini, G; Barberis, I; Bagnasco, A M; Iudici, R; Zanini, M; Martini, M; Toletone, A; Paganino, C; Massa, E; Sasso, L

    2016-01-01

    Objectives Notwithstanding decades of efforts to increase the uptake of seasonal influenza (flu) vaccination among European healthcare workers (HCWs), the immunisation rates are still unsatisfactory. In order to understand the reasons for the low adherence to flu vaccination, a study was carried out among HCWs of two healthcare organisations in Liguria, a region in northwest Italy. Methods A cross-sectional study based on anonymous self-administered web questionnaires was carried out between October 2013 and February 2014. Through univariate and multivariate regression analysis, the study investigated the association between demographic and professional characteristics, knowledge, beliefs and attitudes of the study participants and (i) the seasonal flu vaccination uptake in the 2013/2014 season and (ii) the self-reported number of flu vaccination uptakes in the six consecutive seasons from 2008/2009 to 2013/2014. Results A total of 830 HCWs completed the survey. Factors statistically associated with flu vaccination uptake in the 2013/2014 season were: being a medical doctor and agreeing with the statements ‘flu vaccine is safe’, ‘HCWs have a higher risk of getting flu’ and ‘HCWs should receive flu vaccination every year’. A barrier to vaccination was the belief that pharmaceutical companies influence decisions about vaccination strategies. Discussion All the above-mentioned factors, except the last one, were (significantly) associated with the number of flu vaccination uptakes self-reported by the respondents between season 2008/2009 and season 2013/2014. Other significantly associated factors appeared to be level of education, being affected by at least one chronic disease, and agreeing with mandatory flu vaccination in healthcare settings. Conclusions This survey allows us to better understand the determinants of adherence to vaccination as a fundamental preventive strategy against flu among Italian HCWs. These findings should be used to improve and customise any future promotion campaigns to overcome identified barriers to immunisation. PMID:27188810

  10. 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.

  11. 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…

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

    PubMed Central

    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

  13. 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

  14. Development of regional network for nuclear information in Latin America

    NASA Astrophysics Data System (ADS)

    Ebinuma, Yukio

    Among the recent INIS activities several interesting items are reported. In particular Latin America area where active movements have been seen recently is described in detail in terms of INIS information services. The author reports Latin America regional nuclear information project which has been implemented as 5-year project since 1985 supported by IAEA, and its progress, and describes information service system in Brazil which plays the core role in promoting this project.

  15. 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.

  16. Using TV white space spectrum to practise telemedicine: A promising technology to enhance broadband internet connectivity within healthcare facilities in rural regions of developing countries.

    PubMed

    Chavez, Afton; Littman-Quinn, Ryan; Ndlovu, Kagiso; Kovarik, Carrie L

    2016-06-01

    The following correspondence provides an overview of TV White Space (TVWS) technology, regulations, and potential applications to the health care sector. This report also introduces "Project Kgolagano," a Botswana-based initiative representing the first endeavour to utilize TVWS internet connection for practising telemedicine. TV "white space" refers to the previously unused, wasted spectrum within TV radiofrequency channels that can now be leveraged to obtain broadband internet access. TVWS represents a less costly, faster, and farther-reaching internet connection that is a promising option for connecting the previously unconnected populations of remote and underserved areas. The Botswana-University of Pennsylvania Partnership, Microsoft, Botswana Innovation Hub, Vista Life Sciences, and Global Broadband Solutions have partnered together to bring TVWS wireless broadband access to healthcare facilities in poorly connected regions of Botswana (Lobatse, Francistown, Maun, Gaborone) in order to improve healthcare delivery and facilitate telemedicine in dermatology, cervical cancer screening, and family medicine (HIV/AIDS, TB, general adult and pediatric medicine). PMID:26199278

  17. 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.

  18. 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

  19. 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 FDA’s 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

  20. Healthcare software assurance.

    PubMed

    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 FDA's 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

  1. Mobile healthcare informatics.

    PubMed

    Siau, Keng; Shen, Zixing

    2006-06-01

    Advances in wireless technology give pace to the rapid development of mobile applications. The coming mobile revolution will bring dramatic and fundamental changes to our daily life. It will influence the way we live, the way we do things, and the way we take care of our health. For the healthcare industry, mobile applications provide a new frontier in offering better care and services to patients, and a more flexible and mobile way of communicating with suppliers and patients. Mobile applications will provide important real time data for patients, physicians, insurers, and suppliers. In addition, it will revolutionalize the way information is managed in the healthcare industry and redefine the doctor - patient communication. This paper discusses different aspects of mobile healthcare. Specifically, it presents mobile applications in healthcare, and discusses possible challenges facing the development of mobile applications. Obstacles in developing mobile healthcare applications include mobile device limitations, wireless networking problems, infrastructure constraints, security concerns, and user distrust. Research issues in resolving or alleviating these problems are also discussed in the paper. PMID:16777784

  2. PPEPR for Enterprise Healthcare Integration

    NASA Astrophysics Data System (ADS)

    Fox, Ronan; Sahay, Ratnesh; Hauswirth, Manfred

    PPEPR is software to connect healthcare enterprises. Healthcare is a complex domain and any integration system that connects healthcare enterprise applications must facilitate heterogeneous healthcare systems at all levels - data, services, processes, healthcare vendors, standards, legacy systems, and new information systems, all of which must interoperate to provide healthcare services. The lack of interoperability within healthcare standards (e.g. HL7) adds complexity to the interoperability initiatives. HL7’s user base has been growing since the early 2000s. There are many interoperability issues between the widely adopted HL7 v2 and its successor, HL7 v3, in terms of consistency, data/message modeling, precision, and useability. We have proposed an integration platform called PPEPR: (Plug and Play Electronic Patient Records) which is based on a semantic Service-oriented Architecture (sSOA). PPEPR connects HL7 (v2 & v3) compliant healthcare enterprises. Our main goal is to provide seamless integration between healthcare enterprises without imposing any constraint on existing or proposed EPRs.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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

  10. Objective identification of informative wavelength regions in galaxy spectra

    SciTech Connect

    Yip, Ching-Wa; Szalay, Alexander S.; Budavári, Tamás; Wyse, Rosemary F. G.; Mahoney, Michael W.; Csabai, István; 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), Hβ, and Hδ {sub A} to be most informative. Simulating the Sloan Digital Sky Survey spectrograph configuration with a wavelength range 3450-8350 Å and a model-limited spectral resolution of 3 Å, the most informative regions are: first region—the 4000 Å break and the Hδ line; second region—the Fe-like indices; third region—the Hβ line; and fourth region—the G band and the Hγ 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.

  11. Objective Identification of Informative Wavelength Regions in Galaxy Spectra

    NASA Astrophysics Data System (ADS)

    Yip, Ching-Wa; Mahoney, Michael W.; Szalay, Alexander S.; Csabai, István; Budavári, Tamás; Wyse, Rosemary F. G.; Dobos, Laszlo

    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 n (4000), Hβ, and Hδ A to be most informative. Simulating the Sloan Digital Sky Survey spectrograph configuration with a wavelength range 3450-8350 Å and a model-limited spectral resolution of 3 Å, the most informative regions are: first region—the 4000 Å break and the Hδ line; second region—the Fe-like indices; third region—the Hβ line; and fourth region—the G band and the Hγ 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.

  12. Proactive population health management in the context of a regional health information exchange using standards-based decision support.

    PubMed

    Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Kooy, Kevin R; Eisenstein, Eric L; Silvey, Garry M; Willis, Janese M; Johnson, Frederick; Simo, Jessica

    2007-01-01

    The clinic-based healthcare model does not deliver high quality, cost-effective care to populations of patients. Despite public perception that aggressive investment in information technology will lead to improvements in the safety and quality of healthcare delivery, there is little evidence that health information technology can be used to promote population-based health management. This paper describes the use of a standards-based clinical decision support system to facilitate proactive population health management using data from a regional health information exchange (HIE) network. The initial release of this system was designed to detect ten sentinel health events related to hospitalization, emergency department (ED) utilization, and care coordination in a population of 36,000 individuals. In an analysis of 11,899 continuously enrolled patients from a single county over a six-month period, 2,285 unique patients experienced 7,226 sentinel health events. The most common events were ED utilization for low severity conditions (2,546), two or more missed appointments within a 60-day period (1,728), ED encounters for patients with asthma (1,220), and three or more ED encounters within 90 days (731). Logistic regression analysis identified patients aged 19-64 as the population most likely to have sentinel health events. In addition to presenting data demonstrating the feasibility of population health management in the context of an HIE, this paper also includes lessons learned from the development, implementation, and operational support of the population health management system. PMID:18693881

  13. 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.

  14. 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

  15. 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

  16. 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

  17. Architecture of a consent management suite and integration into IHE-based regional health information networks

    PubMed Central

    2011-01-01

    Background The University Hospital Heidelberg is implementing a Regional Health Information Network (RHIN) in the Rhine-Neckar-Region in order to establish a shared-care environment, which is based on established Health IT standards and in particular Integrating the Healthcare Enterprise (IHE). Similar to all other Electronic Health Record (EHR) and Personal Health Record (PHR) approaches the chosen Personal Electronic Health Record (PEHR) architecture relies on the patient's consent in order to share documents and medical data with other care delivery organizations, with the additional requirement that the German legislation explicitly demands a patients' opt-in and does not allow opt-out solutions. This creates two issues: firstly the current IHE consent profile does not address this approach properly and secondly none of the employed intra- and inter-institutional information systems, like almost all systems on the market, offers consent management solutions at all. Hence, the objective of our work is to develop and introduce an extensible architecture for creating, managing and querying patient consents in an IHE-based environment. Methods Based on the features offered by the IHE profile Basic Patient Privacy Consent (BPPC) and literature, the functionalities and components to meet the requirements of a centralized opt-in consent management solution compliant with German legislation have been analyzed. Two services have been developed and integrated into the Heidelberg PEHR. Results The standard-based Consent Management Suite consists of two services. The Consent Management Service is able to receive and store consent documents. It can receive queries concerning a dedicated patient consent, process it and return an answer. It represents a centralized policy enforcement point. The Consent Creator Service allows patients to create their consents electronically. Interfaces to a Master Patient Index (MPI) and a provider index allow to dynamically generate XACML-based policies which are stored in a CDA document to be transferred to the first service. Three workflows have to be considered to integrate the suite into the PEHR: recording the consent, publishing documents and viewing documents. Conclusions Our approach solves the consent issue when using IHE profiles for regional health information networks. It is highly interoperable due to the use of international standards and can hence be used in any other region to leverage consent issues and substantially promote the use of IHE for regional health information networks in general. PMID:21970788

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 76 FR 52637 - Proposed Information Collection; Comment Request; Southeast Region Vessel Identification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

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

  6. 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.

  7. 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

  8. 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

  9. Prevalence of multiple sclerosis in the Lazio region, Italy: use of an algorithm based on health information systems.

    PubMed

    Bargagli, Anna Maria; Colais, Paola; Agabiti, Nera; Mayer, Flavia; Buttari, Fabio; Centonze, Diego; Di Folco, Marta; Filippini, Graziella; Francia, Ada; Galgani, Simonetta; Gasperini, Claudio; Giuliani, Manuela; Mirabella, Massimiliano; Nociti, Viviana; Pozzilli, Carlo; Davoli, Marina

    2016-04-01

    Compared with other areas of the country, very limited data are available on multiple sclerosis (MS) prevalence in Central Italy. We aimed to estimate MS prevalence in the Lazio region and its geographical distribution using regional health information systems (HIS). To identify MS cases we used data from drug prescription, hospital discharge and ticket exemption registries. Crude, age- and gender-specific prevalence estimates on December 31, 2011 were calculated. To compare MS prevalence between different areas within the region, we calculated age- and gender-adjusted prevalence and prevalence ratios using a multivariate Poisson regression model. Crude prevalence rate was 130.5/100,000 (95 % CI 127.5-133.5): 89.7/100,000 for males and 167.9/100,000 for females. The overall prevalence rate standardized to the European Standard Population was 119.6/100,000 (95 % CI 116.8-122.4). We observed significant differences in MS prevalence within the region, with estimates ranging from 96.3 (95 % CI 86.4-107.3) for Latina to 169.6 (95 % CI 147.6-194.9) for Rieti. Most districts close to the coast showed lower prevalence estimates compared to those situated in the eastern mountainous area of the region. In conclusion, this study produced a MS prevalence estimate at regional level using population-based health administrative databases. Our results showed the Lazio region is a high-risk area for MS, although with an uneven geographical distribution. While some limitations must be considered including possible prevalence underestimation, HIS represent a valuable source of information to measure the burden of SM, useful for epidemiological surveillance and healthcare planning. PMID:26886201

  10. 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

  11. 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

  12. 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

  13. 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,

  14. 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,…

  15. 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 15—Location Information for HUD FOIA Reading Rooms and Contact Information for Regional Counsel The Department maintains a reading room in Headquarters and in each of...

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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 we’ve 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 it’s 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 IVS’s Fledermaus. This talk will present a survey of software packages we’ve used, our successes and remaining challenges.

  1. 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.

  2. 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

  3. 78 FR 68463 - Notice of Emergency Approval of an Information Collection: Regional Analysis of Impediments...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... URBAN DEVELOPMENT Notice of Emergency Approval of an Information Collection: Regional Analysis of Impediments Guidance for Sustainable Communities Grantees AGENCY: Office of the Chief Information Officer, HUD... FURTHER INFORMATION CONTACT: Lynnette McRae, Grants Management Specialist, Office of Sustainable...

  4. 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…

  5. 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.

  6. [Patients' increasing role in healthcare].

    PubMed

    Colombo, Cinzia

    2016-03-01

    Since the late '90s citizens have been increasingly involved in healthcare, thanks to a shift in access to healthcare information, greater patients' and citizens' awareness about their rights and needs, and a change in physicians' attitudes and behavior. At the same time, to ensure the sustainability of the national health services, patients' needs are increasingly being examined in relation to the services and interventions needed, and to foster informed demand by patients and citizens, and appropriate prescriptions by physicians. Nowadays, patients already have a section in an authoritative medical journal. Working with clinicians, they set research priorities and the outcomes to be studied. Especially in UK and USA, they are invited to participate in the design and development of trials and in deciding which trials should be funded. The situation varies widely in different countries, though involving citizens in healthcare decisions is a common mantra. Even when they consult a clinician, the patients' role has evolved. People ask for information more often and want an active part in decisions about their health. Physicians start to pay more attention to the person and the social context, feelings and emotions, and person-centered care has become a reference in the doctor-patient relationship. This article offers an overview of the changing roles of patients and citizens in healthcare. PMID:27030220

  7. 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

  8. [Results of primary healthcare].

    PubMed

    Duponchel, J L

    2004-01-01

    The concept of primary healthcare was formulated at the international conference held in Alma-Ata (USSR) on September 6 to 12, 1978. Over the past quarter-century, the term "primary healthcare" has been widely used as a basis for implementing healthcare policies in various nations, especially those considered as developing countries. However many programs initiated in the name of the primary healthcare concept have only partially complied with the spirit of the final declaration of Alma-Ata. Analysis of the healthcare in Mali shows that the system followed that evolution. Although considerable time and energy were regrettably wasted in implementing the village health agent strategy, this phase may have been a necessary step in the political development of the state at that time. Recent changes in the country's healthcare system in compliance with the original principles of primary healthcare show that the 1978 declaration is sound and remains pertinent as democracy makes further gains in the world. PMID:15816127

  9. 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

  10. 78 FR 44147 - Proposed Information Collection; National Capital Region Application for Public Gathering

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ... 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 Service... events and demonstrations) held on NPS property within the National Capital Region. Regulations at 36...

  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. 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

  13. 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

  14. 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…

  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. 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

  17. Nativity and Perceived Healthcare Quality.

    PubMed

    Orom, Heather

    2016-06-01

    Perceptions of healthcare quality are lower among foreign- than US-born individuals. The objective of the study was to identify possible explanations for this disparity. Data were from 6202 respondents to cycles 1 and 2 of the Health Information National Trends Survey 4 conducted 2011-2013, including 5425 US-born and 777 foreign-born respondents. Perceived quality of healthcare was lower among foreign-born than US-born respondents, accounted for, to some degree (19.5 %), by foreign-born respondents experiencing relatively less patient-centered healthcare provider communication than US-born respondents. More patient-centered provider communication was associated with receiving higher quality healthcare in all respondents. Having a regular provider was associated with perceived quality of care in foreign-born but not US-born respondents, and the reverse was true for frequency of care. Patient centered provider communication and continuity of care may be key targets for improving quality of care for foreign-born individuals. PMID:25957045

  18. Telemedicine can make healthcare greener.

    PubMed

    Yellowlees, Peter M; Chorba, Kathy; Burke Parish, Michelle; Wynn-Jones, Hannah; Nafiz, Najia

    2010-03-01

    The American healthcare industry is generally lacking environmentally sustainable practices. The environmental impact of healthcare practices in the country has been largely disregarded due to ambivalence, ignorance, and fears of additional costs and regulations. The current practices continue to pollute the environment by requiring large amounts of travel and paperwork by both the patient and the clinician. Telemedicine and health information technology help save time, energy, raw materials (such as paper and plastic), and fuel, thereby lowering the carbon footprint of the health industry. By implementing green practices, for instance, by engaging in carbon credit programs, the health industry could benefit financially as well as reduce its negative impact on the health of our planet. Companies that reduce their carbon emissions by implementing energy-saving practices can sell their carbon credits to companies that emit more carbon than permissible by their legally binding commitment. These carbon profits can then be used for healthcare research or to provide healthcare to the underserved. Alternatively, the savings could be used for green purchasing and to implement other carbon-reducing activities. This report reviews the numerous possible options for the American health industry to become greener and lower its carbon footprint while at the same time becoming more time- and cost efficient. PMID:20156125

  19. 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

  20. 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

  1. 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...

  2. 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...

  3. Perinatal health care in a conflict-affected setting: evaluation of health-care services and newborn outcomes at a regional medical centre in Iraq.

    PubMed

    Ahamadani, F A B; Louis, H; Ugwi, P; Hines, R; Pomerleau, M; Ahn, R; Burke, T F; Nelson, B D

    2014-12-01

    A field-based assessment was conducted to assess maternal and newborn health-care services, perinatal and newborn outcomes and associated risk factors at Bint Al-Huda Maternal and Newborn Teaching Hospital, a large referral hospital in southern Iraq. The multi-method approach used interviews, discussions, observation and review of perinatal and newborn outcome data. There is limited assessment of maternal vital signs, labour pattern, fetal response, and complications during pregnancy and labour. Perinatal and neonatal mortality rates are 27.4/1000 births and 30.9/1000 live births respectively. Associated neonatal mortality factors were gestational age < 37 weeks, male sex, birth weight < 2.5 kg, maternal age > 35 years, rural maternal residence and vaginal delivery. Improving birth outcomes in southern Iraq requires evidence-based clinical guidelines, additional supplies and equipment, quality improvement initiatives and in-service training. PMID:25664517

  4. 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…

  5. Wearable device implications in the healthcare industry.

    PubMed

    Erdmier, Casey; Hatcher, Jason; Lee, Michael

    2016-05-01

    This manuscript analyses the impact of wearable device technology in the healthcare industry. The authors provide an exploration of the different types of wearable technology that are becoming popular or are emerging into the consumer market and the personal health information and other user data these devices collect. The applications of wearable technology to healthcare and wellness are discussed, along with the impact of these devices on the industry. Finally, an analysis is provided, describing the current regulations in the US and UK that govern wearable devices and the impact of these device regulations on users and healthcare professionals. PMID:27010250

  6. 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

  7. 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.…

  8. 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

  9. The early career progress of baccalaureate healthcare management students.

    PubMed

    Thompson, Jon M; Cockley, David E; Bopp, Anthony E

    2007-01-01

    Programs in healthcare management are increasingly asked to demonstrate program outcomes by identifying graduates working in the profession of healthcare management. In particular, standards under AUPHA's certification process for undergraduate programs require that programs identify programmatic and educational outcomes. However, little is known about the career track of undergraduate healthcare management graduates. This paper describes management roles and settings for the graduates of a baccalaureate program in healthcare management, and presents salary and career progression information obtained from a recent alumni survey. Findings and implications are important to highlight the success of program graduates, and support the value of undergraduate programs in healthcare management. PMID:18578265

  10. Leveraging Devices, Data and Discovery for Smarter Healthcare in Japan

    PubMed Central

    2011-01-01

    Objectives Over the past decade, hospitals and clinics have gradually adopted hospital information systems, including provider order entries and electronic health records. Although these systems have helped to improve patient safety and efficiency of healthcare providers, not all healthcare providers and patients are satisfied with the current situation. Healthcare should be smarter. Thus, there is a need for state-of-the-art medical and healthcare devices that can handle massive amounts of data with the help of sophisticated information processing and discovery technologies. Methods This article compares hospital information systems with the information systems of other social infrastructures. It also explores the possibilities of smarter healthcare, including personal health devices and personal health records with interoperability. Results The main traits of the iEHR at Teikyo University Hospital in Tokyo include IT governance, unification, and workflow efficiency. Conclusions Smarter healthcare can be achieved by leveraging the full capabilities of devices, data, and sophisticated algorithms. PMID:22084814

  11. 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…

  12. 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…

  13. 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

  14. Use of Formal and Informal Methods To Gain Information among Faculty at an Australian Regional Library.

    ERIC Educational Resources Information Center

    Jirojwong, Sansnee; Wallin, Margie

    2002-01-01

    Compared the use of formal and informal methods of information gathering by faculty at Central Queensland University (Australia) for teaching and research activities. Explored the use of electronic sources, levels of competence, and characteristics of the faculty who used informal methods of information gathering, including personal communication.…

  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. 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

  18. Conflict resolution in healthcare management.

    PubMed

    Lipcamon, James D; Mainwaring, Brian A

    2004-01-01

    Conflict causes decided tension in the workplace and often produces poor professional outcomes. A manager dealing with conflict can experience a crisis of confidence and often ends up second-guessing himself or herself, regardless of how a situation has been handled. In some organizations, conflict is not viewed positively or as an opportunity for improvement. In these organizations, most individuals will see conflict as being unproductive, unpleasant, and a waste of time and energy. Yet, conflict provides employees with critical feedback on how things are going. When viewed in a positive context, even personality conflicts may provide information to the healthcare manager about what is not working in the organization. If conflict is not directed and controlled, it can have damaging effects in the workplace, stifling the growth of departments and deflating employee morale. Our job as healthcare managers is to deal with conflict so that it does not decrease productivity or detract from the provision of patient-centered care. There are 4 general sources for interpersonal conflict: personal differences, informational deficiency, role incompatibility, and environmental stress. There are 5 common responses used in dealing with conflict: forcing, accommodating, avoiding, compromising, and collaborating. Healthcare managers should become comfortable with using all of these approaches. PMID:15259690

  19. [Construction of a regional information system based on standardization and middleware platform].

    PubMed

    Chen, Jin-xiong; Liu, Xiong-fei; Yu, Lun; Pan, Lin; Chen, Zhi-sheng; Liu, Hui

    2006-07-01

    In this article, based on the analysis on the regional information system's development background and its applications, the construction of the regional medical information system through creating the electronic medical record and the medicine image data centers is proposed, for information resource sharing. And then, the system's software construction and various subsystems functions are mainly introduced. Standardization and the middleware platform are suggested as the effective way of constructing these two data centers in the present situation in our country. PMID:17039929

  20. 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

  1. [Asylum seekers and the healthcare situation].

    PubMed

    Klein, P

    2016-05-01

    Medical healthcare for refugees is strictly regulated by law in Germany but the great regional variation in the implementation is currently a huge challenge for healthcare providers. Providers are often not familiar with the specific local regulations and especially in emergencies it is often not possible to clarify open questions before treating patients. The high influx of refugees in the summer and fall of 2015 led to a situation that could only be managed with the voluntary and pragmatic help of all healthcare personnel involved. This article explains the most relevant regulations covering medical healthcare for refugees and asylum seekers. In addition, the procedure for the approval of asylum status in itself can have a direct or indirect impact on the health status of these individuals; therefore, some comments are made regarding this aspect. PMID:27098062

  2. 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 ...

  3. 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…

  4. 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.

  5. 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

  6. The distribution of category and location information across object-selective regions in human visual cortex.

    PubMed

    Schwarzlose, Rebecca F; Swisher, Jascha D; Dang, Sabin; Kanwisher, Nancy

    2008-03-18

    Since Ungerleider and Mishkin [Underleider LG, Mishkin M (1982) Two cortical visual systems. Analysis of Visual Behavior, eds Ingle MA, Goodale MI, Masfield RJW (MIT Press, Cambridge, MA), pp 549-586] proposed separate visual pathways for processing object shape and location, steady progress has been made in characterizing the organization of the two kinds of information in extrastriate visual cortex in humans. However, to date, there has been no broad-based survey of category and location information across all major functionally defined object-selective regions. In this study, we used an fMRI region-of-interest (ROI) approach to identify eight regions characterized by their strong selectivity for particular object categories (faces, scenes, bodies, and objects). Participants viewed four types of stimuli (faces, scenes, bodies, and cars) appearing in each of three different spatial locations (above, below, or at fixation). Analyses based on the mean response and voxelwise patterns of response in each ROI reveal location information in almost all of the known object-selective regions. Furthermore, category and location information can be read out independently of one another such that most regions contain both position-invariant category information and category-invariant position information. Finally, we find substantially more location information in ROIs on the lateral than those on the ventral surface of the brain, even though these regions have equal amounts of category information. Although the presence of both location and category information in most object-selective regions argues against a strict physical separation of processing streams for object shape and location, the ability to extract position-invariant category information and category-invariant position information from the same neural population indicates that form and location information nonetheless remain functionally independent. PMID:18326624

  7. Utilizing Healthcare Developments, Demographic Data with Statistical Techniques to Estimate the Diarrhoea Prevalence in India.

    PubMed

    Srivastava, Shweta; Vatsalya, Vatsalya; Arora, Ashoo; Arora, Kashmiri L; Karch, Robert

    2012-03-22

    Diarrhoea is one of the leading causes of morbidity and mortality in developing countries in Africa and South Asia such as India. Prevalence of diarrheal diseases in those countries is higher than developed western world and largely has been associated with socio-economic and sanitary conditions. However, present available data has not been sufficiently evaluated to study the role of other factors like healthcare development, population density, sex and regional influence on diarrheal prevalence pattern. Study was performed to understand the relationship of diarrheal prevalence with specific measures namely; healthcare services development, demographics, population density, socio-economic conditions, sex, and regional prevalence patterns in India. Data from Annual national health reports and other epidemiological studies were included and statistically analyzed. Our results demonstrate significant correlation of the disease prevalence pattern with certain measures like healthcare centers, population growth rate, sex and region-specific morbidity. Available information on sanitation like water supply and toilet availability and socioeconomic conditions like poverty and literacy measures could only be associated as trends of significance. This study can be valuable for improvisation of appropriate strategies focused on important measures like healthcare resources, population growth and regional significances to evaluate prevalence patterns and management of the diarrhoea locally and globally. PMID:25285244

  8. Utilizing Healthcare Developments, Demographic Data with Statistical Techniques to Estimate the Diarrhoea Prevalence in India

    PubMed Central

    Srivastava, Shweta; Vatsalya, Vatsalya; Arora, Ashoo; Arora, Kashmiri L.; Karch, Robert

    2014-01-01

    Diarrhoea is one of the leading causes of morbidity and mortality in developing countries in Africa and South Asia such as India. Prevalence of diarrheal diseases in those countries is higher than developed western world and largely has been associated with socio-economic and sanitary conditions. However, present available data has not been sufficiently evaluated to study the role of other factors like healthcare development, population density, sex and regional influence on diarrheal prevalence pattern. Study was performed to understand the relationship of diarrheal prevalence with specific measures namely; healthcare services development, demographics, population density, socio-economic conditions, sex, and regional prevalence patterns in India. Data from Annual national health reports and other epidemiological studies were included and statistically analyzed. Our results demonstrate significant correlation of the disease prevalence pattern with certain measures like healthcare centers, population growth rate, sex and region-specific morbidity. Available information on sanitation like water supply and toilet availability and socioeconomic conditions like poverty and literacy measures could only be associated as trends of significance. This study can be valuable for improvisation of appropriate strategies focused on important measures like healthcare resources, population growth and regional significances to evaluate prevalence patterns and management of the diarrhoea locally and globally. PMID:25285244

  9. 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.

  10. 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

  11. 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

  12. Healthcare technology and technology assessment.

    PubMed

    Herndon, James H; Hwang, Raymond; Bozic, K J; Bozic, K H

    2007-08-01

    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

  13. 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

  14. 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

  15. Creating knowledge-driven healthcare processes with the Intelligence Continuum.

    PubMed

    Wickramasinghe, Nilmini; Schaffer, Jonathan L

    2006-01-01

    Medical science has made revolutionary changes in the past few decades. Contemporaneously, however, healthcare has made incremental changes at best. One area within healthcare that best exemplifies this is the operating room (OR). The growing discrepancy between the revolutionary changes in medicine and the minimal changes in healthcare processes leads to inefficient and ineffective healthcare deliver and one if not the significant contributor to the exponentially increasing costs plaguing healthcare globally. Significant quantities of data and information permeate the healthcare industry, yet the healthcare industry has not maximised this data resource by fully embracing key business management processes or techniques (such as Knowledge Management (KM), data mining, Business Intelligence (BI) or Business Analytics (BA)) to capitalise on realising the full value of this data/information resource to reengineer processes. The Intelligence Continuum (IC), a Mobius strip of sophisticated tools, techniques and process provides a systematic mechanism for healthcare organisations to facilitate superior clinical practice and administrative management. In this paper, the case example of the orthopaedic OR is used to illustrate the power of the IC in effecting more efficient and effective healthcare processes to ensue and thereby enabling healthcare to make evolutionary changes. PMID:18048242

  16. 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

  17. 76 FR 37139 - Notice of Submission of Proposed Information Collection to OMB Sustainable Communities Regional...

    Federal Register 2010, 2011, 2012, 2013, 2014

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    ... 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..., QDAM, Department of Housing and Urban Development, 451 Seventh Street, SW., Washington, DC 20410;...

  18. 76 FR 2406 - Notice of Proposed Information Collection: Comment Request Sustainable Communities Regional Grant...

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  19. 76 FR 12339 - Proposed Information Collection; Comment Request; Southwest Region Vessel Identification...

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  1. 75 FR 9157 - Proposed Information Collection; Comment Request; Alaska Region Scale and Catch Weighing...

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  7. 76 FR 9551 - Proposed Information Collection; Comment Request; Northeast Region Observer Providers Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-18

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration Proposed Information Collection; Comment Request; Northeast Region Observer Providers Requirements AGENCY: National Oceanic and Atmospheric Administration...

  8. 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.

  9. Comparison of the Five Danish Regions Regarding Demographic Characteristics, Healthcare Utilization, and Medication Use—A Descriptive Cross-Sectional Study

    PubMed Central

    Henriksen, Daniel Pilsgaard; Rasmussen, Lotte; Hansen, Morten Rix; Hallas, Jesper; Pottegård, 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: 6.7–7.4, CV = 0.040), and 114 per 1,000 residents were admitted to the hospital (range: 101–131, CV = 0.107). The annual number of persons redeeming a prescription of any medication was 723 per 1,000 residents (range: 718–743, 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

  10. Applications of Business Analytics in Healthcare.

    PubMed

    Ward, Michael J; Marsolo, Keith A; Froehle, Craig M

    2014-09-01

    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

  11. 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

  12. [Healthcare rights: an invitation for reflection].

    PubMed

    Nogueira, Vera Maria Ribeiro; de Pires, Denise Elvira Pires

    2004-01-01

    This study focuses on changes and breaks in contemporary society relating to the right to healthcare as a universal value, in conformity with the guidelines provided by multilateral agencies and disseminated particularly since the 1990s. From the genesis of social rights and by tracing the interdependence between social and economic aspects of social citizenship in democratic capitalist countries, the study presents the two paradigms informing the approach to healthcare in the early 21st century: the full citizenship paradigm, according to which the right to healthcare is a universal value, and the paradigm of restricted social citizenship, according to which the right to healthcare is guided by the criterion of efficiency and economic rationalization. These propositions align with the health economy paradigm, which (i) defends focused resource allocation to attenuate poverty conditions, (ii) reduces the role of the state, (iii) recommends resource allocation to healthcare in association with social protection, and (iv) defines the market as the privileged regulator of healthcare actions. PMID:15263986

  13. 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

  14. 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

  15. 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…

  16. 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), Office of the Secretary of Transportation (OST), DOT. ACTION: Notice of request for extension...

  17. 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

  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. 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

  20. 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 gather information on the fishing effort, location and type of gear used on individual trips. This data collection...

  1. Consumer Health Information Services in Medical Libraries of the Akron-Canton-Youngstown Region.

    ERIC Educational Resources Information Center

    Hashlamoun, Linda A.

    Many library communities are establishing various services to cope with increasing demand for consumer health information (CHI). This study was engaged to ascertain what is currently being done by the medical libraries in the Akron-Canton-Youngstown (Ohio) region to provide this type of information, particularly what policies, practices, and…

  2. REGIONAL CENTER FOR COLLECTION, SYNTHESIS AND DISSEMINATION OF CAREER INFORMATION FOR SCHOOLS OF SAN DIEGO COUNTY.

    ERIC Educational Resources Information Center

    GERSTEIN, MARTIN; HOOVER, RICHARD

    THE PURPOSE OF THIS REGIONAL CENTER IS TO DEVELOP AN EFFICIENT SYSTEM OF PROVIDING CAREER INFORMATION TO SAN DIEGO COUNTY SCHOOLS. SIX JUNIOR COLLEGES ARE PARTICIPATING IN THE PILOT PROJECT. THE PROGRAM IS DIVIDED INTO TWO PHASES. THE FIRST IS THE COLLECTION AND SYNTHESIS OF OCCUPATIONAL INFORMATION BASED UPON STUDENT AND COUNSELOR PERCEPTIONS OF…

  3. 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...

  4. 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

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

    NASA Astrophysics Data System (ADS)

    Wintell, M.; Lundberg, N.; Lindsköld, 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 Västra Götaland (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.

  6. 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

  7. 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

  8. Healthcare experiences of lesbian and bisexual women in Cape Town, South Africa.

    PubMed

    Smith, Riley

    2015-01-01

    Understanding the health needs and experiences of South African lesbian and bisexual women is imperative for implementing effective and inclusive public health strategies. Such understanding, however, is limited due to the exclusion of these women from most existing research on healthcare access in the region. This paper bridges that gap by investigating the healthcare experiences of lesbian and bisexual women in Cape Town. Data were gathered from 22 interviews with self-identified lesbian and bisexual community members and university students in the Cape Town area. Interviews explored obstacles women face in accessing affirming services, different experiences with public and private healthcare, fear of stigma/discrimination, availability of relevant sexual health information and suggestions to improve existing programmes. Findings suggest that South African lesbians and bisexual women may have a range of both positive and negative experiences in public and private health services, that they use protective strategies when 'coming out' and that they find that sexual health information pertinent to them is largely unavailable. These discussions contribute to a more inclusive understanding of the experiences of lesbian and bisexual women accessing healthcare and other services and help to inform providers, thereby enabling them to deliver more meaningful care to lesbian, gay, bisexual and transgender persons in South Africa. PMID:25291355

  9. 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

  10. 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

  11. Leadership strategies in healthcare.

    PubMed

    Menaker, Ronald

    2009-01-01

    Healthcare is one of the largest and most important industries in the United States because it affects every individual in the nation. Numerous parties are stakeholders in healthcare, which contributes to the complexity of change efforts. Physicians and administrators play a significant role by providing direct care and influencing other decisions that impact the delivery of patient care. Success in the healthcare industry is influenced by numerous factors, some of which are controllable and others that are not. Understanding leadership and change management will be increasingly important to overcome resistance to change and to improve relationships, the core of leadership in an environment that will become more challenging. In what follows, different approaches to understanding leadership and change management are presented along with other leadership strategies to enhance the effectiveness of leaders. Raising leader awareness regarding transformational leadership behaviors and developing strategies to increase the use of these behaviors may be helpful to enhance organizational performance. PMID:19663356

  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. Computer skills for the next generation of healthcare executives.

    PubMed

    Côté, Murray J; Van Enyde, Donald F; DelliFraine, Jami L; Tucker, Stephen L

    2005-01-01

    Students beginning a career in healthcare administration must possess an array of professional and management skills in addition to a strong fundamental understanding of the field of healthcare administration. Proficient computer skills are a prime example of an essential management tool for healthcare administrators. However, it is unclear which computer skills are absolutely necessary for healthcare administrators and the extent of congruency between the computer skills possessed by new graduates and the needs of senior healthcare professionals. Our objectives in this research are to assess which computer skills are the most important to senior healthcare executives and recent healthcare administration graduates and examine the level of agreement between the two groups. Based on a survey of senior healthcare executives and graduate healthcare administration students, we identify a comprehensive and pragmatic array of computer skills and categorize them into four groups, according to their importance, for making recent health administration graduates valuable in the healthcare administration workplace. Traditional parametric hypothesis tests are used to assess congruency between responses of senior executives and of recent healthcare administration graduates. For each skill, responses of the two groups are averaged to create an overall ranking of the computer skills. Not surprisingly, both groups agreed on the importance of computer skills for recent healthcare administration graduates. In particular, computer skills such as word processing, graphics and presentation, using operating systems, creating and editing databases, spreadsheet analysis, using imported data, e-mail, using electronic bulletin boards, and downloading information were among the highest ranked computer skills necessary for recent graduates. However, there were statistically significant differences in perceptions between senior executives and healthcare administration students as to the extent of computer skills required in areas such as word processing, graphics and presentation, spreadsheet analysis, using imported data, and working with local area networks (LANs). PMID:15887847

  15. 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

  16. Maryland's Top 25 Demand Healthcare Occupations: Projected Demand and Reported Supply Provided by Maryland Higher Education Institutions.

    ERIC Educational Resources Information Center

    Maryland State Department of Education, 2004

    2004-01-01

    This report compares the demand for qualified healthcare workers in Maryland and the supply provided by Maryland higher education institutions. It identifies: (1) Maryland?s top 25 demand healthcare occupations, and (2) any gaps between the supply and demand for these 25 healthcare occupations. Additional information on each healthcare occupation…

  17. 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.

  18. Improving GHG inventories by regional information exchange: a report from Asia

    PubMed Central

    Umemiya, Chisa

    2006-01-01

    Background The Parties to the United Nations Framework Convention on Climate Change (UNFCCC) are required to develop and report a national inventory of greenhouse gases not controlled by the Montreal Protocol. In the Asia region, "Workshops on Greenhouse Gas Inventories in Asia (WGIA)" have been organised annually since 2003 under the support of the government of Japan. WGIAs promote information exchange in the region to support countries' efforts to improve the quality of greenhouse gas inventories. This paper reports the major outcomes of the WGIAs and discusses the key aspects of information exchange in the region for the improvement of inventories. Results The major outcomes of WGIAs intended to help countries improve GHG inventories, can be summarised as follows: (1) identification of common issues and possible solutions by sector, (2) reporting country inventory practices, and (3) verification of the UNFCCC reporting requirements. Conclusion The workshops provided the opportunity for countries to share common issues and constraints pertinent to GHG inventories and to exchange information regarding possible solutions for those issues based on their own experience. The relevance of information exchange is determined due to emission sources, emitting mechanisms from sources, and technologies used. Information exchange about emission sources that are unique to Asia, like those of the agriculture sector, contributes significantly to the accumulation of knowledge at the regional and global levels. Enabling countries to verify their national circumstances with the reporting requirements under UNFCCC is also an essential part of the WGIA information exchange activities. PMID:16930465

  19. [The informational analytical support of management of regional health care on the basis of expertise].

    PubMed

    Finchenko, E A; Tsytsorina, I A; Shalygina, L S; Ivaninskii, O I; Sharapov, I V

    2014-01-01

    The development of the system of informational analytical support based on expertise data is one of most important stage of increasing of effectiveness of management of regional health care. The study was organized to substantiate formation of the system of informational analytical support of management of regional health care on the basis of expertise data. The study was carried out on the basis of expertise data from subjects involved in informational analytical support of management of regional health care (health care management executives, chief specialists and directors of medical organizations in the subjects of the Russian Federation situated in the Siberian federal okrug). The study established that alongside with statistical information the expertise is enough important, objective and informative information to be applied in developing of managerial decisions. The highest integral estimated value of importance, objectiveness and informativeness has the information concerning competence of medical personnel, proportions of medical care of population and conditions of material technical base of health institutions. The most foreground issues concerning expertise are population health condition, pharmaceutical and medical equipment support of medical institutions, level and quality of population medical care. The degree of impact of expertise information on managerial decision making is highest in such directions as support of population with medical care, increasing of availability of medical care and degree of organization of medical care rendering. The probability of increasing of degree of impact of expertise information on managerial decision making is the highest in such directions as population provision with medical care, competence of medical personnel, level and quality of medical care, level of organization of medical care support, that is to be considered during implementation of expertise. The study data was used in developing the major principles of elaboration of system of informational analytical support of management of regional health care. The unified expertise questionnaire was developed to be used as a document basis of expertise system. The study results can be implemented in practical activities of regional health administration and medical organizations. The results of study made it possible to substantiate the development of the system of informational analytical support of regional health care and to determine priority directions of its formation. PMID:25799752

  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. 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…

  2. 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

  3. Engineering healthcare as a service system.

    PubMed

    Tien, James M; Goldschmidt-Clermont, Pascal J

    2010-01-01

    Engineering has and will continue to have a critical impact on healthcare; the application of technology-based techniques to biological problems can be defined to be technobiology applications. This paper is primarily focused on applying the technobiology approach of systems engineering to the development of a healthcare service system that is both integrated and adaptive. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components - people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation. PMID:20543250

  4. Untangling healthcare competition.

    PubMed

    Harris, I C; McDaniel, R R

    1993-11-01

    Traditional approaches to competition may be inappropriate for healthcare providers. Neoclassical economics makes the implicit assumption that a single actor embodies consumption, compensation, and benefit from a transaction. In healthcare, this assumption does not hold. Instead, such actions are accomplished by three separate actors--consumers (physicians), customers (third-party payers), and clients (patients). A hospital simultaneously competes in three arenas. Hospitals compete for physicians along a technological dimension. Competition for third-party payers takes on a financial dimension. Hospitals compete for patients along a marketing dimension. Because of the complex marketplace interactions among hospital, patient, physician, and third-party payer, the role of price in controlling behavior is difficult to establish. The dynamics underlying the hospital selection decision--that is, the decision maker's expectations of services and the convenience of accessing services--must also be considered. Healthcare managers must understand the interrelationships involved in the three-pronged competitive perspective for several reasons. This perspective clarifies the multiple facets of competition a hospital faces. It also disentangles the actions previously fulfilled by the traditional single buyer. It illuminates the critical skills underlying the competition for each audience. Finally, it defines the primary criterion each audience uses in sorting among hospitals. Recognition of the multifaceted nature of competition among healthcare providers will help demystify market behavior and thereby improve internal organizational communication systems, managers' ability to focus on appropriate activities, and the hospital's ability to adapt to changing market conditions. PMID:10129792

  5. 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

  6. 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

  7. Will healthcare reform work?

    PubMed

    Mulvany, Chad

    2010-11-01

    Providers should support efforts to reorganize the healthcare delivery system by undertaking four key market-centric activities: Improve customer service. Develop a deeper understanding of utilization patterns and the health statuses of the populations they serve. Build patient engagement. Help patients understand value in health care. PMID:21061818

  8. 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

  9. 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

  10. 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.

  11. Translation of Large Scale Climate Information to Regional Hydrologic and Ecologic Decision Making (Invited)

    NASA Astrophysics Data System (ADS)

    Rajagopalan, B.; Lall, U.

    2009-12-01

    Global Climate Models (GCMs) provide information about land-ocean-atmosphere system at large spatial and temporal scales. However, hydrological and ecological resource management decisions are made at smaller scales (e.g., watershed, urban region, etc.). Furthermore, these decisions require information about process variables (e.g., streamflow, water quality, stream temperature, fire potential etc.) that are a result of the input climate. This mis-match in scales prohibit the direct use of GCM outputs for decision making. To this end, tools and techniques are required to translate ('downscale') large scale climate information to regional scales. Two class of methods have been proposed - (i) regional models - that operate at the spatial and temporal scale of interest and are driven by the large scale climate information and (ii) statistical methods - that aim to construct the probability density function of the regional variables conditioned on the large scale climate information. Both classes of models have their advantages and their ability to quantify uncertainty. Here, we provide an expose of these methods for a suite of applications to guide decision makers.

  12. 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

  13. 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

  14. Best practice in healthcare environment decontamination.

    PubMed

    Siani, H; Maillard, J-Y

    2015-01-01

    There is now strong evidence that surface contamination is linked to healthcare-associated infections (HCAIs). Cleaning and disinfection should be sufficient to decrease the microbial bioburden from surfaces in healthcare settings, and, overall, help in decreasing infections. It is, however, not necessarily the case. Evidence suggests that there is a link between educational interventions and a reduction in infections. To improve the overall efficacy and appropriate usage of disinfectants, manufacturers need to engage with the end users in providing clear claim information and product usage instructions. This review provides a clear analysis of the scientific evidence supporting the role of surfaces in HCAIs and the role of education in decreasing such infections. It also examines the debate opposing the use of cleaning versus disinfection in healthcare settings. PMID:25060802

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

    PubMed

    Wein, B B

    2003-02-01

    Parallel to the introduction of diagnosis related groups (DRGs) for the reimbursement of hospitals, a marked reduction of financial means within the healthcare system is taking place. Healthcare enterprise information systems will play an increasing role to accommodate the new working conditions by developing reliable and efficient workflow solutions. Interfacing the systems currently in use can meet considerable obstacles. By offering high connectivity, IHE (Integrating the Healthcare Enterprise), which was initiated by concerted actions of users and vendors, ensures improved health care delivery and, furthermore, assists in acquiring new information systems in the future. IHE is not a standard but makes extensive use of existing international standards, such as HL7 and DICOM. National IHE demonstrations confirmed the power of this approach and presented its mission to large groups of users and vendors. The concept continues to grow and for the first time provides groups of various interests cooperative solutions to the problems encountered in collecting and distributing information. PMID:12584616

  16. [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; de San Pedro, Marc; Martínez Roldan, Jordi

    2015-11-01

    We find ourselves at the end of an era of asymmetry in the domain of health information where the majority of this data is in the hands of the healthcare system. Increasingly, the public are calling for a more central role in the new paradigm that enables them to duly exercise their right of access to their health data while availing of more reliable and safer technologies which contribute to the management of their condition and promote healthy lifestyles. So far, the TIC Salud strategic plan has been developed independently from the Generalitat de Catalunya Health Department's Healthcare Plan, which sets out health policy strategy in Catalonia. However, from its initial design stage the new Healthcare Plan (2016- 2020) envisages incorporating a new strategic Information and communications technology (ICT) line called "Digital Health". Incorporating ICT into the Health Plan will allow these technologies to become integral part of all strategic healthcare processes, acting as a driving force for a shift towards a new healthcare models and an innovative relationship between the public and healthcare professionals. The Digital Health implies a disruption in itself, by way of the convergence of several technologies and their positive impact on health and healthcare procedures, by way of the public's access to information concerning their health, and by creating new opportunities for promoting health and the salutogenic paradigm which empowers people to develop their health, welfare and quality of life. PMID:26711061

  17. 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

  18. Do tests for cochlear dead regions provide important information for fitting hearing aids? (L)

    NASA Astrophysics Data System (ADS)

    Summers, Van

    2004-04-01

    For listeners with cochlear hearing loss, cochlear damage may include ``dead regions'' with no functioning inner hair cells and/or associated neurons. Recent studies indicate that amplifying frequencies more than 1.7 times the edge frequency (1.7Fe) of a high-frequency dead region is unlikely to improve (and may reduce) speech scores [Vickers et al., J. Acoust. Soc. Am. 110, 1164-1175 (2001); Baer et al., J. Acoust. Soc. Am. 112, 1133-1144 (2002)]. These results were taken as evidence that tests to identify dead regions could improve hearing aid fitting. In the current study, practicing audiologists examined audiograms of listeners diagnosed as having high-frequency dead regions. The audiologists were given no specific information regarding dead regions for any individual, and were asked to base amplification decisions entirely on the audiograms. Most audiologists did not recommend amplification of frequencies with hearing losses exceeding 90 dB HL. Reexamination of speech results reported by Vickers et al. and Baer et al. indicated that limiting amplification based on audiograms alone (90-dB rule) or on specific testing for dead regions (1.7Fe rule) produced similar performance. Thus, testing for dead regions may not provide important information for hearing aid fitting that is not already available in the audiogram.

  19. 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...

  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. 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…

  2. 77 FR 67792 - Proposed Information Collection; Comment Request; Northeast Region Permit Family of Forms

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... Region Permit Family of Forms AGENCY: National Oceanic and Atmospheric Administration (NOAA), Commerce... to vessels of a particular size, using a certain gear type, or fishing for a particular species...: None. Type of Review: Regular submission (revision and extension of a current information...

  3. Regional Accreditation Organizations' Treatment of Information Literacy: Definitions, Collaboration, and Assessment

    ERIC Educational Resources Information Center

    Saunders, Laura

    2007-01-01

    Content analysis of regional accrediting organizations Web-based resources reveals support for information literacy as an important student learning outcome and encouragement of partnerships between librarians and faculty in instruction and assessment. This study offers librarians, faculty, and administrators insight into how the library can…

  4. 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...

  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. 76 FR 54737 - Proposed Information Collection; Comment Request; Southeast Region Gear Identification Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Region Gear Identification Requirements AGENCY: National Oceanic and Atmospheric Administration (NOAA... for this collection of information. Requirements that fishing gear be marked are essential to facilitate enforcement. The ability to link fishing gear to the vessel owner is crucial to enforcement...

  8. 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...

  9. 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…

  10. 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...

  11. 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

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

    PubMed

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

    2016-04-18

    Purpose - Healthcare productivity is a growing issue in most Western countries where healthcare expenditure is rapidly increasing. Therefore, accurate productivity metrics are essential to avoid sub-optimization within a healthcare system. The purpose of this paper is to focus on healthcare production system productivity measurement. Design/methodology/approach - Traditionally, healthcare productivity has been studied and measured independently at the unit, organization and system level. Suggesting that productivity measurement should be done in different levels, while simultaneously linking productivity measurement to incentives, this study presents the challenges of productivity measurement at the different levels. The study introduces different methods to measure productivity in healthcare. In addition, it provides background information on the methods used to measure productivity and the parameters used in these methods. A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical information for managers. Findings - The study introduces different approaches and methods to measure productivity in healthcare. Practical implications - A pilot investigation of productivity measurement is used to illustrate the challenges of measurement, to test the developed measures and to prove the practical benefits for managers. Originality/value - The authors focus on the measurement of the whole healthcare production system and try to avoid sub-optimization. Additionally considering an individual patient approach, productivity measurement is examined at the unit level, the organizational level and the system level. PMID:27120507

  13. Healthcare justice and human rights in perinatal medicine.

    PubMed

    Chervenak, Frank A; McCullough, Laurence B

    2016-06-01

    This article describes an approach to ethics of perinatal medicine in which "women and children first" plays a central role, based on the concept of healthcare justice. Healthcare justice requires that all patients receive clinical management based on their clinical needs, which are defined by deliberative (evidence-based, rigorous, transparent, and accountable) clinical judgment. All patients in perinatal medicine includes pregnant, fetal, and neonatal patients. Healthcare justice also protects the informed consent process, which is intended to empower the exercise of patient autonomy in the decision-making process about patient care. In the context of healthcare justice, the informed consent process should not be influenced by ethically irrelevant factors. Healthcare justice should be understood as a basis for the human rights to healthcare and to participate in decisions about one's healthcare. Healthcare justice in perinatal medicine creates an essential role for the perinatologist to be an effective advocate for pregnant, fetal, and neonatal patients, i.e., for "women and children first." PMID:26811097

  14. 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

  15. 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.

  16. Regional-technical information network system by PC-based communication 'Kougi Net Niigata'

    NASA Astrophysics Data System (ADS)

    Tanaka, Koichi; Kitagawa, Yoichi; Hoshino, Kimiaki

    'Regional-technical information' database was constructed by Industrial research institute of Niigata prefecture. This is available for industries in our prefecture with our PC-based communication network system. And also, it provides communication measures called BBS and electronic mail service with which they can communicate each other. This system is considered to give three effects. First of all, they can get technical information required in regional industries that is not provided by commercial database at their office or factory speedy and correctly. Secondly, they can easily survey technical background of local industries they want to take into partnership in their extension of work. Thirdly, since it provides a place where they can exchange information each other, it promotes their development of new commercial products and partnership.

  17. [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

  18. ExtraTrain: a database of Extragenic regions and Transcriptional information in prokaryotic organisms

    PubMed Central

    Pareja, Eduardo; Pareja-Tobes, Pablo; Manrique, Marina; Pareja-Tobes, Eduardo; Bonal, Javier; Tobes, Raquel

    2006-01-01

    Background Transcriptional regulation processes are the principal mechanisms of adaptation in prokaryotes. In these processes, the regulatory proteins and the regulatory DNA signals located in extragenic regions are the key elements involved. As all extragenic spaces are putative regulatory regions, ExtraTrain covers all extragenic regions of available genomes and regulatory proteins from bacteria and archaea included in the UniProt database. Description ExtraTrain provides integrated and easily manageable information for 679816 extragenic regions and for the genes delimiting each of them. In addition ExtraTrain supplies a tool to explore extragenic regions, named Palinsight, oriented to detect and search palindromic patterns. This interactive visual tool is totally integrated in the database, allowing the search for regulatory signals in user defined sets of extragenic regions. The 26046 regulatory proteins included in ExtraTrain belong to the families AraC/XylS, ArsR, AsnC, Cold shock domain, CRP-FNR, DeoR, GntR, IclR, LacI, LuxR, LysR, MarR, MerR, NtrC/Fis, OmpR and TetR. The database follows the InterPro criteria to define these families. The information about regulators includes manually curated sets of references specifically associated to regulator entries. In order to achieve a sustainable and maintainable knowledge database ExtraTrain is a platform open to the contribution of knowledge by the scientific community providing a system for the incorporation of textual knowledge. Conclusion ExtraTrain is a new database for exploring Extragenic regions and Transcriptional information in bacteria and archaea. ExtraTrain database is available at . PMID:16539733

  19. 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

  20. Military Healthcare Battlefield Immunity.

    PubMed

    Kelly, J C

    2012-12-01

    The combatant soldier on the battlefield remains protected from any claim in negligence by the doctrine of combat immunity for any negligent act or omission they may make when fighting. In other words, the combatant soldier does not owe a fellow soldier a duty of care on the battlefield, as the duty of care is non-justiciable. However, the non-combatant Military Healthcare Professional, although sometimes operating in the same hostile circumstances as the fighting soldier, is unlikely to benefit from combat immunity for any clinical negligence on the battlefield. This is because they continue to owe their patient a duty of care, although this has not been tested in the courts. This paper considers if any military healthcare professional could ever benefit from combat immunity, which is unlikely due to their non-combatant status. Instead, this paper suggests that a modified form of immunity; namely, Military Healthcare Battlefield Immunity could be a new, unique and viable doctrine, however, this could only be granted in rare circumstances and to a much lesser degree than combat immunity. PMID:23402067

  1. 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

  2. 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…

  3. 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 Niño 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 Niño 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.

  4. 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-Réglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Véronique; Le Jeunne, Claire; Leurs, Irina; Liard, François; 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

  5. Economic growth of states under alternative macroeconomic projections in the DRI Regional Information Service

    SciTech Connect

    McDonald, J.F.; South, D.W.

    1985-01-01

    This paper presents results of simulations performed using the DRI Regional Information Service model in order to examine the impacts on states of increasing the rate of economic growth at the national level over a ten-year period. The macroeconomic scenario with higher economic growth is the Department of Energy Reference Case, a projection that is consistent with the policy of the Reagan Administration. The more pessimistic scenario is the DRI Pessimistic Case for Fall 1984. In conclusion, the results of the RIS model simulations suggest that the northeastern region of the US would benefit more than other regions from an increase in national growth. It appears that the intentions of the Reagan Administration regarding economic growth translate into a regional development policy favoring the Northeast.

  6. Too much coronary angioplasty in the USA?: less may be better - the conflicting roles of inexactness of medicine as a science, asymmetric information, technologic imperative, unnecessary care and ethicomedicinomics in US healthcare.

    PubMed

    Onuigbo, M A C; Agbasi, N

    2014-09-01

    US healthcare expenditure per capita far exceeds that of any other nation in the world. Indeed, over the last 15 years, the USA has distantly surpassed most countries in the developed world in total healthcare expenditures per capita with the USA now spending 17.4% of its gross domestic product (GDP) on healthcare ($7960 per capita), compared with only 8.5% of GDP in Japan ($2878 per capita), a distant second. Consequently, by current projections, the US healthcare bill will have ballooned from $2.5 trillion in 2009 to over $4.6 trillion by 2020. Such spending growth rates are unsustainable and the system would soon go broke if not corrected. The drivers of these spending growth rates in US healthcare are several and varied. Indeed, in September 2012, the Institute of Medicine reported that US healthcare squandered $750 billion in 2009 through unneeded care, Byzantine paperwork, fraud and other wasteful activities. Recently, the question was raised as to whether we have too much coronary angioplasty in the USA. In this analysis, we examine these and other various related aspects of US healthcare, make comparisons with other national healthcare delivery systems, and suggest several reengineering modalities to help fix these compellingly glaring glitches and maladies of US healthcare. PMID:25196182

  7. 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.

  8. 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.

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

    PubMed

    Eason, Tarsha; Cabezas, Heriberto

    2012-02-01

    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 important method in information theory. Our adaptation of Fisher information provides a means of monitoring the variables of a system to characterize dynamic order, and, therefore, its regimes and regime shifts. This work is part of the SLB Sustainability Metrics Project, which aimed to evaluate movement over time towards or away from regional sustainability. One of the key goals of this project was to use readily available data to assess the sustainability of the system including its environmental, social and economic aspects. For this study, Fisher information was calculated for fifty-three variables which characterize the consumption of food and energy, agricultural production, environmental characteristics, demographic properties and changes in land use for the SLB system from 1980 to 2005. Our analysis revealed that while the system displayed small changes in dynamic order over time with a slight decreasing trend near the end of the period, there is no indication of a regime shift. Therefore, the SLB system is stable with very slight movement away from sustainability in more recent years. PMID:21930337

  10. Economics and resourcing of complex healthcare systems.

    PubMed

    Baghbanian, Abdolvahab; Torkfar, Ghazal

    2012-11-01

    With rapid increases in healthcare spending over recent years, health economic evaluation might be thought to be increasing in importance to decision-makers. Such evaluations are designed to inform the efficient management of healthcare resources. However, research into health policy decisions often report, at best, moderate use of economic evaluation information, especially at the local level of administration. Little attention seems to have been given to the question of why economic evaluations have been underused and why they may yield different results in different contexts. There are many barriers to applying economic evaluations in situations which combine complexity with uncertainty. These barriers call for innovative and creative responses to economic evaluation of healthcare interventions. One response is to view economic evaluations in the context of complex adaptive systems theory. Such theory offers a conceptual framework that takes into account contextual factors, multiple input and output, multiple perspectives and uncertainty involved in healthcare interventions. This article illustrates how complexity theory can enrich and broaden policy-makers' understanding of why economic evaluations have not always been as successful as health economists would have hoped. It argues for health economists to emphasise contextual knowledge and relativist understanding of decision contexts rather than seeking more technically sound evidence-based reviews including economic evaluations. PMID:22958896

  11. Predictors of Access to Healthcare: What Matters to Rural Appalachians?

    PubMed Central

    Wilson, Susan L.; Kratzke, Cynthia; Hoxmeier, Jill

    2012-01-01

    Objective: Lack of access to healthcare is frequently cited as a primary reason for health disparities globally, especially in poor, rural areas such as Appalachia in the U.S. This study examined predictors of perceived access to healthcare among residents in a poor, medically underserved, rural Appalachian community. Methods: The study was guided by the revised behavioral model of healthcare services utilization. Self-reported survey data were obtained from a convenience sample of 921 residents in rural Tennessee. Results: The majority of respondents in this study did not perceive access to healthcare to be a problem in their community. Financial factors, health status, and associated social factors negatively affected only a small number respondents’ perceptions of access to healthcare. Conclusions: Despite the presence of multiple factors previously shown to affect access to healthcare, the majority of respondents in this study did not perceive access to healthcare to be a problem in their community. Results of this study suggest that to understand an individual’s passage through the healthcare system, the contextual aspects of healthcare utilization, should be added to coverage, services, timeliness, and workforce as a fifth component of access to healthcare. Assessing perceived need and associated cultural factors that affect individuals’ concepts of health and wellness represent important areas for future exploration to explain observed health disparities. Additionally, findings showed that having sufficient quality and quantity of healthcare professionals and services in a community or region may be necessary, but not sufficient to explain health disparities and the underlying reasons why individuals choose or choose not to seek health services. PMID:23121739

  12. Applications of monsoon research: Opportunities to inform decisionmaking and reduce regional vulnerability

    NASA Astrophysics Data System (ADS)

    Ray, A. J.; Garfin, G. M.; Wilder, M.; Lenart, M.; Vásquez-León, M.; Comrie, A. C.

    2007-05-01

    This presentation will describe ongoing efforts to understand interactions between the North American Monsoon and society, in order to develop applications for monsoon research in a highly complex, multicultural and binational region. The North American Monsoon is an annual precipitation regime that begins in early June in Mexico and progresses northward to the southwestern United States. The region includes stakeholders in large urban complexes, productive agricultural areas, and sparsely populated arid and semi-arid ecosystems. The political, cultural, and socioeconomic divisions between the U.S. and Mexico create a broad range of sensitivities to climate variability as well as capacities to use forecasts and other information to cope with climate. We will highlight methodologies to link climate science with society and analyze opportunities for monsoon science to benefit society in four sectors: natural hazards management, agriculture, public health, and water management. We present a synthesized list of stakeholder needs and a calendar of decisions to help scientists link user needs to potential forecasts and products. To ensure usability of forecasts and other research products, we recommend iterative scientist-stakeholder interactions, through integrated assessments. These knowledge- exchange interactions can improve the capacity for stakeholders to use forecasts thoughtfully and inform the development of research, and for the research community to obtain feedback on climate-related products and receive insights to guide research direction. We expect that integrated assessments can capitalize on the opportunities for monsoon science to inform decisionmaking, in the best instances, reduce regional climate vulnerabilities and enhance regional sustainability

  13. Understanding receptivity to informal supportive cancer care in regional and rural Australia: a Heideggerian analysis.

    PubMed

    Pascal, J; Johnson, N; Dickson-Swift, V; McGrath, P; Dangerfield, F

    2016-05-01

    The concept of receptivity is a new way of understanding the personal and social factors that affect a person living with and beyond cancer, and how these factors influence access to formal supportive care service provision and planning. This article contributes to new knowledge through applying the concept of receptivity to informal supportive cancer care in regional Australia. Literature indicates that a cancer diagnosis is a life-changing experience, particularly in regional communities, where survival rates are lower and there are significant barriers to accessing services. Heideggerian phenomenology informed the design of the study and allowed for a rich and nuanced understanding of participants lived experiences of informal supportive cancer care. These experiences were captured using in-depth interviews, which were subsequently thematically analysed. Nineteen participants were recruited from across regional Victoria, Australia. Participants self-reported a range of stages and types of cancer. Significantly, findings revealed that most participants were not referred to, and did not seek, formal supportive care. Instead, they were receptive to informal supportive care. Understanding receptivity and the role of anxiety and fear of death has implications for partners, family, community members, as well as professionals working with people with living with and beyond cancer. PMID:26047366

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Integration of groundwater information into decision making for regional planning: a portrait for North America.

    PubMed

    Lavoie, Roxane; Lebel, Alexandre; Joerin, Florent; Rodriguez, Manuel J

    2013-01-15

    Groundwater is widely used as a source of drinking water in North America. However, it can be contaminated by microbial or chemical agents potentially hazardous to human health. In recent decades, governments have developed better knowledge of groundwater and established measures to protect and preserve the resource. Several studies have shown that relevant information on groundwater might prove very useful for regional planning purposes. However, there is little information on how groundwater information contributes to decision making in urban and regional planning in Canada and the United States. The objective of this study is to explore the level of use of groundwater information for land use planning purposes in Canada and the United States and to identify the factors that may explain why some provinces or states are more proactive than others when it comes to using such data for groundwater protection purposes. This paper presents the results of a survey sent across North America to groundwater information producers. The resulting data from the survey were examined using descriptive analyses and multiple correspondence analysis, and illustrate how groundwater data can be integrated into land planning. PMID:23200773

  19. 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

  20. 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

  1. Regional health information organizations: a vehicle for transforming health care delivery?

    PubMed

    Solomon, Michael R

    2007-02-01

    Information technology (IT) has the potential to be a significant enabler in transforming the health care delivery system. New types of organizations are needed to guide the change. Regional Health Information Organizations (RHIOs) hold promise as agents for transformation. This essay discusses the results from a case study on how RHIOs are advancing IT adoption in the health care community. Results indicate that the RHIO model is early in its evolution. To be a catalyst of change, the RHIO must overcome privacy barriers, actively engage purchasers of care, and create compelling incentives for clinicians to adopt the RHIOs' services. PMID:17283921

  2. 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.

  3. 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.

  4. 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-à-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

  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. Tectonic regionalization without a priori information: A cluster analysis of upper mantle tomography

    NASA Astrophysics Data System (ADS)

    Lekic, Vedran; Romanowicz, Barbara

    2011-08-01

    Global mantle tomography can be improved through better use of data and application of more accurate wave propagation methods. However, few techniques have been developed for objective validation and exploration of the resulting tomographic models. We show that cluster analysis can be used to validate and explore the salient features across such models. We present a cluster analysis of a global upper mantle radially anisotropic model SEMum developed using full waveform tomography and the Spectral Element Method. Applied to SEMum down to 350 km depth, the cluster analysis reveals that absolute shear wave velocity (Vs) depth profiles naturally group into families that correspond with known surface tectonics. This allows us to construct a global tectonic regionalization based solely on tomography, without the help of any a priori information. We find that the profiles of stable platforms and shields consistently exhibit a mid-lithospheric low velocity zone (LVZ) between 80 and 130 km depth, while the asthenosphere is found at depths greater than 250 km in both regions. This global intra-continental-lithosphere low velocity zone agrees with recent receiver function studies and regional tomographic studies. Furthermore, we identify an anomalous oceanic region characterized by slow shear wave speeds at depths below 150 km. Hotspots are found preferentially in the vicinity of this anomalous region. In the Pacific Ocean, where plate velocities are largest, these regions have elongated shapes that align with absolute plate motion, suggesting a relationship between the location of hotspots and small-scale convection in the oceanic upper mantle.

  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 product—La Niña Drought Tracker—that 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 projects—main goals of climate services.

  10. 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.                                                                                

  11. 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.                                                                                

  12. [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

  13. 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

  14. 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

  15. 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

  16. Multimodal functional imaging using fMRI-informed regional EEG/MEG source estimation.

    PubMed

    Ou, Wanmei; Nummenmaa, Aapo; Ahveninen, Jyrki; Belliveau, John W; Hämäläinen, Matti S; Golland, Polina

    2010-08-01

    We propose a novel method, fMRI-Informed Regional Estimation (FIRE), which utilizes information from fMRI in E/MEG source reconstruction. FIRE takes advantage of the spatial alignment between the neural and the vascular activities, while allowing for substantial differences in their dynamics. Furthermore, with a region-based approach, FIRE estimates the model parameters for each region independently. Hence, it can be efficiently applied on a dense grid of source locations. The optimization procedure at the core of FIRE is related to the re-weighted minimum-norm algorithms. The weights in the proposed approach are computed from both the current source estimates and fMRI data, leading to robust estimates in the presence of silent sources in either fMRI or E/MEG measurements. We employ a Monte Carlo evaluation procedure to compare the proposed method to several other joint E/MEG-fMRI algorithms. Our results show that FIRE provides the best trade-off in estimation accuracy between the spatial and the temporal accuracy. Analysis using human E/MEG-fMRI data reveals that FIRE significantly reduces the ambiguities in source localization present in the minimum-norm estimates, and that it accurately captures activation timing in adjacent functional regions. PMID:20211266

  17. 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.

  18. 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

  19. 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

  20. Robust coastal region detection method using image segmentation and sensor LOS information for infrared search and track

    NASA Astrophysics Data System (ADS)

    Kim, Sungho; Sun, Sun-Gu; Kwon, Soon; Kim, Kyung-Tae

    2013-05-01

    This paper presents a novel coastal region detection method for infrared search and track. The coastal region detection is critical to home land security and ship defense. Detected coastal region information can be used to the design of target detector such as moving target detection and threshold setting. We can detect coastal regions robustly by combining the infrared image segmentation and sensor line-of-sight (LOS) information. The K-means-based image segmentation can provide initial region information and the sensor LOS information can predict the approximate horizon location in images. The evidence of coastal region is confirmed by contour extraction results. The experimental results on remote coasts and near coasts validate the robustness of the proposed coastal region detector.

  1. 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

  2. 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

  3. 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)

  4. Healthcare public key infrastructure (HPKI) and non-profit organization (NPO): essentials for healthcare data exchange.

    PubMed

    Takeda, Hiroshi; Matsumura, Yasushi; Nakagawa, Katsuhiko; Teratani, Tadamasa; Qiyan, Zhang; Kusuoka, Hideo; Matsuoka, Masami

    2004-01-01

    To share healthcare information and to promote cooperation among healthcare providers and customers (patients) under computerized network environment, a non-profit organization (NPO), named as OCHIS, was established at Osaka, Japan in 2003. Since security and confidentiality issues on the Internet have been major concerns in the OCHIS, the system has been based on healthcare public key infrastructure (HPKI), and found that there remained problems to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority by contracting with the Ministry of Economics and Trading Industries in 2003. This paper describes the experimental design with NPO and the results of the study concerning message security and HPKI. The developed system has been operated practically in Osaka urban area. PMID:15361019

  5. 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

  6. Quality of Big Data in Healthcare

    DOE PAGESBeta

    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.

  7. Innovations in healthcare and medicine editorial.

    PubMed

    Graña, Manuel; Chyzhyk, Darya; Toro, Carlos; Rios, Sebastian

    2016-05-01

    This special issue editorial begins with a brief discussion on the current trends of innovations in healthcare and medicine driven by the evolution of sensing devices as well as the information processing techniques, and the social media revolution. This discussion aims to set the stage for the actual papers accepted for the special issue which are extensions of the papers presented at the InMed 2014 conference held in San Sebastian, Spain, in July 2014. PMID:27000205

  8. 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

  9. Interruptions and Distractions in Healthcare: Review and Reappraisal

    PubMed Central

    Rivera, A. Joy; Karsh, Ben-Tzion

    2010-01-01

    Healthcare settings can be hectic, demanding, time-constrained environments. Within these environments, health care professionals (HCP) are expected to perform tasks that often require their undivided attention. However, HCPs are frequently interrupted, which can distract their attention and add to the complexity of their work. That said, not all interruptions are bad; many interruptions are essential to the patient care process and provide HCPs with necessary information. This paper systematically reviews the peer-reviewed literature on interruptions in healthcare settings to determine the state of the science and to identify gaps. It then provides a complex sociotechnical systems approach to understanding interruptions in healthcare. PMID:20378621

  10. 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

  11. Modeling healthcare data using multiple-channel latent Dirichlet allocation.

    PubMed

    Lu, Hsin-Min; Wei, Chih-Ping; Hsiao, Fei-Yuan

    2016-04-01

    Information and communications technologies have enabled healthcare institutions to accumulate large amounts of healthcare data that include diagnoses, medications, and additional contextual information such as patient demographics. To gain a better understanding of big healthcare data and to develop better data-driven clinical decision support systems, we propose a novel multiple-channel latent Dirichlet allocation (MCLDA) approach for modeling diagnoses, medications, and contextual information in healthcare data. The proposed MCLDA model assumes that a latent health status group structure is responsible for the observed co-occurrences among diagnoses, medications, and contextual information. Using a real-world research testbed that includes one million healthcare insurance claim records, we investigate the utility of MCLDA. Our empirical evaluation results suggest that MCLDA is capable of capturing the comorbidity structures and linking them with the distribution of medications. Moreover, MCLDA is able to identify the pairing between diagnoses and medications in a record based on the assigned latent groups. MCLDA can also be employed to predict missing medications or diagnoses given partial records. Our evaluation results also show that, in most cases, MCLDA outperforms alternative methods such as logistic regressions and the k-nearest-neighbor (KNN) model for two prediction tasks, i.e., medication and diagnosis prediction. Thus, MCLDA represents a promising approach to modeling healthcare data for clinical decision support. PMID:26898516

  12. 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 Manatí 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

  13. 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 Manatí 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

  14. Use of information technology to improve quality of healthcare: Kosova's telemedicine project and international virtual e-hospital as an example.

    PubMed

    Latifi, Rifat; Muja, Shaip; Bekteshi, Flamur; Reinicke, Matthias

    2004-01-01

    The idea to create the Telemedicine Project of Kosova and the International Virtual e-Hospital Network of Kosova, was presented at G8-Meeting, in Berlin May 4-5, 2000, by the senior author (RL) then Assistant Professor of Surgery at Virginia Commonwealth University, in Richmond, Virginia during the presentation, the "The anatomy of war and destruction of Kosova: The alumni view on reconstruction of heath in Kosova". Following wide spread acceptance by many countries and institutions around the world of the idea of creating a virtual e-hospital in Kosova,, became a reality. To ensure the creation of a telemedicine center and realization of the project in Kosova, the Telemedicine Association of Kosova was created in Prishtina, September 30, 2000. On February 2, 2001 a Memorandum of Understanding (MOU) for the implementation of TPK was signed between all stakeholders in health in Kosova. After extensive preparation, with the funding from the European Agency for Reconstruction, the Telemedicine Center of Kosova (TCK) was inaugurated on December 10, 2002, making way for the official beginning of the first phase of development of the TPK. This historical moment for Kosova and for the Balkan countries received extensive media coverage locally and abroad. Currently we are at the second year and phase of TPK realization. The Telemedicine Center of Kosova (TCK) is a state-of-the-art telemedicine center, the best in the Balkan and southeastern Europe. As such TCK is providing basic foundations for development of educational medical programs within the Kosova's medical system; as well it is establishing the standards of regional and international consultations and collaboration in the Balkan Peninsula. Furthermore, it is providing a solid basis for creation of human capacity that will lead and implement telemedicine program in the nine regional telemedicine centers of Kosova, for many years and decades to come. PMID:15747975

  15. 14 CFR Special Federal Aviation... - Prohibition Against Certain Flights Within the Flight Information Region (FIR) of the Democratic...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... requirements of 14 CFR parts 121, 125, or 135, each person who deviates from this rule shall, within ten (10... the Flight Information Region (FIR) of the Democratic People's Republic of Korea (DPRK) Federal... Within the Flight Information Region (FIR) of the Democratic People's Republic of Korea (DPRK)...

  16. Access control in healthcare: the methodology from legislation to practice.

    PubMed

    Ferreira, Ana; Correia, Ricardo; Chadwick, David; Antunes, Luis

    2010-01-01

    Translating legislation and regulations into access control systems in healthcare is, in practice, not a straightforward task. Excessive regulation can create barriers to appropriate patient treatment. The main objective of this paper is to present a new methodology that can define, from legislation to practice, an access control policy as well as a RBAC model, in order to comprise generic legislation and regulation issues together with the access control needs from the ends users of a healthcare information system. The methodology includes the use of document analysis as well as grounded theory and mixed methods research. This methodology can be easily applied within a healthcare practice or any other domain with similar requirements. It helps to bridge the gap between legislation and end users' needs, while integrating information security into the healthcare processes in a more meaningful way. PMID:20841770

  17. 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

  18. 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.

  19. 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 speaker’s 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

  20. 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